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Fernando Jauregui — ADJ12570636

FERNANDO JAUREGUI, Applicant vs. HAMSTRA DAIRY, permissibly self-insured, administered by INTERCARE HOLDINGS INSURANCE SERVICES, INC., Defendants

ADJ number
ADJ12570636
Decision date
Dec 22, 2021
District office
Fresno
WCJ
—
Claim administrator
Intercare Holdings Insurance Services, Inc.
Commissioners
CRAIG SNELLINGS, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: back, legs

LC §4062.3LC §5313LC §5903LC §5952CCR §31.5CCR §10787

Summary

Applicant Fernando Jauregui sought removal of a WCJ's September 21, 2021 Order that struck the reports and deposition of QME Dr. Timothy Butler and ordered restitution of his fees (except deposition fee). Defendant had petitioned to strike Dr. Butler's reporting, arguing he was not objective due to 'egregious billing practices.' The Appeals Board granted removal, finding the Order was issued without an evidentiary record, making it impossible to assess whether the decision was supported by substantial evidence. The Board noted that a QME billing dispute is not among the 16 enumerated grounds for a replacement panel under AD Rule 31.5(a), nor did it involve ex parte communication under section 4062.3(g). The Board rescinded the Order and returned the matter to the trial level for further proceedings.

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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