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PanelQMEMed-legalGranted

Rancour, Kandas

KANDAS RANCOUR, Applicant vs. MEDREVENU, LLC; MASSACHUSETTS BAY INSURANCE COMPANY, administered by THE HANOVER INSURANCE GROUP, Defendants

ADJ number: ADJ18473989
Decision date: May 6, 2025
District office: Marina del Rey
WCJ: —
Claim administrator: The Hanover Insurance Group (administering Massachusetts Bay Insurance Company)
Commissioners: CRAIG SNELLINGS, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: psyche, neurological

LC §5313CCR §10566CCR §10955

Summary

Defendant Massachusetts Bay Insurance Company sought removal of a WCJ's October 29, 2024 Finding and Order directing an additional QME panel in psychiatry, arguing that no injury to the psyche had been alleged. Applicant countered that the existing neurology PQME, Dr. Kent, had indicated at his October 8, 2024 deposition that a psychiatric evaluation was needed to determine industrial causation of applicant's complaints. The Appeals Board found that although the WCJ's observations appeared relevant, neither Dr. Kent's deposition transcript nor his medical report had been filed, and there was no petition requesting the additional panel in EAMS/FileNet, leaving an inadequate record. The Board granted removal, finding the defendant would suffer significant prejudice and due process violation if a decision issued without an adequate evidentiary record. The October 29, 2024 Findings and Order was rescinded, all issues deferred, and the matter returned to the trial level.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.