ADJ17029088 — California WCAB decision

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Reconsideration granted; November 20, 2023 decision rescinded; panel no. 7590870 declared invalid; panel no. 7590891 declared valid; parties ordered to proceed with QME evaluation by Dr.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.

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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.

QME/AME processApplicant prevailedback · right knee

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

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).)

ADJ17029088 · March 18, 2024

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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What the panel did with the medical opinions

The rules the panel named

What proof carried it

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