WCPanelIQ
PanelQMEMed-legalDenied

Arevalo Garcia, Stephanie

STEPHANIE AREVALO GARCIA, Applicant vs. PLANNED PARENTHOOD; AIG CLAIMS SERVICES, Defendants

ADJ number
ADJ13282654
Decision date
Dec 20, 2023
District office
Van Nuys
WCJ
—
Claim administrator
AIG Claims Services
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: lumbar spine, right wrist

LC §5904LC §5903LC §5952LC §5701LC §5906CCR §31.5CCR §41.5CCR §10955

Summary

Applicant, a medical assistant, sustained admitted industrial injury to her lumbar spine and right wrist on July 18, 2019. The orthopedic QME Dr. Wilker initially found industrial causation and impairment, but after reviewing surveillance video that he believed contradicted applicant's statement that she had used a walker since her fall, he downgraded his findings, increased nonindustrial apportionment, and questioned applicant's credibility. The WCJ found good cause to replace Dr. Wilker because his deposition testimony showed he was unwilling to reconsider his opinions regardless of additional evidence, and because of a potential conflict of interest (a related criminal fraud prosecution in which he was a potential witness). The WCAB, applying the removal standard since defendant only challenged interlocutory discovery findings, denied reconsideration, agreeing the QME's reporting was not substantial evidence and that further development with the existing QME would be unlikely to cure the deficiencies.

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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