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PanelQMEMed-legalGranted

Boursalian, Maral

MARAL BOURSALIAN, Applicant vs. STANFORD UNIVERSITY and AMERICAN ZURICH INSURANCE COMPANY, administered by ZURICH NORTH AMERICA, Defendants

ADJ number: ADJ14002457
Decision date: Dec 1, 2024
District office: San Jose
WCJ: —
Claim administrator: American Zurich Insurance Company, administered by Zurich North America
Commissioners: JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: psyche

LC §5909LC §3208.3LC §4060LC §4061LC §4062.3LC §5701LC §5906LC §5313

Summary

Applicant, appearing in pro per after dismissing her attorney, claimed a psychiatric injury AOE/COE during her employment as an administrative associate at Stanford University. The WCJ found applicant failed to meet her burden of proving injury to her psyche and denied the claim without the benefit of a QME psychiatric evaluation. The WCAB granted reconsideration, finding that the WCJ improperly decided a medical issue (psychiatric injury compensability) without medical evidence, particularly where applicant had requested a QME panel in psychiatry, the originally selected QME (Dr. Sidle) had retired, and applicant was awaiting a replacement QME evaluation. The Board rescinded the F&O and remanded for further development of the record, emphasizing that unrepresented employees are entitled to QME evaluations to determine compensability and permanent impairment.

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.