WCPanelIQ
PanelQMEMed-legalGranted

Bear, Scott

SCOTT BEAR, Applicant vs. CVS HEALTH CORPORATION; XL INSURANCE AMERICA, INC., administered by SEDGWICK, Defendants

ADJ number
ADJ11412367
Decision date
Date unavailable
District office
Pomona
WCJ
—
Claim administrator
Sedgwick (administering for XL Insurance America, Inc.)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: head, neck, left trapezius, brain, headache, neurological, psyche, sleep disorder

LC §4602.3LC §4062.3LC §5313LC §5277CCR §31.5CCR §34CCR §10955CCR §10787CCR §10803CCR §10832CCR §10421CCR §10325

Summary

Applicant Scott Bear obtained neurology QME Dr. Anees from a panel, but the doctor's office could not accommodate the initial examination at the Fontana location listed on the panel selection form, so applicant's attorney requested a replacement panel under AD Rule 31.5(a)(11)/34(b). The WCJ granted the replacement panel but declined to rule on disputes over what documents (advocacy letter language and witness deposition transcripts) could be served to the QME, finding those issues not yet 'ripe' because no new QME had been selected. Defendant sought removal, challenging both the replacement panel finding and the WCJ's failure to decide the document/objection issues. The Board granted removal, affirmed the replacement panel as mandatory (because inability to conduct the exam at the listed office is a Rule 34(b) violation and the request was timely within 15 days), but held the document disputes were ripe and must be decided. The Board rescinded the F&O, substituted new findings preserving the replacement panel order, and returned the matter to the trial level for findings on Issue Nos. 1-5 consistent with Suon, Maxham, Hamilton, Blackledge, and section 5313.

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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