WCPanelIQ
PanelQMEMed-legalGranted

Tiller Kelley, Heather

HEATHER TILLER KELLEY, Applicant vs. SACRAMENTO CITY UNIFIED SCHOOL DISTRICT, permissibly self-insured, Defendants

ADJ number
ADJ18027061
Decision date
Jun 9, 2025
District office
Sacramento
WCJ
—
Claim administrator
Sacramento City Unified School District (permissibly self-insured)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: low back, neck, stress/psyche, stroke, brain, head, face, speech, bilateral upper extremities, bilateral lower extremities, circulatory system, nervous system

LC §4062.2LC §4062.3LC §4060LC §4061LC §4064LC §4600LC §4616LC §4620LC §5307.6LC §5703LC §5900LC §5902LC §5903LC §5909LC §3202.5CCR §9785CCR §9767.9CCR §10955

Summary

Applicant Heather Tiller Kelley sought reconsideration of a March 20, 2025 F&O in which the WCJ found her primary treating physician (Dr. Zuber) and two secondary treating physicians (Drs. Pasek and Maasumi) had not established treatment relationships, deemed their comprehensive medical-legal reports obtained in violation of Labor Code section 4062.2(a), and excluded them from evidence and from submission to QMEs/AMEs. Defendant had denied all liability on August 9, 2023, then partially admitted the low back claim on March 27, 2024, but never offered medical treatment or sought to transfer care into an MPN. The Appeals Board, applying the removal standard to the interlocutory evidentiary issue, held that because defendant relinquished medical control by denying the claim and never offered treatment or MPN access, applicant was entitled to self-procure treatment and obtain treating physician reports. The Board rescinded the F&O and substituted orders allowing the treating physician reports to be submitted to properly selected QMEs and AMEs. The petition was granted.

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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