WCPanelIQ
PanelQMEMed-legalGranted

Montes, Rosario

ROSARIO MONTES, Applicant vs. WESTSIDE CHILDREN’S CENTER; STATE COMPENSATION INSURANCE FUND; EVEREST NATIONAL INSURANCE COMPANY, administered by GALLAGHER BASSETT SERVICES, INC.; PACIFIC EMPLOYERS INSURANCE COMPANY/ACE AMERICAN INSURANCE COMPANY, administered by ESIS, Defendants

ADJ number
ADJ11018186
Decision date
Apr 10, 2024
District office
Los Angeles
WCJ
—
Claim administrator
Gallagher Bassett Services, Inc. (for Everest National Insurance Company); ESIS (for Pacific Employers Insurance Company/ACE American Insurance Company); State Compensation Insurance Fund
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: orthopedic (unspecified)

LC §3202.5LC §4064LC §4062.3LC §5701LC §5703LC §5708LC §5709LC §5906CCR §10955CCR §10682

Summary

Applicant and SCIF previously selected Dr. Alan Sanders as the orthopedic AME, but he became unavailable for further reporting or cross-examination. The WCJ issued an Order Vacating Submission on May 19, 2023, finding good cause to strike Dr. Sanders' reports and develop the record, in part because co-defendant Pacific/ACE was joined approximately ten years after the last claimed injury and needed adequate discovery. SCIF sought removal, arguing irreparable harm because the AME's contemporaneous observations, diagnostics, and record reviews from 2010-2017 would be lost. The Board granted removal and amended the order so that Dr. Sanders' reports remain in evidence rather than being stricken, while otherwise affirming the vacating of submission for development of the record. The matter was returned to the trial level with instructions to set a status conference under McDuffie protocols regarding selection of an AME or appointment of a regular physician.

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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