What the panel ordered
The Petition for Reconsideration is granted, the WCJ's Findings of Fact and Orders of October 14, 2025 are affirmed except amended to order the parties to determine if Dr. Frederic Newton is still willing to act as the AME with specified billing rates for medical record review, medical research, and report writing.
Defendant sought removal of the WCJ's Findings of Fact and Orders issued on October 14, 2025, which the WCJ recommended denying removal and the Appeals Board treated as a petition for reconsideration, granting reconsideration to amend the order regarding the AME's billing and duties.
This docket was decided more than once. Shown here is the latest released decision; we also hold June 10, 2022.
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 WCJ's order is final on threshold issues of employment and injury AOE/COE, so removal is treated as reconsideration. Defendant failed to show significant prejudice or irreparable harm from the AME billing order. The Appeals Board affirmed the WCJ's order but amended the billing terms for Dr. Newton's services.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Defendant refused to pay Dr. Newton's requested billing rates for re-reviewing medical records and conducting medical research, leading to a dispute over AME removal and billing.
Favours Applicant prevailed
This refusal prompted defendant's petition for removal and was central to the dispute over the AME's continued role and billing terms.
From the decision · page 5On October 2, 2024, by correspondence, defendant indicated it would not agree to any billing outside of the medical-legal fee schedule and set parameters for additional billing. (Jt. Exhibit 7, at p. 2.) On April 24, 2025, defendant re-sent Dr. Newton their October 2, 2024 request and indicated that absent a response from him within 30 days, it would request he be removed as AME in this matter. (Id. at p. 1.) It does not appear that Dr. Newton responded to the October 2, 2024 or April 24, 2025 requests.
The WCJ found that allowing defendant to withdraw from the AME agreement would result in paying two medical evaluators to review all medical records, which is inefficient and burdensome.
Favours Applicant prevailed
This finding supported the denial of removal and continuation of Dr. Newton as AME under amended billing terms.
From the decision · page 6Petitioner wants to unilaterally withdraw from the AME agreement to use Dr. Newton and be allowed to obtain their own Defense QME evaluation with a new evaluator under medical legal evaluation rules for pre 1/1/2005 dates of injury. Petitioner is objecting to paying Dr. Newton to rereview medical records he has already reviewed as part of prior evaluations and supplemental reports, and when Dr. Newton has not issued a report after being told he will not be paid for doing work, using that as the basis to request to be relieved from their AME agreement. If Petitioner is allowed to withdraw from their AME agreement at this time, they will have to pay the new Defense QME to review all of the medical records in the case that they are refusing to agree to pay Dr. Newton. Furthermore, if they continue to refuse to pay Dr. Newton to re-review any medical records, Applicant will likely be forced to obtain their own QME evaluation, resulting in a[n] Applicant's QME reviewing all of the medical records. In other words, Petitioner is objecting to paying for Dr. Newton to re- review medical records, and their request will result in them paying 2 medical legal evaluators to review all of the medical records.
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. Lang was the prior AME who evaluated the applicant before Dr. Newton was agreed upon as the AME.
From the decision · page 4(MSC), was filed by defendant on August 29, 2011 on the issue of permanent disability. Per the DOR, applicant had been evaluated for his claimed injury by AME Gilbert Lang, M.D.3
Dr. Newton deferred apportionment on the S1 mass and other findings, indicated applicant has permanent and total disability with work limitation of 'no work', and requested authorization for medical literature review and additional billing to provide a supplemental report on causation and apportionment.
Dr. Newton's reports and testimony were central to the dispute over AME removal and billing terms.
From the decision · page 4On September 7, 2023, Dr. Newton was deposed. (Jt. Exhibit 6.) Regarding applicant's S1 nerve root lesion, Dr. Newton testified that the June 8, 2023 MRI of the sacrum and coccyx did not show the S1 nerve root. (Id. at p. 7:22-24.) A lumbar spine MRI was needed to hone in on the S1 nerve root lesion. (Id. at p: 8:2-3.) After he reviewed the lumbar spine MRI and evaluated applicant in person, Dr. Newton hoped he could issue a report addressing apportionment. (Id. at p. 11:1-10.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, §§ 5900, 5902, 5903; Cal. Code Regs., tit. 8, § 10955(a)
A petition for reconsideration may be taken only from a final order, decision, or award. Interlocutory procedural or evidentiary decisions are not final orders and are subject to removal standards. The Appeals Board grants removal only if significant prejudice or irreparable harm will result and reconsideration is inadequate.
The WCJ's decision included threshold findings making it final and subject to reconsideration. The petition was treated as reconsideration, but interlocutory issues were reviewed under removal standards. Defendant failed to show significant prejudice or irreparable harm to justify removal.
From the decision · page 7Conversely, 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. 1180 ["[t]he term [`final'] does not include intermediate procedural orders or discovery orders"]; Kramer, supra, at p. 45 ["[t]he term [`final'] does not include intermediate procedural orders"].) Such interlocutory decisions include, but are not limited to, pre-trial orders regarding evidence, discovery, trial setting, venue, or similar issues and are subject to the removal standard. Removal is an extraordinary remedy rarely exercised by the Appeals Board. (Cortez v. Workers' Comp. Appeals Bd. (2006) 136 Cal.App.4th 596, 599, fn. 5 [71 Cal.Comp.Cases 155]; Kleemann v.
What proof carried it
The evidence the panel weighed, by kind.
Dr. Newton's refusal to answer defendant's questions about causation, work restrictions, and apportionment for over five years.
From the decision · page 7Defendant contends it will suffer irreparable harm and reconsideration will not be an adequate remedy on the issue of AME's continued service as the medical evaluator in this matter. Specifically, defendant asserts that for over five years Dr. Newton has refused to answer their questions about causation of schwannoma, work restrictions and apportionment. Defendant further
The WCJ's observation that allowing defendant to withdraw from the AME agreement would result in paying two medical evaluators to review all medical records, which is inefficient and burdensome.
From the decision · page 6Petitioner wants to unilaterally withdraw from the AME agreement to use Dr. Newton and be allowed to obtain their own Defense QME evaluation with a new evaluator under medical legal evaluation rules for pre 1/1/2005 dates of injury. Petitioner is objecting to paying Dr. Newton to rereview medical records he has already reviewed as part of prior evaluations and supplemental reports, and when Dr. Newton has not issued a report after being told he will not be paid for doing work, using that as the basis to request to be relieved from their AME agreement. If Petitioner is allowed to withdraw from their AME agreement at this time, they will have to pay the new Defense QME to review all of the medical records in the case that they are refusing to agree to pay Dr. Newton. Furthermore, if they continue to refuse to pay Dr. Newton to re-review any medical records, Applicant will likely be forced to obtain their own QME evaluation, resulting in a[n] Applicant's QME reviewing all of the medical records. In other words, Petitioner is objecting to paying for Dr. Newton to re- review medical records, and their request will result in them paying 2 medical legal evaluators to review all of the medical records.
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
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