WCPanelIQ
PanelQMEMed-legalGranted

Amarjeet Gill — ADJ12918124

AMARJEET GILL, Applicant vs. COUNTY OF FRESNO; permissibly self-insured, administered by AIMS, Defendants

ADJ number
ADJ12918124
Decision date
Feb 24, 2021
District office
Fresno
WCJ
—
Claim administrator
AIMS (administrator for permissibly self-insured County of Fresno)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, DEIDRA E. LOWE, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: left shoulder, neck, lower back, shoulders, wrists, hands, diabetes, alopecia, hiatal hernia, bilateral wrists, bilateral hands

LC §4060LC §4061LC §4062LC §4062.2LC §4062.3LC §4064LC §4620LC §5401LC §5402LC §5404LC §5813LC §5904CCR §30CCR §35.5CCR §9812CCR §10421CCR §10500CCR §10507CCR §10561CCR §10605CCR §10628CCR §10843CCR §10955

Summary

Applicant, a district attorney investigator for the County of Fresno, filed three injury claims. After filing a DWC-1 claim form for a 2019 cumulative trauma, applicant's attorney sent a January 23, 2020 letter demanding a medical-legal evaluation under sections 4060 and 4062.2, then requested a QME panel after waiting 15 days. The WCJ found the letter insufficient to trigger the 10-day period. On reconsideration, the Appeals Board rescinded the F&O, holding that the January 23 letter was a legally sufficient request for a medical evaluation and that applicant's initial panel request (resulting in replacement panel 2533182) was valid. The Board found defendant's later-obtained panel 7328637 invalid because both cumulative trauma claims must be evaluated using panel 2533182 per sections 4062.3 and 4064, and denied applicant's request for attorney's fees for lack of evidence of bad faith.

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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