WCPanelIQ
PanelQMEMed-legalDenied

Rodriguez, Juana

JUANA RODRIGUEZ, Applicant vs. TAYLOR FRESH FOODS; AMERICAN ZURICH INSURANCE COMPANY, Defendants

ADJ number
ADJ17603587
Decision date
Jan 3, 2024
District office
Salinas
WCJ
—
Claim administrator
American Zurich Insurance Company
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: neck, hips, knee, upper extremities

LC §3202LC §4060LC §4061LC §4062LC §4062.2LC §5401LC §5904CCR §10605CCR §10955

Summary

Applicant Juana Rodriguez sought reconsideration of an October 13, 2023 F&O in which the WCJ invalidated two QME panels (7584902 obtained by applicant in chiropractic, and 7586333 obtained by defendant in orthopedic surgery). Applicant claimed cumulative industrial injury to her neck, hips, knee, and upper extremities while employed by Taylor Fresh Foods, but the claim was denied/under investigation. The majority agreed applicant's April 22, 2023 opening letter sufficiently communicated a section 4060 compensability evaluation request, but ultimately invalidated panel 7584902 because the claim form was served simultaneously with the request rather than the request being made 'after the filing of the claim form' as required by section 4060(c). The Board also invalidated defendant's panel 7586333 because it was improperly requested under section 4062 while the claim was still under investigation and the underlying Dr. Klick report was never admitted into evidence. The Board treated the petition as one for removal (applying that standard) and denied it. Commissioner Capurro dissented, arguing the claim form was filed when served on April 22, 2023 so the May 14, 2023 panel request was timely and valid.

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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