What the panel ordered
The April 12, 2024 Findings of Fact and Orders is rescinded and the matter is returned to the trial level for further proceedings consistent with this opinion.
Defendant sought reconsideration of the WCJ's order denying a replacement QME panel and maintaining Dr. Campos as PQME; the Appeals Board granted reconsideration and now rescinds the WCJ's order, remanding for further proceedings.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The Appeals Board found that the re-evaluation was scheduled over 120 days from the initial request, in violation of AD Rules 31.3(e) and 31.5(a)(2), and remanded for the WCJ to consider whether good cause exists to replace the QME due to unavailability, as required by Vazquez.
From the decision · page 6a. The length of delay caused by the QME's unavailability. b. The amount of prejudice caused by the delay in availability versus the amount of prejudice caused by restarting the QME process. c. What efforts, if any, have been made to remedy the QME's availability. d. Case specific factual reasons that justify replacing or keeping the current QME, including whether a party may have waived its objection. e. The Appeals Board's constitutional mandate to "accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character." (Cal. Const., art. XIV, § 4.) (Vazquez, supra, at p. 527.) Defendant first requested the re-evaluation by Dr, Campos on August 22, 2023 (Ex. A), which was after the February 2, 2023 change in regulations. It did so again on September 21, 2023, and September 28, 2023, before QME Campos provided the appointment date of February 4, 2024, on September 28, 2023. (Exs. B, C, E.) The re-evaluation was scheduled over 120 days from the initial request in violation of AD Rules 31.3(e) and 31.5(a)(2). Thus, the WCJ should consider whether there was good cause pursuant to Vazquez to replace the QME due to unavailability. Therefore, we rescind the F&O and return this matter to the WCJ for consideration of whether good exists to order a replacement QME panel.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The re-evaluation by Dr. Campos was scheduled for February 4, 2024, more than 120 days after defendant's initial request on August 22, 2023.
Favours Defendant prevailed
This delay triggered the regulatory requirement to consider replacement of the QME under AD Rules 31.3(e) and 31.5(a)(2), subject to a good cause analysis per Vazquez.
From the decision · page 6a. The length of delay caused by the QME's unavailability. b. The amount of prejudice caused by the delay in availability versus the amount of prejudice caused by restarting the QME process. c. What efforts, if any, have been made to remedy the QME's availability. d. Case specific factual reasons that justify replacing or keeping the current QME, including whether a party may have waived its objection. e. The Appeals Board's constitutional mandate to "accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character." (Cal. Const., art. XIV, § 4.) (Vazquez, supra, at p. 527.) Defendant first requested the re-evaluation by Dr, Campos on August 22, 2023 (Ex. A), which was after the February 2, 2023 change in regulations. It did so again on September 21, 2023, and September 28, 2023, before QME Campos provided the appointment date of February 4, 2024, on September 28, 2023. (Exs. B, C, E.) The re-evaluation was scheduled over 120 days from the initial request in violation of AD Rules 31.3(e) and 31.5(a)(2). Thus, the WCJ should consider whether there was good cause pursuant to Vazquez to replace the QME due to unavailability. Therefore, we rescind the F&O and return this matter to the WCJ for consideration of whether good exists to order a replacement QME panel.
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Dr. Campos evaluated applicant and issued multiple reports regarding injury to right hand; his availability for re-evaluation was at issue due to scheduling beyond 120 days from request.
Dr. Campos' scheduling of a re-evaluation beyond the regulatory 120-day limit triggered the dispute over replacement under AD Rules 31.3(e) and 31.5(a)(2).
From the decision · page 6a. The length of delay caused by the QME's unavailability. b. The amount of prejudice caused by the delay in availability versus the amount of prejudice caused by restarting the QME process. c. What efforts, if any, have been made to remedy the QME's availability. d. Case specific factual reasons that justify replacing or keeping the current QME, including whether a party may have waived its objection. e. The Appeals Board's constitutional mandate to "accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character." (Cal. Const., art. XIV, § 4.) (Vazquez, supra, at p. 527.) Defendant first requested the re-evaluation by Dr, Campos on August 22, 2023 (Ex. A), which was after the February 2, 2023 change in regulations. It did so again on September 21, 2023, and September 28, 2023, before QME Campos provided the appointment date of February 4, 2024, on September 28, 2023. (Exs. B, C, E.) The re-evaluation was scheduled over 120 days from the initial request in violation of AD Rules 31.3(e) and 31.5(a)(2). Thus, the WCJ should consider whether there was good cause pursuant to Vazquez to replace the QME due to unavailability. Therefore, we rescind the F&O and return this matter to the WCJ for consideration of whether good exists to order a replacement QME panel.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Vazquez v. Inocensio Renteria (2025) 90 Cal.Comp.Cases 514 (en banc)
A QME may be replaced due to unavailability to set an evaluation if good cause is shown, considering factors such as length of delay, prejudice, efforts to remedy, waiver, and substantial justice.
Remanded for WCJ to consider whether good cause exists to replace QME due to unavailability, applying Vazquez factors.
From the decision · page 6a. The length of delay caused by the QME's unavailability. b. The amount of prejudice caused by the delay in availability versus the amount of prejudice caused by restarting the QME process. c. What efforts, if any, have been made to remedy the QME's availability. d. Case specific factual reasons that justify replacing or keeping the current QME, including whether a party may have waived its objection. e. The Appeals Board's constitutional mandate to "accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character." (Cal. Const., art. XIV, § 4.) (Vazquez, supra, at p. 527.) Defendant first requested the re-evaluation by Dr, Campos on August 22, 2023 (Ex. A), which was after the February 2, 2023 change in regulations. It did so again on September 21, 2023, and September 28, 2023, before QME Campos provided the appointment date of February 4, 2024, on September 28, 2023. (Exs. B, C, E.) The re-evaluation was scheduled over 120 days from the initial request in violation of AD Rules 31.3(e) and 31.5(a)(2). Thus, the WCJ should consider whether there was good cause pursuant to Vazquez to replace the QME due to unavailability. Therefore, we rescind the F&O and return this matter to the WCJ for consideration of whether good exists to order a replacement QME panel.
What proof carried it
The evidence the panel weighed, by kind.
Defendant requested re-evaluation by Dr. Campos on August 22, 2023, and again on September 21 and 28, 2023, but the re-examination was scheduled for February 4, 2024, over 120 days from the initial request.
From the decision · page 6a. The length of delay caused by the QME's unavailability. b. The amount of prejudice caused by the delay in availability versus the amount of prejudice caused by restarting the QME process. c. What efforts, if any, have been made to remedy the QME's availability. d. Case specific factual reasons that justify replacing or keeping the current QME, including whether a party may have waived its objection. e. The Appeals Board's constitutional mandate to "accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character." (Cal. Const., art. XIV, § 4.) (Vazquez, supra, at p. 527.) Defendant first requested the re-evaluation by Dr, Campos on August 22, 2023 (Ex. A), which was after the February 2, 2023 change in regulations. It did so again on September 21, 2023, and September 28, 2023, before QME Campos provided the appointment date of February 4, 2024, on September 28, 2023. (Exs. B, C, E.) The re-evaluation was scheduled over 120 days from the initial request in violation of AD Rules 31.3(e) and 31.5(a)(2). Thus, the WCJ should consider whether there was good cause pursuant to Vazquez to replace the QME due to unavailability. Therefore, we rescind the F&O and return this matter to the WCJ for consideration of whether good exists to order a replacement QME panel.
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