What the panel ordered
Reconsideration granted; November 20, 2023 decision rescinded; panel no. 7590870 declared invalid; panel no. 7590891 declared valid; parties ordered to proceed with QME evaluation by Dr. Ruben A. Amezquita.
Petition for reconsideration granted, rescinding the November 20, 2023 Findings of Fact and Orders and substituting new findings regarding the validity of QME panels.
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 panel obtained by defendant was invalid due to incorrect claim number and failure to timely serve, while the panel obtained by applicant was valid and applicable.
From the decision · page 9Here, there is no dispute that defendant's panel QME request listed an incorrect claim number. Because panel QME requests are available in litigated and non-litigated cases, a case number is not required to obtain a panel of QMEs. Rather, the issuance of a panel requires a claim number as a means for the parties and the Medical Unit to identify a claim and any prior panels that may have issued with respect to that claim.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Defendant's QME panel request used an incorrect claim number, rendering the request void ab initio.
Favours Applicant prevailed
This invalidated the panel no. 7590870 obtained by defendant, favoring applicant's position.
From the decision · page 9Here, there is no dispute that defendant's panel QME request listed an incorrect claim number. Because panel QME requests are available in litigated and non-litigated cases, a case number is not required to obtain a panel of QMEs. Rather, the issuance of a panel requires a claim number as a means for the parties and the Medical Unit to identify a claim and any prior panels that may have issued with respect to that claim.
Defendant failed to timely serve the QME panel as required by AD Rule 30(b)(1)(C).
Favours Applicant prevailed
This procedural failure further invalidated defendant's panel request, supporting applicant's challenge.
From the decision · page 3Applicant's Petition for Removal contends panel no. 7590870, issued in response to defendant's request, was void ab initio because it listed an incorrect claim number, and further, that defendant failed to timely serve the panel as required by Administrative Director (AD) Rule 30(b)(1)(C). (Cal. Code Regs., tit. 8, § 30(b)(1)(C).)
Defendant unilaterally cancelled the QME evaluation selected by applicant without seeking an emergency stay.
Favours Applicant prevailed
This action was found improper and led to admonishment of defense counsel, supporting applicant's position.
From the decision · page 10pending a hearing may file an Emergency Petition for Stay pursuant to WCAB Rule 10530. (Cal. Code Regs., tit. 8, § 10530.) Here, however, notwithstanding actual knowledge that its panel request used an incorrect claim number, and notwithstanding the June 13, 2023 revocation of panel no. 7590870 by the DWC Medical Unit, defendant unilaterally contacted the QME selected by applicant and declared applicant's selection to be wrongful and unlawful. (Ex. 6, Defendant's letter requesting cancellation of Chiropractic QME Evaluation, July 20, 2023.) Defendant's letter advised the QME that defendant would not pay for, or participate in, the QME's evaluation of applicant. (Ibid.)
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.
Selected by applicant as valid QME from valid panel no. 7590891.
Applicant's selection of Dr. Amezquita from the valid panel was upheld.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Cal. Code Regs., tit. 8, 30(b)(1)(C)
QME panel requests must include correct claim number and be timely served as required by AD Rule 30(b)(1)(C).
Failure to comply renders the panel request void ab initio.
From the decision · page 9Here, there is no dispute that defendant's panel QME request listed an incorrect claim number. Because panel QME requests are available in litigated and non-litigated cases, a case number is not required to obtain a panel of QMEs. Rather, the issuance of a panel requires a claim number as a means for the parties and the Medical Unit to identify a claim and any prior panels that may have issued with respect to that claim.
Lab. Code, 5813
Parties are prohibited from actions causing unnecessary delay or increased litigation costs under WCAB Rule 10421 and Labor Code section 5813.
Defendant's cancellation of valid QME evaluation without proper stay was admonished.
From the decision · page 10We remind defendant that under Workers' Compensation Appeals Board (WCAB) Rule 10421 (Cal. Code Regs., tit. 8, § 10421), parties are prohibited from bringing a claim, conducting a defense or asserting a position that is done solely or primarily for the purpose of causing unnecessary delay or a needless increase in the cost of litigation, or where such claim or defense is not warranted under existing law. (Cal. Code Regs., § 10421(b)(6)(A)(iii)-(b)(7).) While defendant had a right to bring a legal challenge to applicant's requested QME panel, defendant opted not to seek an emergency stay or take other appropriate interim action, and instead sought the cancellation of a properly obtained QME evaluation by asserting the basis for the QME appointment was unlawful and declaring the defendant would not reimburse the QME for the evaluation. We thus find it necessary to ADMONISH defense counsel Christine D. Putnam and Michael Sullivan & Associates, jointly and severally, for these actions and note that similar actions in the future may result in the imposition of costs and sanctions pursuant Labor Code section 5813 and WCAB Rule 10421(a). (Lab. Code, § 5813; Cal. Code Regs., tit. 8, § 10421(a).)
What proof carried it
The evidence the panel weighed, by kind.
Defendant's use of incorrect claim number in QME panel request
From the decision · page 9Here, there is no dispute that defendant's panel QME request listed an incorrect claim number. Because panel QME requests are available in litigated and non-litigated cases, a case number is not required to obtain a panel of QMEs. Rather, the issuance of a panel requires a claim number as a means for the parties and the Medical Unit to identify a claim and any prior panels that may have issued with respect to that claim.
Defendant's failure to timely serve the QME panel
From the decision · page 3Applicant's Petition for Removal contends panel no. 7590870, issued in response to defendant's request, was void ab initio because it listed an incorrect claim number, and further, that defendant failed to timely serve the panel as required by Administrative Director (AD) Rule 30(b)(1)(C). (Cal. Code Regs., tit. 8, § 30(b)(1)(C).)
Defendant's unilateral cancellation of QME evaluation without emergency stay
From the decision · page 10pending a hearing may file an Emergency Petition for Stay pursuant to WCAB Rule 10530. (Cal. Code Regs., tit. 8, § 10530.) Here, however, notwithstanding actual knowledge that its panel request used an incorrect claim number, and notwithstanding the June 13, 2023 revocation of panel no. 7590870 by the DWC Medical Unit, defendant unilaterally contacted the QME selected by applicant and declared applicant's selection to be wrongful and unlawful. (Ex. 6, Defendant's letter requesting cancellation of Chiropractic QME Evaluation, July 20, 2023.) Defendant's letter advised the QME that defendant would not pay for, or participate in, the QME's evaluation of applicant. (Ibid.)
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
About this page
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