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Allison Macleod — ADJ21245209

ALLISON MACLEOD, Applicant vs. KAWEAH DELTA HEALTHCARE DISTRICT, permissibly self-insured, administered by TRISTAR RISK MANAGEMENT, Defendants

ADJ number
ADJ21245209
Decision date
Aug 13, 2026
District office
Fresno
WCJ
—
Claim administrator
TRISTAR Risk Management (administering for Kaweah Delta Healthcare District, permissibly self-insured)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: bilateral shoulders, left arm

LC §5909LC §5900LC §5310LC §3209.10LC §4062LC §4062.1LC §5900CCR §9785

Summary

Applicant Allison MacLeod, a registered nurse, sustained admitted industrial injury to her bilateral shoulders on November 29, 2021. While unrepresented, she received treatment from nurse practitioner Barbara Uichanco under the review of Dr. William Roach, and after Uichanco's report the defendant objected and initiated the QME process, resulting in applicant selecting QME orthopedist Dr. William Bolling, who examined her and issued two reports. After becoming represented, applicant objected to Dr. Bolling, and the WCJ found Dr. Roach was not the primary treating physician, invalidated the QME panel, and excluded Dr. Bolling's reports. The WCAB granted reconsideration and reversed, holding that under Labor Code section 3209.10 the supervising physician (Dr. Roach) is deemed the treating physician when a nurse practitioner provides care, and that AD Rule 9785 must be harmonized with the statute. The Board also found applicant waived any irregularities by participating in the QME process and that requiring a new evaluator would cause prejudice. The Findings and Order was rescinded and a new decision issued finding Dr. Roach was the primary treating physician and Dr. Bolling should continue as QME.

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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