LexisNexis® Legal Newsroom
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 Panel QME Process: Is It Time to Admit We Are Dealing With a Monster?

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 to increase litigation. No question, at least...

California: Procedure for Striking a Panel Qualified Medical Evaluator

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 WCAB granted removal and rescinded WCJ’s order that applicant violated LC 4062.2(c)...

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...

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...

California: W.C.A.B. Rules ADR 35.5(e) Invalid

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 35.5(e) would suggest the employee is limited to...

California: 2004 Stipulation Regarding Future Medical Treatment Disputes Being Referred to AME Could Not Circumvent UR Procedures

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 the WCJ’s order, determined that the...

California: How Physicians Can Provide the Most Accurate WPI Rating Under the AMA Guides

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 as a result of a 7/23/2012 industrial injury to...

Split Panel Grants Applicant Another Bite at the PQME Apple: Cal. Comp. Cases September Advanced Postings (9/2/2015)

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 rights reserved. St. Helena Hospital v. WCAB...

Psychiatric Injuries Post-SB 863: The PQME Process Lives On

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 to a panel qualified medical evaluator (PQME...

California: Communications With the AME or PQME

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 entitled to a replacement qualified medical evaluator...

California: The PQME Process and the Remote Medical-Legal Evaluation

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 the originally assigned qualified medical evaluator...

California: Face to Face With a Bunch of PQMEs

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, and a workers’ compensation judge who...

California: Revisiting Navarro: When Is A New Panel QME Required?

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 application. That application apparently listed a...