WCPanelIQ
PanelQMEMed-legalGranted

Fernando Yanes — ADJ15870256

FERNANDO YANES, Applicant vs. VALLEY CHILDREN’S HOSPITAL; SAFETY NATIONAL CASUALTY CORPORATION, Defendants

ADJ number
ADJ15870256
Decision date
May 22, 2023
District office
Fresno
WCJ
—
Claim administrator
Safety National Casualty Corporation
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: left knee

LC §4060LC §4061LC §4062LC §4062.1LC §4062.2LC §139.2LC §5904LC §5909CCR §10305

Summary

Applicant Fernando Yanes, a respiratory therapist, sustained an admitted left knee injury on October 24, 2021, with defendant disputing the nature and extent (specifically ACL findings and need for surgery). While unrepresented, applicant requested and received QME panel no. 2802519 in orthopedics under section 4062.1, but never attended an evaluation. After retaining counsel, applicant requested and received a new panel (no. 2839682) in chiropractic medicine, which the WCJ invalidated, ordering the parties to restart the panel process under section 4062.2. The Board granted reconsideration, applied the removal standard, and held that because applicant had not yet received a QME evaluation before becoming represented, he was entitled to a new panel under Romero and Luckhardt without reinitiating the dispute resolution process. The Board amended the F&O to find panel no. 2839682 validly obtained and rescinded the orders requiring a new panel.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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