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PanelQMEMed-legalGranted in Part

Elvia Bautista — ADJ13487168

ELVIA BAUTISTA, Applicant vs. THE BEAUTY BOX; EMPLOYERS PREFERRED INSURANCE COMPANY, Defendants

ADJ number: ADJ13487168
Decision date: Sep 28, 2022
District office: Van Nuys
WCJ: —
Claim administrator: Employers Preferred Insurance Company
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER

Injury / body parts: back, neck, shoulders, legs, pelvis, COVID, head, sleep, cervical spine, lumbar spine, psyche

LC §4062.2LC §5701LC §5708LC §5709LC §5900LC §5902LC §5903LC §5906CCR §31.7CCR §10421CCR §10517

Summary

Applicant Elvia Bautista sought reconsideration of an August 3, 2022 F&O in which the WCJ denied her request for additional QME panels in neurology and psychiatry/psychology, finding no medical issue requiring consultation outside the orthopedic QME's expertise. The Board held that the QME panel dispute was an interlocutory, non-final order, so it dismissed the petition for reconsideration and treated it as a petition for removal. Reviewing the merits, the Board found that orthopedic QME Dr. Getelman expressly deferred evaluation of psychiatric and sleep issues to specialists outside his field, and that applicant claimed injury to body parts beyond orthopedics. The Board concluded there was good cause under AD Rule 31.7 for additional QME panels in neurology and psychology, rescinded the F&O, and granted the requested panels.

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.