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PanelQMEMed-legalDenied

Avila, Lourdes

LOURDES AVILA, Applicant vs. PRIORITY WORKFORCE; MVP PAYROLL FINANCING, LLC lcf PRIORITY BUSINESS SERVICES, INC. (VENSURE); SUNZ INSURANCE COMPANY, administered by NEXT LEVEL ADMINISTRATORS, Defendants

ADJ number: ADJ19417386
Decision date: Mar 16, 2025
District office: Van Nuys
WCJ: —
Claim administrator: Next Level Administrators, administering for SUNZ Insurance Company
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

LC §4062LC §4062.2CCR §10955CCR §10600

Summary

Defendant petitioned for removal of a WCJ's order replacing QME panel number 7709310 in orthopedics. Due to unusual circumstances where both parties initially struck the same physician (Dr. Galloni) and their subsequent strikes were both untimely, the WCJ found an irreparable ambiguity and ordered the DWC medical director to issue a replacement panel with future strikes to occur via email. Defendant argued the mailbox rule entitled it to an additional strike and that its due process rights were violated by the order issuing without a hearing. The Appeals Board denied removal, finding defendant failed to demonstrate substantial prejudice or irreparable harm, particularly since no evaluation had yet taken place, and the order determined no substantive rights.

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.

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.