WCPanelIQ
PanelQMEMed-legalRemanded

Lynn, Richard

RICHARD LYNN, Applicant vs. CONTRA COSTA ELECTRIC; AMERICAN CASUALTY COMPANY OF READING, PA, Defendants

ADJ number
ADJ14547470
Decision date
Apr 16, 2025
District office
Oakland
WCJ
Alfonso Moresi
Claim administrator
American Casualty Company of Reading, PA
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: back, chest, neck, head

LC §3600LC §3201.5LC §5708LC §5272LC §5701LC §5906LC §5952LC §4050LC §4056

Summary

Richard Lynn claimed an industrial back injury on September 6, 2018 while employed by Contra Costa Electric, whose workers' compensation claims were governed by a NECA/IBEW carve-out ADR program under Labor Code section 3201.5. Defendant denied the claim asserting a post-termination defense under section 3600(a)(10), but an arbitrator found the claim was not barred and ordered applicant to re-open his claim. The applicant selected occupational medicine QME Dr. Wiggins but failed to attend the scheduled examination, and after delays an arbitrator ruled he was no longer entitled to a QME under Section 48, Article 13(g) of the ADR rules. The Appeals Board granted reconsideration, found that subsection (g) did not apply because a QME had in fact been selected and an appointment set, and held that the ADR rules do not abrogate the arbitrator's authority to develop the record and appoint a medical evaluator. The Board rescinded the F&O and returned the matter to the arbitrator, noting the arbitrator's discretion under ADR Section 4.14 to appoint a health care professional if the parties cannot agree on an AME.

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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