WCPanelIQ
PanelQMEMed-legalDenied

Cardona, Elmer

ELMER CARDONA, Applicant vs. CEDARS-SINAI MEDICAL CENTER, permissibly self-insured, administered by BETA HEALTHCARE, Defendants

ADJ number
ADJ19847475
Decision date
Apr 7, 2025
District office
Van Nuys
WCJ
—
Claim administrator
BETA Healthcare
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, PAUL F. KELLY, COMMISSIONER
LC §5909LC §5900LC §5904LC §4060LC §4061LC §4062LC §4062.1LC §4062.2CCR §10955

Summary

Elmer Cardona filed a workers' compensation claim against Cedars-Sinai Medical Center, permissibly self-insured and administered by BETA Healthcare. The WCJ issued a decision that included a finding of employment (a threshold issue) but the defendant's petition only challenged an interlocutory ruling regarding the propriety of triggering a QME panel after issuing a delay notice. The Appeals Board treated the petition as one for reconsideration because the underlying decision was final, but applied the removal standard because only an interlocutory issue was challenged. The Board found defendant failed to show significant prejudice or irreparable harm, and confirmed that an employer's decision to delay compensability creates a 'dispute' permitting either party to request a QME panel. The Petition for Removal was denied.

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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