Mendoza A En Banc Re Ad Rule 30(d)(3) (6 2 10 Final Draft)

Applicant Amelia Mendoza, a hospital patient care associate, allegedly suffered industrial injuries from a patient attack and later collapsed into a comatose state from an intracerebral hemorrhage. Defendant Huntington Hospital (through Sedgwick) timely denied both claims within 90 days. After applicant's treating physician found the injuries industrial, defendant initiated the AME/QME process to obtain a compensability evaluation, but applicant argued AD Rule 30(d)(3) barred defendant from requesting a panel QME because injury had been denied. The Appeals Board, sitting en banc, held that AD Rule 30(d)(3) is invalid because it conflicts with Labor Code sections 4060(c) and 4062.2 and exceeds the scope of section 5402(b), since those statutes allow 'either party' to request a QME panel 'at any time' after the claim form is filed. The Board affirmed the WCJ's order allowing defendant to obtain a panel QME on compensability and remanded for further proceedings.