WCPanelIQ
PanelQMEMed-legalRemanded

Danielle Manning — ADJ9607300

DANIELLE MANNING, Applicant vs. CONIFER HEALTH SOLUTIONS, permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number
ADJ9607300
Decision date
Dec 22, 2021
District office
Santa Ana
WCJ
—
Claim administrator
Sedgwick Claims Management Services
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: psyche, headaches, right index finger

LC §4050LC §4060LC §4061LC §4062LC §4062.2LC §4605LC §4610LC §4656LC §5412LC §5701LC §5703LC §5903LC §5904LC §5906LC §5952CCR §31.5CCR §35CCR §41CCR §41.5CCR §10955

Summary

The WCJ found applicant Danielle Manning temporarily totally disabled for two periods based on the 2020 reporting of Jeffrey Bone, Psy.D., after rejecting the psychiatric QME (Dr. Watkin) reports as unsubstantial due to perceived bias. Defendant sought reconsideration, arguing Dr. Bone's reporting could not support the award and that the order returning the parties to Dr. Bone violated due process. The Appeals Board determined Dr. Bone's role was unclear—he originally evaluated applicant at defendant's request under section 4050, was not properly designated a treating physician until at least August 2020, and was not appointed as a regular physician under section 5701 or a medical-legal evaluator under section 4062.2. The Board held Dr. Bone's 2020 reporting could not be the sole evidentiary basis for the temporary disability award. The Board rescinded the December 11, 2020 F&A and remanded for further discovery, recommending consideration of a replacement QME panel or an AME.

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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