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PanelQMEMed-legalGranted

Orozco, Gabriel

GABRIEL OROZCO, Applicant vs. HEALTHVIEW INC., dba HARBOR VIEW HOUSE; ZURICH AMERICAN INSURANCE COMPANY; CYPRESS INSURANCE COMPANY, administered by, BERKSHIRE HATHAWAY, Defendants

ADJ number: ADJ11930717
Decision date: Oct 22, 2025
District office: Van Nuys
WCJ: —
Claim administrator: Berkshire Hathaway (administering Cypress Insurance Company); Zurich American Insurance Company
Commissioners: ANNE SCHMITZ, DEPUTY COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: internal/diabetes, internal medicine system

LC §4062LC §4060LC §5813CCR §10955CCR §9785CCR §31.7CCR §10787

Summary

Applicant Gabriel Orozco sought an additional QME panel in internal medicine to address an alleged diabetes injury, after the current QME stated diabetes was outside their area of expertise. The WCJ denied the request, finding no good cause because applicant had not provided medical evidence (complaints or diagnosis) of diabetes. The Appeals Board granted removal, finding the WCJ's denial was based on legal error that precluded applicant from completing discovery, constituting irreparable harm. Following the reasoning in Salcido v. Waste Management, the Board held that asking the currently serving QME whether they can address all disputed issues is a valid way to show good cause for an additional panel under Rule 31.7(b). The Board rescinded the F&O and substituted a finding that good cause exists for an additional internal medicine panel.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.