WCPanelIQ
PanelQMEMed-legalGranted

Mark James — ADJ11340780, ADJ12409465, ADJ13306184

MARK JAMES, Applicant vs. ALAMEDA SUPERIOR COURT, legally uninsured, adjusted by ACCLAMATION INSURANCE MANAGEMENT SERVICES, Defendants

ADJ number
ADJ11340780, ADJ12409465, ADJ13306184
Decision date
Sep 16, 2021
District office
Oakland
WCJ
Lilla J. Szelenyi
Claim administrator
Acclamation Insurance Management Services
Commissioners
—

Injury / body parts: low back

Summary

Applicant Mark James had three claims (a specific October 19, 2017 low back injury, a specific June 24, 2019 injury, and a cumulative trauma through October 19, 2017) addressed by an AME, Dr. Atkin, who physically examined applicant only once in 2019 before deciding to retire from workers' compensation practice. Dr. Atkin issued supplemental reports, including a September 14, 2020 report declaring applicant permanent and stationary and addressing permanent disability and causation, all without re-examining applicant. The WCJ found Dr. Atkin's later reports did not constitute substantial medical evidence because they lacked a current physical examination and ordered the case restarted with a new AME or panel QME. Defendant filed a Petition for Removal. The WCAB granted removal, rescinded the WCJ's July 16, 2021 decision, and returned the matter to the WCJ to determine whether Dr. Atkin remained available to examine applicant.

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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