WCPanelIQ
PanelQMEMed-legalDenied

Cecil Lopez — ADJ8919280

CECIL LOPEZ, Applicant vs. GALE BANK ENGINEERING; MITSUI SUMITOMO INSURANCE COMPANY OF AMERICA, Defendants

ADJ number
ADJ8919280
Decision date
Jul 21, 2021
District office
Los Angeles
WCJ
—
Claim administrator
Mitsui Sumitomo Insurance Company of America
Commissioners
DEIDRA E. LOWE, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, AMBER INGELS, DEPUTY COMMISSIONER

Injury / body parts: orthopedic (musculoskeletal)

LC §5904CCR §10843CCR §10955

Summary

Applicant Cecil Lopez filed a Petition for Removal challenging the WCJ's April 27, 2021 Findings and Order, specifically a finding regarding whether defendant Mitsui Sumitomo was entitled to an additional QME panel in orthopedic surgery. Because the WCJ's decision included a finding on a threshold issue, the Appeals Board treated the petition as one seeking reconsideration, but because the applicant only disputed an interlocutory issue, the Board applied the removal standard. The Board found that applicant failed to demonstrate significant prejudice or irreparable harm, or that reconsideration would not be an adequate remedy. The Board also noted that the record did not reflect an affirmative agreement by defendant Mitsui to the agreed medical evaluator used by applicant and co-defendant Fireman's Fund. The petition was denied.

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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