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PanelQMEMed-legalGranted

Rivera Silva, Jose

JOSE RIVERA SILVA, Applicant vs. INTERCON SECURITY SYSTEMS, INC., insured by HARTFORD FIRE AND CASUALTY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number: ADJ17366311
Decision date: Jan 7, 2024
District office: Oakland
WCJ: —
Claim administrator: Sedgwick Claims Management Services (administering for Hartford Fire and Casualty)
Commissioners: CRAIG SNELLINGS, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, LISA A. SUSSMAN, DEPUTY COMMISSIONER

Injury / body parts: head trauma, left shoulder, neck, eye, right shoulder, psyche

LC §5900LC §5902LC §5903CCR §30CCR §10955

Summary

Applicant Jose Rivera Silva sought reconsideration of an F&O finding that defendant's orthopedic QME Panel #7578289 was valid and ordering a medical-legal evaluation pursuant to that panel. Applicant argued the panel was invalid because defendant served the panel only via fax and email, rather than serving a complete paper copy of the panel request and supporting documents as required by AD Rule 30(b)(1)(C). The Board treated the panel validity issue under the removal standard (an interlocutory discovery matter) even though the decision also contained final findings. The Board found defendant failed to serve all required documents (the panel list alone was insufficient), concluding the panel was improperly procured. The Board granted reconsideration, amended the F&O to find Panel #7578289 invalid, and ordered the panel stricken.

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

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.

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.