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PanelQMEMed-legalDenied

Amaya, Daisy

DAISY AMAYA, Applicant vs. JALSON CO. dba BERSON BAKAR; NORTH RIVER INSURANCE COMPANY; administered by CRUM AND FORSTER, Defendants

ADJ number: ADJ13002614
Decision date: Jan 4, 2026
District office: San Francisco
WCJ: —
Claim administrator: Crum and Forster (administering North River Insurance Company)
Commissioners: KATHERINE WILLIAMS DODD, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: cervical spine, lumbar spine, bilateral shoulders, bilateral wrists (carpal tunnel syndrome), psyche

LC §4062.2LC §5900LC §5902LC §5903LC §5904LC §5909CCR §31.5CCR §10955

Summary

Applicant Daisy Amaya sought reconsideration/removal of an October 1, 2025 F&O finding industrial injury to multiple body parts and resolving a psyche QME panel dispute. After the original psyche PQME (Dr. Gould) became unable or unwilling to conduct in-person evaluations, a replacement panel (3448334) was issued, but the parties had agreed on April 3, 2024 to continue using Dr. Gould. The WCJ found applicant's December 9, 2024 selection of Dr. Tahami from the replacement panel premature because the agreement to use Dr. Gould was not terminated until December 6, 2024, restarting the section 4062.2(c) striking period. The Board treated the QME issue under the removal standard, applied equitable tolling (noting the defense attorney was not copied on the December 6, 2024 email), and held the striking timeframe restarted on October 1, 2025, the date of service of the F&O. 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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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.