WCPanelIQ
PanelQMEMed-legalGranted in Part

Theresa Rocha — ADJ11672907

THERESA ROCHA, Applicant vs. MAS LI, INC., dba MCDONALDS; SAFETY NATIONAL CASUALTY CORPORATION, adjusted by BROADSPIRE, Defendants

ADJ number
ADJ11672907
Decision date
Aug 5, 2026
District office
Salinas
WCJ
—
Claim administrator
Broadspire (TPA for Safety National Casualty Corporation)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: right ankle, right foot, left foot, left leg, psyche

LC §5900LC §5903LC §5410LC §5803LC §5811LC §5708LC §5709LC §5407CCR §10605CCR §10600CCR §31.7

Summary

Applicant Theresa Rocha, a McDonald's cashier who sustained an admitted right ankle/foot injury on February 14, 2017 with a 46% PD stipulated award, sought reconsideration of a June 14, 2022 F&O denying her a psyche QME panel, finding no psyche injury or new and further disability, and refusing liability for her vocational expert's report. The orthopedic AME, Dr. Feinberg, diagnosed CRPS with a psyche comorbidity and testified during his March 11, 2021 deposition that input from a psychiatric evaluator was needed to assess whether applicant would be off task due to pain. The Board rescinded the F&O, finding good cause for issuance of an additional psyche QME panel, holding defendant liable for the vocational expert costs, and deferring the underlying psyche injury and reopening issues. The Board reasoned that the WCJ improperly relied on the orthopedic AME to decide the psyche issue and failed to develop the record. The Board also confirmed the petition was timely because the claims administrator was served in Kentucky, extending the deadline by 10 days.

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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