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PanelQMEMed-legalGranted in Part

Ramirez, Evangelina

EVANGELINA RAMIREZ, Applicant vs. IHSS - CALIFORNIA DEPT. OF SOCIAL SERVICES, legally uninsured, administered by YORK RISK SERVICES GROUP, INC., Defendants

ADJ number: ADJ12634125
Decision date: Jul 11, 2024
District office: Salinas
WCJ: —
Claim administrator: York Risk Services Group, Inc.
Commissioners: JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: left foot, left ankle, hypertension, psyche, back, right shoulder, left hip, right knee

LC §5904LC §4062.2CCR §31.7CCR §31.5CCR §31.1CCR §30.5CCR §10955CCR §41CCR §11.5CCR §14

Summary

Applicant Evangelina Ramirez, while unrepresented, requested and obtained a QME panel in chiropractic, and Dr. Henry Domeniconi, D.C., evaluated her and issued multiple reports over several years. After applicant sought a replacement QME based on Dr. Domeniconi's inability to provide a substantive evaluation, the WCJ found a replacement panel was needed but ordered that the replacement be in the specialty of orthopedic surgery rather than chiropractic. The Board granted reconsideration, applying the removal standard since only an interlocutory issue was challenged. It held that the WCJ exceeded her authority by changing the specialty when no party had raised a specialty dispute, violating due process, and that no good cause existed under AD Rule 31.7(b) to change the specialty. The Board amended the order to provide a replacement QME panel in the specialty of chiropractic.

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.