WCPanelIQ
PanelQMEMed-legalGranted

Gilroy, Christine

CHRISTINE GILROY, Applicant vs. KAISER PERMANENTE, permissibly self-insured, administered by SEDGWICK CMS, Defendants

ADJ number
ADJ15590671
Decision date
Sep 24, 2025
District office
Van Nuys
WCJ
—
Claim administrator
Sedgwick CMS (administering for Kaiser Permanente, permissibly self-insured)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER
LC §5701LC §5906CCR §10955CCR §10682

Summary

Defendant Kaiser Permanente (self-insured, administered by Sedgwick CMS) petitioned for removal from a WCJ's May 31, 2024 Orders that vacated submission, struck the QME reports of Dr. Darakjian as not substantial medical evidence, and ordered development of the record. The Appeals Board granted removal, finding substantial prejudice or irreparable harm resulted from the order striking the QME reports because the parties could be forced to conduct discovery without those records. The Board affirmed the WCJ's Orders except it amended Order #2 to clarify that the QME reports are not stricken but rather are simply not substantial medical evidence, and that returning to the current QME would not be fruitful. The Board emphasized that whether a report is substantial evidence goes to its weight, not its admissibility, so insubstantial reports remain in the record. The WCJ's decision to develop the record, potentially through a regular physician under Labor Code section 5701, was found prudent.

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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