WCPanelIQ
PanelQMEMed-legalGranted in Part

Hadley, Raymond

RAYMOND HADLEY, Applicant vs. EAST BAY MUNICIPAL UTILITY DISTRICT, PERMISSIBLY SELF-INSURED, BY ATHENS ADMINISTRATORS, Defendants

ADJ number
ADJ10222062
Decision date
Jan 26, 2025
District office
Oakland
WCJ
—
Claim administrator
Athens Administrators (for East Bay Municipal Utility District, permissibly self-insured)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: bilateral knees, low back, internal organs (bladder cancer), hypertension, hearing loss, psyche

LC §5701LC §5900LC §5903LC §5904LC §5906LC §5909LC §5952LC §4062.1LC §4062.2CCR §31.5CCR §35.5CCR §10330CCR §10600CCR §10955

Summary

Applicant Raymond Hadley sustained an accepted cumulative knee injury and claimed additional cumulative injuries including bladder cancer, hypertension, hearing loss, and psyche. After the original internal medicine QME (Dr. Duhan) died before issuing final reporting, replacement QME Dr. Bronshvag issued nine reports over four years but was unable or unwilling to provide final opinions on causation and impairment for the bladder cancer and hypertension claims, instead requesting a genitourinary specialist consultation, while efforts to obtain an oncology QME panel failed due to insufficient available doctors. The WCJ found good cause to replace Dr. Bronshvag and appointed Dr. Scott Anderson as a regular physician under Labor Code section 5701. The WCAB majority granted reconsideration and affirmed the replacement but amended the decision to require the parties to first attempt to agree on an AME before appointing a regular physician, consistent with McDuffie. Chair Zalewski dissented, arguing the QME's request for a consulting specialist was a valid medical opinion that did not justify replacement.

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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