LexisNexis® Legal Newsroom
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: What Constitutes an Ex-Parte Communication Post-Alvarez?

There have been a number of cases decided by the Workers’ Compensation Appeals Board (WCAB) dealing with Labor Code Section 4062.3 and what constitutes a prohibited ex parte communication with a Panel Qualified Medical Evaluator (PQME). Though many thought the Court of Appeal’s decision in...

California: WCAB Panel Allows Report of Non-Examining Panel QME in Contribution Proceeding

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 proceeding, and that the Arbitrator did not err in...

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...

Herlick Handbook 31st Edition: Educating the California Workers’ Comp Community Since 1964

LexisNexis Announces New Editors-in-Chief: Richard Jacobsmeyer, Julius Young, Barry Bloom This 31st edition marks a transition in the history of Herlick, California Workers’ Compensation Handbook . Longtime author Stanford D. Herlick passed away in 2010, and the handbook is now co-edited by a...

Does an Employee Have to Obtain a Comprehensive Medical-Legal Evaluation Prior to Disputing a Utilization Review Determination?

In State Compensation Insurance Fund v. Workers' Comp. Appeals Bd. (Sandhagen) (2008) 44 Cal.4th 230 [73 Cal.Comp.Cases 981] (Sandhagen), the California Supreme Court clarified that an employer did not have the option of going through either UR or the QME process in addressing a treatment request...

Lien Claimant’s PQME Reports Admitted Into Evidence: Cal. Comp. Cases February Advanced Postings (2/10/2012)

Here’s the second batch of advanced postings for the February 2012 issue of Cal. Comp. Cases. Lexis.com subscribers can link to the case to read the complete headnotes and summaries. County of Mendocino, PSI, Petitioner v. Workers' Compensation Appeals Board, City of Willits, PSI, Aaron...

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: Court Upholds W.C.A.B. Ruling Excluding Medical Legal TD From Labor Code § 4656 Window

The 3rd Appellate District has resolved a one of the issues that has been frequently discussed but almost never raised (at least in my experience) regarding payment of TTD during the period between 4/19/2004 and 12/31/2007 when the first payment of TD triggered a 2 year window for payment of TTD benefits...

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...