In the matter of Hugo Cisneros the applicant filed a claim for specific injury to his low back while performing lifting activities at the insured, Bayview Vineyards Corporation. Applicant’s counsel submitted a request for QME panel list in the field of chiropractic medicine. Nine days later defendants submitted a response to the medical unit submitting a request for assignment of QME panel in Spine. Defendant’s request enclosed a copy of the treating physicians permanent and stationary report as well as diagnostic MRI testing of the lumbar spine which indicated a disk herniation. The report of the treating physician also indicated that applicant would have a right to future spinal surgery. In response, the medical unit issued a panel QME list in the field of Spine. The parties each struck a physician. Applicant’s counsel advised defendant’s by correspondence that the applicant would not attend the evaluation with the spinal QME. Applicant’s counsel filed a declaration of readiness to proceed on the spinal QME dispute. In response defendants filed a petition to compel the applicant’s attendance at the spinal QME appointment with Dr. David Osborne. Applicant attended the appointment with Dr. Osborne and a report issued without objection from applicant’s counsel. Applicant’s counsel refused to acknowledge the report and instead proceeded to mandatory settlement conference arguing that the report was issued in the incorrect specialty.
Just prior to the mandatory settlement conference applicant’s counsel obtained a new panel QME list from the medical unit in the field of chiropractic medicine. However, the medical unit issued this lists based on inaccurate representations of fact in applicant’s attorney’s request for the list.
The matter was set for trial on the issue of the correct panel QME specialty. The matter proceeded to trial on October 6, 2014. Defendants argued not only that pursuant to the CCR that the medical unit had initially issued the correct medical specialty based on their review of the medical reporting but that since applicant had attended the QME evaluation with Dr. Osborne and that a report issued timely; the parties were required to resolve any further disputes with Dr. Osborne under labor code section 4062.3 (K).
Judge Casey at the San Francisco Worker’s Compensation appeals Board agreed with defendants and ruled that the correct QME specialty in this case was Spinal medicine and that Dr. Osborne would serve as the QME for all purposes in this case.
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