Workers' Compensation

Recent Posts

California: Intervention of WCJ When PQME Process Fails
Posted on 26 Jul 2018 by LexisNexis Workers' Comp Law Newsroom Staff

It is difficult to come up with a more controversial not to mention hotly litigated topic in California’s workers’ compensation system than the Panel Qualified Medical Evaluation (PQME) process. Though there is little question that the old... Read More

California: Procedure for Striking a Panel Qualified Medical Evaluator
Posted on 26 Jul 2012 by Calif. WCAB Noteworthy Panel Decisions Reporter

FREE ENEWSLETTER; SIGN UP TODAY HERE Here's a sneak peek of a recent noteworthy panel decision that will be added soon to the LexisNexis services: Medical-Legal Procedure; Assignment of QME Panel. WCAB granted removal and rescinded WCJ’s... Read More

California Panel QME Process: Is It Time to Admit We Are Dealing With a Monster?
Posted on 17 May 2012 by Calif. WCAB Noteworthy Panel Decisions Reporter

A serious question needs to be asked about whether requiring the use of one Qualified Medical Evaluator (QME) in a workers’ compensation case, as opposed to the use of “battling QME’s”, has reduced litigation or has actually served... Read More

California: The PQME Process and the Remote Medical-Legal Evaluation
Posted on 6 Dec 2016 by Calif. WCAB Noteworthy Panel Decisions Reporter

What is the potential role of telemedicine when it comes to PQME evaluations? In Gonzales v. ABM Industries , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB panel, denying removal, affirmed the WCJ’s order instructing the Medical Director to replace... Read More

California: 2004 Stipulation Regarding Future Medical Treatment Disputes Being Referred to AME Could Not Circumvent UR Procedures
Posted on 8 Aug 2014 by Calif. WCAB Noteworthy Panel Decisions Reporter

But parties not required to follow new IMR process created by SB 863 as change in law does not supersede parties’ prior stipulation In Bertrand v. County of Orange , 2014 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel, granting removal and amending... Read More

California: How Physicians Can Provide the Most Accurate WPI Rating Under the AMA Guides
Posted on 12 Mar 2015 by Robert G. Rassp, Esq.

In Ramirez v. Space Lok, Inc., 2015 Cal. Wrk. Comp. P.D. LEXIS 9 (lexis.com), 2015 Cal. Wrk. Comp. P.D. LEXIS 9 (Lexis Advance), the WCAB rescinded the WCJ’s finding that the applicant, a machine operator, incurred 36 percent permanent disability... Read More

California: Revisiting Navarro: When Is A New Panel QME Required?
Posted on 19 Apr 2017 by Brad Wixen

From the limited information in the record in Hasley v. Frito-Lay, Inc., 2017 Cal. Wrk. Comp. P.D. LEXIS --, it appears that applicant, pro per, sustained injury to one or both of her hands. She did not initially file a claim form but instead filed an... Read More

California: W.C.A.B. Rules ADR 35.5(e) Invalid
Posted on 28 Feb 2014 by Richard M. Jacobsmeyer

The W.C.A.B. has issued an en banc decision on an issue that comes up fairly frequently before the W.C.A.B.—the application of Rule 35.5 to QME where an injured worker has multiple injuries to similar parts of the body with the same parties. Rule... Read More

California: The Right to Select the Specialty of the Panel QME: Whose Choice Is It Anyways?
Posted on 26 Jul 2012 by Calif. WCAB Noteworthy Panel Decisions Reporter

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... Read More

Split Panel Grants Applicant Another Bite at the PQME Apple: Cal. Comp. Cases September Advanced Postings (9/2/2015)
Posted on 2 Sep 2015 by California Compensation Cases Staff

Here’s the latest batch of advanced postings for the September 2015 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2015 LexisNexis. All... Read More

California: The PQME Process Runs Amok - A Tragic-Comedy
Posted on 21 Oct 2011 by Robert G. Rassp, Esq.

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... Read More

California: Ex Parte Communications: When Replacement Panel Not Warranted
Posted on 16 Apr 2018 by LexisNexis Workers' Comp Law Newsroom Staff

A recent noteworthy panel decision, Turner v. PT Gaming , addresses three interrelated issues on QME reporting and service of reports and whether they provide grounds for a new PQME. The majority, in this split opinion, concludes per Alvarez v. WCAB,... Read More

California: Face to Face With a Bunch of PQMEs
Posted on 15 Mar 2017 by Robert G. Rassp, Esq.

In early 2017, a PQME referral company hosted a continuing medical education (CME) program for its panel QME physicians in the Southern California area. The first three hours of the six hour program featured an applicant’s attorney, a defense attorney... Read More

Psychiatric Injuries Post-SB 863: The PQME Process Lives On
Posted on 10 Sep 2015 by Calif. WCAB Noteworthy Panel Decisions Reporter

In Hernandez v. Fremont Bank, 2015 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB affirmed the WCJ’s finding that the applicant bank teller, who alleged that she suffered psychiatric injury as a compensable consequence of an orthopedic injury, was entitled... Read More

California: Communications With the AME or PQME
Posted on 30 Nov 2016 by Calif. WCAB Noteworthy Panel Decisions Reporter

When do communications with the AME or PQME have to be cleared by the opposing side? In Lopez Castaneda v. Forever 21 , 2016 Cal. Wrk. Comp. P.D. LEXIS --, the WCAB, in a split panel opinion, affirmed the WCJ’s finding that the applicant was... Read More