WCPanelIQ
PanelQMEMed-legalGranted in Part

Ruben Ceballos — ADJ12559747, ADJ12573699

RUBEN CEBALLOS, Applicant vs. ACCESS TO INDEPENDENCE OF SAN DIEGO; OAK RIVER INSURANCE COMPANY, c/o BERKSHIRE HATHAWAY HOMESTATE COMPANIES, Defendants

ADJ number
ADJ12559747, ADJ12573699
Decision date
Apr 3, 2022
District office
San Diego
WCJ
—
Claim administrator
Berkshire Hathaway Homestate Companies (administering for Oak River Insurance Company)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSÉ H. RAZO, COMMISSIONER, DEIDRA E. LOWE, COMMISSIONER

Injury / body parts: psyche, bilateral upper extremities, bilateral hands, fingers

LC §139.3LC §5310LC §5313LC §5502LC §5705LC §5708LC §5709LC §5904CCR §31.3CCR §31.5CCR §46.2CCR §46.3CCR §10955

Summary

Applicant Ruben Ceballos claimed psychiatric and bilateral upper extremity injuries while employed by Access to Independence of San Diego. After the psychology QME, Dr. Mednitsky, would only conduct a re-evaluation by telehealth and applicant refused to agree, defendant requested and obtained a replacement QME panel from the Medical Unit rather than presenting the telehealth dispute to the WCAB. The WCJ found defendant was not entitled to a replacement panel, and defendant sought reconsideration, also challenging the WCJ's admission of a post-MSC letter from Dr. Mednitsky. The Board granted reconsideration solely to add an order formally admitting applicant's Exhibit 3 into evidence, but otherwise affirmed, holding that the proper remedy for a disputed telehealth evaluation under AD Rule 46.2 is an objection and DOR to the WCAB, not a replacement panel, and that AD Rule 31.5(a)(2)'s scheduling timeframe applies only to initial appointments, not re-evaluations.

Issues

Member is $25/month or $250/year and includes full case search.

Holding

Member is $25/month or $250/year and includes full case search.

Analysis

Member is $25/month or $250/year and includes full case search.

Applicant takeaway

Member is $25/month or $250/year and includes full case search.

Defense takeaway

Member is $25/month or $250/year and includes full case search.

Provider takeaway

Member is $25/month or $250/year and includes full case search.

Similar decisions

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.