WCPanelIQ
PanelQMEMed-legalIBRRemanded

Ashley Thurmond — ADJ19265320, ADJ19267101

ASHLEY THURMOND, Applicant vs. SANTA CLARA VALLEY TRANSPORTATION AUTHORITY, permissibly self-insured, adjusted by TRISTAR, Defendants

ADJ number
ADJ19265320, ADJ19267101
Decision date
Jul 29, 2026
District office
San Jose
WCJ
—
Claim administrator
Tristar (TPA for Santa Clara Valley Transportation Authority, permissibly self-insured)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, PAUL F. KELLY, COMMISSIONER
LC §4603LC §4622LC §5702

Summary

Cost petitioner Jack Yen, M.D., a QME, sought reconsideration of an October 22, 2025 Joint Findings of Fact and Order in which the WCJ found that defendant's $4,946.26 payment for Dr. Yen's QME report was not unreasonably delayed, that any payment dispute belonged in the Independent Bill Review process under Labor Code section 4603, and denied claims for interest, penalties, sanctions, and attorney fees. The Board issued an interim non-final order on January 30, 2026 granting the petition, deferring a final decision, and encouraging mediation. The parties participated in voluntary mediation and filed a signed Stipulation to Remand the matter to the trial level to develop the record on whether defendant was obligated to file a Petition for Determination of Medical-Legal Expense Dispute and concurrent Declaration of Readiness within 60 days of the provider's objection under section 4622. The Board approved the Stipulation under section 5702, rescinded the F&O, and returned the matter to the WCJ for further proceedings, expressly noting this was not a decision on the merits.

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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