WCPanelIQ
PanelQMEMed-legalDenied

Patrick Hanson — ADJ14125839

PATRICK HANSON, Applicant vs. COUNTY OF FRESNO, PERMISSIBLY SELF-INSURED; ADMINISTERED BY ACCLAMANTION INSURANCE MANAGEMENT SERVICES, Defendants

ADJ number
ADJ14125839
Decision date
Jun 29, 2022
District office
Fresno
WCJ
—
Claim administrator
Acclamation Insurance Management Services (AIMS)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: skin, hearing, shoulders, right wrist, hands, low back, right hip, knees, right ankle, acid reflux, coronary artery disease, arrhythmia, left ventricular hypertrophy

LC §5904CCR §31.3CCR §31.5CCR §42.6CCR §46.2CCR §10955

Summary

Applicant Patrick Hanson, a deputy sheriff, sought a replacement QME panel under AD Rule 31.5(a)(2), claiming the selected orthopedic QME could not schedule an appointment within 60 days. The DWC Medical Unit and WCJ denied the request, finding that COVID emergency Rule 46.2 had suspended Rule 31.3(e)'s 60/90-day limits and replaced them with 90/120-day limits applicable during the public health emergency. Applicant petitioned for reconsideration/removal, arguing Rule 31.5's independent 60-day limit was not suspended by Rule 46.2. The Board treated the petition as a hybrid (final on the employment threshold issue but interlocutory as to the panel dispute) and applied the removal standard. The Board harmonized the regulations, holding that Rule 31.5(a)(2) is merely the remedy for time limits exceeded under Rule 31.3(e) or emergency Rule 46.2, and that the extended 90/120-day limits governed. The petition was denied because applicant failed to show irreparable harm or significant prejudice.

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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