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PanelQMEMed-legalGranted in Part

Rico, Jackie

JACKIE RICO, Applicant vs. KING PLASTICS, INC.; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, Defendants

ADJ number: ADJ18158400
Decision date: Date unavailable
District office: Pomona
WCJ: —
Claim administrator: Travelers Property Casualty Company of America
Commissioners: JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: multiple body parts (wide range, unspecified)

LC §4062.21LC §4062.2LC §4060LC §4061LC §4062LC §4600LC §5900LC §5902LC §5903CCR §10955CCR §31.1CCR §31.5

Summary

Applicant Jackie Rico filed a specific injury claim (ADJ18158400) and a cumulative trauma claim (ADJ18158401) while employed as a packer for King Plastics. Defendant obtained an orthopedics QME panel on the specific claim without serving applicant's counsel (violating section 4062.2), while applicant obtained a chiropractic QME panel on the CT claim before the CT claim was denied. The WCJ found both panels improperly obtained and ordered the parties to confer over use of an orthopedics panel. The Board dismissed the petition as to reconsideration (non-final order), but granted removal, holding that defendant's defective panel meant applicant's panel was a valid replacement triggered by representation, and that applicant's panel was not prematurely obtained because the delay letter and overall course of conduct established the need for a medical evaluation. The Board rescinded the F&O and held applicant's chiropractic QME panel valid.

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.