WCPanelIQ
PanelQMEMed-legalGranted

Adriana Gonzalez — ADJ14413931

ADRIANA GONZALEZ, Applicant vs. HUNTINGTON DRIVE HEALTH REHABILITATION; LIBERTY MUTUAL INSURANCE, Defendants

ADJ number
ADJ14413931
Decision date
Oct 17, 2021
District office
Van Nuys
WCJ
—
Claim administrator
Liberty Mutual Insurance
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, PATRICIA A. GARCIA, DEPUTY COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER

Injury / body parts: back

LC §4060LC §4061LC §4062LC §4062.2LC §5705CCR §30.5CCR §31.1CCR §31.5CCR §10605CCR §10507CCR §10843CCR §10955

Summary

Applicant Adriana Gonzalez, a nurse's assistant claiming back injury, sought removal of a WCJ's F&O that struck QME panel number 7413157 as improperly obtained under Labor Code section 4062.2. The WCJ found applicant obtained the chiropractic panel before defendant denied the claim and without any party requesting a medical evaluation. The Board granted removal, finding that defendant's April 23, 2021 delay letter—which stated a med-legal examination was needed—constituted a 'mailing of a request for a medical evaluation' under section 4062.2(b), and applicant properly waited the requisite time before requesting the panel on May 19, 2021. The Board further found defendant failed to meet its burden of showing the chiropractic specialty was inappropriate. The F&O was rescinded and a new decision substituted finding the panel was properly obtained and the parties were ordered to use it.

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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