An En Banc decision of the Workers’ Compensation Appeals Board (WCAB) on return to Qualified Medical Evaluator

• Posted By: Harvey Brown
• April 1, 2014

This is an En Banc decision of the WCAB

This is a very significant case for workers’ compensation principles.

The applicant was a police officer. The applicant filed a cumulative trauma. The applicant was referred to a Qualified Medical Evaluator (QME) for this injury.

Thereafter, the applicant had two subsequent claims of injury. These involved the same parts of the body as the original injury.

The defendant petitioned to have the original QME evaluate the two subsequent injuries but did not seek to have the applicant reevaluated for the original injury.

The case went to trial on the sole issue of whether the applicant had to return to the original QME for the two subsequent dates of injury. The Workers’ Compensation Judge (WCJ) ruled that the applicant was entitled to a new panel QME for the two subsequent injuries. The defendant filed a Petition For Removal and The WCAB issued this En Banc decision.

The WCAB reviewed rule 35(c). They also reviewed Labor Code Sections 4060, 4062.2, 4062.3 and 4064. Because the two specific claims were reported after the original QME evaluation and before a reevaluation the WCAB determined the applicant was entitled to a new QME. HB

Case:

• Posted In: Medical Treatment, Work Injury