WCPanelIQ
PanelQMEMed-legalGranted in Part

Carla Miller Clark — ADJ9582709

CARLA MILLER LARK, Applicant vs. STARS BEHAVIORAL HEALTH GROUP; NEW HAMPSHIRE INSURANCE COMPANY, administered by ACE USA/ESIS, Defendants

ADJ number
ADJ9582709
Decision date
Jan 12, 2022
District office
Anaheim
WCJ
—
Claim administrator
ACE USA/ESIS (administering for New Hampshire Insurance Company)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, DEIDRA E. LOWE, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: neck, back, legs, psyche, knees, feet, left knee, left foot

LC §139.2LC §3202.5LC §3208.3LC §3600LC §4062.1LC §4062.2LC §5313LC §5701LC §5702LC §5705LC §5903LC §5906LC §5952CCR §31.5CCR §35CCR §40CCR §41CCR §41.5CCR §10787

Summary

Applicant Carla Miller Lark, a mental health specialist, claimed multiple injuries including a cumulative trauma claim with a psychiatric component (ADJ9582709). After applicant became pro per, the WCJ replaced the orthopedic AME Dr. Aval with a regular physician based on applicant's allegations of bias and fraud, found a compensable psychiatric injury AOE/COE, and awarded temporary disability. Defendant sought reconsideration. The Board held the WCJ erred in removing Dr. Aval because, under Labor Code section 4062.2(f), an AME agreement reached while applicant was represented can only be canceled by mutual written consent, and applicant admitted she had no specific evidence of race- or gender-based bias. The Board also found the record lacked substantial medical evidence on psychiatric causation, given Dr. Tang's confusing and shifting opinions. The Board rescinded the Joint F&A, ordered Dr. Aval to continue as the AME, retained the statute of limitations findings, dismissal, and evidentiary rulings, and deferred remaining issues for further development of the record.

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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