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CA: WCAB Signals That Rule 30 May Contravene LC 4060 With Respect to Party's Ability to Obtain Medical Evidence

Beverly Washington v. County of Los Angeles, PSI, c/o Acclamation Insurance Management Services Medical-Legal Procedure--Panel Qualified Medical Evaluations--WCAB, granting removal on its own motion, rescinded WCJ's finding that defendant was not entitled to a panel QME under Labor Code §§...

California WCAB Holds Rule 30 Limitation on Defendant’s Obtaining QME Report Invalid

The W.C.A.B. in surprising and welcome en banc decision has held the recently adopted administrative director regulation commonly known as Rule 30 [ADR § 30(d)(3) ] is invalid in that it conflicts the provisions of Labor Code § 4060(c) and § 4062.2 . The W.C.A.B. found numerous reasons...

California: Mendoza En Banc Decision Makes Fundamental Change to Initial QME Procedures in Denied Claims

Sophisticated Applicants have been using Administrative Director Rule 30(d)(3) to preclude defendants from either obtaining or introducing rebuttal or subsequent medical reports to establish compensability in denied claims. Rule 30(d)(3) provides that whenever a claim had been entirely denied, only the...

California: Alvarez Decision Emphasizes Importance of NEVER Communicating Ex Parte with QME

The Second Appellate District has issued a published decision in the matter of Alvarez v. WCAB which takes a literal approach to labor code 4062.3(e) which prohibits ex parte communication with the panel QME. The facts of the case best illustrate the point. In a denied death case, the panel QME...

California: Rule 30(d)(3) OUT!

In a significant en banc decision ( Mendoza v. Huntington Hospital , ADJ6820138; ADJ6820197, attached), the WCAB found Rule 30(d)(3) invalid. Additionally, the WCAB said there were no time limits on requesting a QME panel on claims which are denied. This decision is a significant development and benefit...

California 2nd District Modifies Holding and Disposition in Ex Parte Contact Case

The 2nd District Court of Appeals has issued its 2nd decision in the Alvarez v W.C.A.B. case addressing the issue of ex parte communication with a QME/AME prohibited under Labor Code § 4062.3. In its initial decision which issued earlier this year, the appellate court had adopted a strict interpretation...

California: Rule 30 is Dead; Long Live the New Rule

In an en banc decision that binds all trial judges, the WCAB has ruled that the dreaded Administrative Director Rule 30(d)(3) is invalid, and that a defendant may request and receive a proposed QME panel on a previously denied case. Rule 30(d)(3) read: “Whenever an injury or illness claim of an...

Cal. Comp. Cases August 2010 Advanced Postings (8/25/2010)

Here's the fourth batch of advanced postings for the August 2010 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the cases below to read the complete headnotes and full case summaries. © Copyright 2010 LexisNexis. All rights reserved. Contra Costa County Fire Protection...

California EAMS: Compliance With QME Regulations

New Qualified Medical Examiner (QME) regulations were issued on Feb. 17, 2009. These regulations provide helpful guidance for both attorneys and doctors on how to obtain the highest quality evaluations for injured workers. Compliance with these regulations will ensure that once the case goes to trial...

California: W.C.A.B. Provides Guidance on AME/QME Request Process Timing Issues

If there was ever a question the medical legal process in workers’ compensation has become concerned with tactical minutia rather than dealing with substantive issues in the day to day comp practice, the W.C.A.B.’s en banc opinion in Tsegay Messele v. Pitco Foods, Inc.; California Insurance...

California: W.C.A.B. Provides Guidance on AME/QME Request Process Timing Issues

If there was ever a question the medical legal process in workers’ compensation has become concerned with tactical minutia rather than dealing with substantive issues in the day to day comp practice, the W.C.A.B.’s en banc opinion in Tsegay Messele v. Pitco Foods, Inc.; California Insurance...

California: The PQME Process Runs Amok - A Tragic-Comedy

By Robert G. Rassp, Esq. This story is true. The names were changed to protect the guilty. This story is a great example of what is wrong with the panel QME process under Labor Code sections 4062.1 and 4062.2. There are many cases where claims administrators are paying for medical reports and deposition...

California: The PQME Process Runs Amok - A Tragic-Comedy

By Robert G. Rassp, Esq. This story is true. The names were changed to protect the guilty. This story is a great example of what is wrong with the panel QME process under Labor Code sections 4062.1 and 4062.2. There are many cases where claims administrators are paying for medical reports and deposition...

California: W.C.A.B. Limits Application of Messele Decision

After seeking input on its Notice of Intent to limit application of the Messele decision prospectively, and getting none, the W.C.A.B. has confirmed its decision to limit the application of its holding. The W.C.A.B. has, in a decision which issued yesterday as follows: To cases where a QME panel...

California: The Right to Select the Specialty of the Panel QME: Whose Choice Is It Anyways?

Lexis.com subscribers can link to the citations below. Prior to the passage of Senate Bill 899, both sides maintained the right to select their own QME. Inherent in the use of “battling QME’s” was also the right to decide what type of specialist a party would utilize. Where a back...