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
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
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
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
Here are the second and third batch of advanced postings for the August 2014 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2014 LexisNexis.... Read More
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
[ Note: This article was updated on January 11, 2012, to provide the reader with more information about handling civil matters. ] Workers’ compensation practitioners enjoy a rule that is unique to the world of EAMS litigation. 8 CCR 10507 provides... Read More
Are applicants entitled to reimbursement for self-procured medical marijuana both pre- and post-SB 863? In Cockrell v. Farmers Insurance , 2015 Cal. Wrk. Comp. P.D. LEXIS --, a WCAB panel has once again rescinded the WCJ’s finding that the applicant... Read More
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
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
In Chirinos v. Heartwood Cabinet , No. ADJ2087163, the WCAB panel found that the applicant’s failure to submit to a physical examination by the panel QME did not render the panel QME’s reports inadmissible for purposes of this contribution... Read More
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
Here’s the latest batch of advanced postings for the February 2014 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2014 LexisNexis. All... Read More
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
Lexis.com subscribers can link to the cases and statutes cited below. California Labor Code Section 4062 provides that if either party objects to a “medical determination” made by the treating physician concerning any medical issues not... Read More