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PanelQMEMed-legalDenied

Jauregui, Andrew

ANDREW JAUREGUI, Applicant vs. INVO PEO, INC./LCF TOWING SAN DIEGO, and UNITED WISCONSIN INSURANCE COMPANY administered by NEXT LEVEL ADMINISTRATORS, Defendants

ADJ number: ADJ17141277
Decision date: Date unavailable
District office: Pomona
WCJ: —
Claim administrator: Next Level Administrators (administering United Wisconsin Insurance Company)
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: head, circulatory system (stroke)

CCR §10955

Summary

Applicant Andrew Jauregui claimed two injuries: a dog bite on June 13, 2022 (ADJ17354037) and a stroke on June 20, 2022 (ADJ17141277). Defendant obtained an occupational medicine QME panel for the dog bite claim, and applicant obtained a neurology QME panel for the stroke claim. After occupational medicine QME Dr. Esfahane opined the stroke was not industrial, defendant canceled the scheduled neurology QME exam with Dr. Maasumi. The WCJ found applicant entitled to be evaluated by the neurology QME, and defendant petitioned for reconsideration/removal. The Appeals Board denied relief, holding Dr. Esfahane's report was not substantial evidence because he reviewed no medical records, and defendant showed no substantial prejudice or irreparable harm warranting removal.

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.