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PanelQMEMed-legalIBRGranted

Thurmond, Ashley

ASHLEY THURMOND, Applicant vs. SANTA CLARA VALLEY TRANSPORTATION AUTHORITY, permissibly self-insured, adjusted by TRISTAR, Defendants

ADJ number: ADJ19265320
Decision date: Jan 29, 2026
District office: San Jose
WCJ: —
Claim administrator: TRISTAR (TPA for Santa Clara Valley Transportation Authority, permissibly self-insured)
Commissioners: JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, PAUL KELLY, COMMISSIONER

Injury / body parts: psyche, back, neck

LC §4603LC §5909LC §5900LC §4622LC §4603.3LC §4620LC §4621LC §5703LC §5903LC §5952LC §5313LC §5701LC §5906LC §5907LC §5908LC §5908.5LC §5803LC §5901LC §5950CCR §10786CCR §10787

Summary

QME psychiatrist Jack Yen, M.D. sought reconsideration of a WCJ's October 22, 2025 Joint Findings and Order, which found that defendant's $4,946.26 payment to Alexa Healthcare for Dr. Yen's QME report was not unreasonably delayed and denied his claims for interest, penalties, sanctions, and attorney fees. The WCJ found part of cost petitioner's Exhibit 2 (the unsigned HICFA claim form showing $4,946.26) inadmissible and noted a discrepancy with the $4,030.00 amount stated under penalty of perjury in Dr. Yen's report. Cost petitioner challenged the WCJ's evidentiary rulings, including the admission of defendant's EOR without proof of service on him. The Appeals Board granted reconsideration, finding the record insufficient to determine whether and when defendant properly served an EOR on Dr. Yen. The Board deferred a final decision pending further review and development of the record.

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.