Serrano, Ruth

Applicant Ruth Serrano sustained an industrial injury to her left leg, left hip, and lumbar spine while working as a custodian. After exhausting the MPN second and third opinion process, she requested an MPN independent medical review (MPN-IMR), and Dr. Michael Smith performed the review, opining that excision/biopsy of a left hip mass (probable lipoma) was needed but characterizing it as 'nonindustrial.' The AD adopted Dr. Smith's report. The disputes were whether the MPN-IMR physician could address causation, whether his report could be sent to QME Dr. Roland, and whether the surgery could be ordered. The Board held that the MPN-IMR physician cannot address causation (industrial vs. nonindustrial) because his role is limited to disputed treatment/diagnostic service, that his report constituted substantial evidence that applicant needs and is entitled to the left hip surgery as a diagnostic procedure, and that his report may not be sent to QME Dr. Roland because treatment is not a QME issue.