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PanelQMEMed-legalDenied

Borrego, Esmeralda

ESMERALDA BORREGO, Applicant vs. MONTEREY COUNTY OFFICE OF EDUCATION, permissibly self-insured; administered by INTERCARE HOLDINGS INSURANCE SERVICES, Defendants

ADJ number: ADJ15429242
Decision date: Jan 10, 2024
District office: Salinas
WCJ: —
Claim administrator: Intercare Holdings Insurance Services
Commissioners: JOSÉ H. RAZO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: hands, forearms, elbows, right shoulder

LC §4060LC §4061LC §4062LC §4062.1LC §4062.2LC §139.2CCR §10955

Summary

Applicant Esmeralda Borrego sustained an industrial injury to her hands, forearms, and elbows, and claimed a disputed right shoulder injury. Because defendant denied the shoulder injury, she requested a PQME panel while unrepresented, and selected Dr. Curran under the unrepresented track of Labor Code section 4062.1. Defendant sought removal of the WCJ's F&O validating the panel, arguing that applicant should have used the represented track (section 4062.2) because she had been 'coached' by an attorney before the evaluation, and that its sanctions petition should have been granted. The Board denied removal, holding that consulting an attorney without signing a fee agreement does not make an applicant 'represented,' so the unrepresented track was proper. The Board also found that applicant checking the wrong box on the panel request was harmless because a PQME was needed under either category.

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.