WCPanelIQ
PanelQMEMed-legalDenied

Alvarado, Leticia

LETICIA ALVARADO, Applicant vs. COMMUNITY ACTION PARTNERSHIP OF KERN; CYPRESS INSURANCE COMPANY, administered by BERKSHIRE HATHAWAY; and BOYS & GIRLS CLUBS OF BAKERSFIELD; ILLINOIS MIDWEST INSURANCE AGENCY, LLC, on behalf of STATE NATIONAL INSURANCE COMPANY, Defendants

ADJ number
ADJ10884845
Decision date
Jun 20, 2024
District office
Bakersfield
WCJ
—
Claim administrator
Berkshire Hathaway (administering Cypress Insurance Company); Illinois Midwest Insurance Agency, LLC on behalf of State National Insurance Company
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: lumbar spine, back, lower extremities, internal organs, psyche

LC §5900LC §5903LC §5904CCR §10600CCR §10605CCR §10615CCR §10940CCR §10955CCR §10964

Summary

Applicant Leticia Alvarado sought reconsideration of the WCJ's April 2, 2024 Findings and Orders, which invalidated psychology/psychiatry QME panel #3397632 because applicant's attorney failed to comply with the timing requirements of an earlier April 20, 2023 discovery order. The April 20, 2023 order had granted a new QME panel in psychiatry but denied a panel in general surgery for medically-assisted weight loss, and instructed applicant's attorney to provide the order to the AD's Medical Unit within thirty days of finality. Applicant challenged both the denial of a general surgery panel and the invalidation of the psychiatry panel. The Board found the challenge to the general surgery denial untimely because it became final May 26, 2023 and no reconsideration was sought within 25 days. Because the April 2, 2024 decision was a hybrid order and applicant only challenged interlocutory discovery findings, the Board applied the removal standard and found no significant prejudice or irreparable harm, especially since either party may still request a psychiatry panel or agree to an AME. The Petition was denied.

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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