WCPanelIQ
PanelQMEMed-legalGranted

Diaz, Francelia

FRANCELIA DIAZ, Applicant vs. MEDTRONIC, INC.; ACE AMERICAN INSURANCE COMPANY, administered by ESIS, Defendants

ADJ number
ADJ12180865
Decision date
Mar 26, 2023
District office
Van Nuys
WCJ
—
Claim administrator
ESIS (administering Ace American Insurance Company)
Commissioners
PATRICIA A. GARCIA, DEPUTY COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: neck, bilateral elbows, bilateral wrists, bilateral shoulders, Chronic Regional Pain Syndrome (CRPS), right upper extremity

LC §4062.2LC §5909LC §5904LC §5903LC §5952LC §4062CCR §31.7CCR §32.6CCR §10955CCR §10966

Summary

Applicant Francelia Diaz, a quality control inspector, claimed an industrial injury on September 4, 2013 to multiple body parts and was evaluated over several years by orthopedic panel QME Dr. Charles Schwartz, who diagnosed CRPS in earlier reports but omitted it in his May 5, 2021 report. The WCJ ordered the Medical Unit to issue an additional QME panel in pain management, and defendant petitioned for reconsideration/removal. The Board treated the petition under the removal standard because it challenged an interlocutory issue, and found that applicant had not shown good cause for an additional pain management panel because Dr. Schwartz had never stated the CRPS impairment issues were outside his expertise. The Board granted the petition, rescinded the Amended F&O, and substituted new findings affirming AOE/COE injury (including CRPS) but denying the additional panel, recommending further development of the record with Dr. Schwartz. A companion order corrected a clerical omission of the date of service (March 20, 2023).

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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