ADJ20165742 · July 18, 2025

The Appeals Board found that the omission of the final digit in the claim number by defendant rendered the QME panel number 7773036 invalid, requiring strict compliance with AD Rule 30 for claim numbers to ensure due process and avoid conflicting panels.

From the decision · page 9Accordingly, we will treat applicant's petition as one seeking reconsideration, and applying the removal standard, grant reconsideration, rescind the F&O, and substitute new findings of fact that panel 7773036 is invalid and that panel number 7775940 is valid.

Defendant requested QME panel number 7773036 using an incorrect claim number missing the last digit.

Favours Applicant prevailed

This omission caused issuance of conflicting panels and was found to invalidate panel 7773036.

From the decision · page 2On January 22, 2025, defendant requested a panel of QMEs in orthopedic surgery, listing claim number 4A2412DXQHT-000. (Id. at p. 1.) The Division of Workers' Compensation (DWC) Medical Unit issued panel number 7773036 in response to the request.

Labor Code 5900(a), 5902, 5903

Petition for reconsideration may be taken only from a final order, decision, or award; interlocutory decisions are reviewed under removal standard.

The WCAB applied the removal standard to the interlocutory issue of QME panel validity.

From the decision · page 3I. A petition for reconsideration may properly be taken only from a "final" order, decision, or award. (Lab. Code, § 5900(a), 5902, 5903.) A "final" order has been defined as one that either "determines any substantive right or liability of those involved in the case" (Rymer v. Hagler (1989) 211 Cal.App.3d 1171, 1180; Safeway Stores, Inc. v. Workers' Comp. Appeals Bd. (Pointer) (1980) 104 Cal.App.3d 528, 534-535 [45 Cal.Comp.Cases 410]; Kaiser Foundation Hospitals v. Workers' Comp. Appeals Bd. (Kramer) (1978) 82 Cal.App.3d 39, 45 [43 Cal.Comp.Cases 661]) or determines a "threshold" issue that is fundamental to the claim for benefits. (Maranian v. Workers' Comp. Appeals Bd. (2000) 81 Cal.App.4th 1068, 1070, 1075 [65 Cal.Comp.Cases 650].) Interlocutory procedural or evidentiary decisions, entered in the midst of the workers' compensation proceedings, are not considered "final" orders. (Id. at p. 1075 ["interim orders, which do not decide a threshold issue, such as intermediate procedural or evidentiary decisions, are not `final'"]; Rymer, supra, at p.

Cal. Code Regs., tit. 8, 30

Parties must strictly comply with AD Rule 30 requirements for QME panel requests, including providing a complete and correct claim number.

The Appeals Board emphasized strict compliance with AD Rule 30 to ensure due process and avoid conflicting QME panels.

From the decision · page 8In sum, we believe that the better course is to require that parties strictly comply with the requirement in AD Rule 30 to provide a complete and correct claim number in making a request, rather than weighing and adjudging the individual facts and equity surrounding each incorrectly listed claim number in a QME panel dispute. In so doing, we seek to avoid the dangers of inconsistent outcomes, provide clarity to parties with respect to applicable minimum standards in requesting a QME panel, and allow parties to more easily predict whether a particular panel is valid without the need to seek intervention at the WCAB.

Claim number is the unique identifier for a case and must be correct to avoid issuance of conflicting panels.

From the decision · page 6v. Dispute type vi. Name of primary treating physician vii. Date of report being objected to viii. Date of objection communication ix. Specialty of treating physician x. QME Specialty Requested xi. Opposing Party's QME Specialty Preferred (if known) (Cal. Code Regs., tit. 8, § 30(b)(1)(A)(1).) The claim number corresponding to applicant's currently pending claim is 4A2412DXQHT-0001. (Ex. AA, Defendant's Panel Request Packet, dated December 30, 2024, at p. 5.) On January 22, 2025, defendant obtained panel number 7773036 using a claim number that omitted the last digit of applicant's claim number. (Id. at p. 1.) On January 30, 2025, applicant obtained panel number 7775940 using the correct claim number. (Ex. CC, Applicant's Panel Request Packet, dated January 30, 2025, at p. 1.) The F&O determined the omission of a single digit from the claim number was not a sufficient basis upon which to invalidate defendant's panel request and resulting panel 7773036. (Finding of Fact No. 1.) Applicant's Petition argues that the claim number is the means by which the DWC Medical Unit identifies potentially duplicate requests for panels corresponding to the same underlying workers' compensation claim.