Salcido v. Waste Management Collection and Recycling (2024 Cal. Wrk. Comp. P.D. LEXIS 63)

The WCAB held that an applicant who filed a claim alleging orthopedic and internal injuries was entitled to an additional QME panel in internal medicine per CCR §31.7(b) when the orthopedic QME testified that it would be appropriate for an internist or appropriate specialist to evaluate him.

The WCAB explained that obtaining the opinion of the primary treating physician, then objecting per LC §4062 is one way to show good cause for an additional panel pursuant to CCR §31.7(b).

The WCAB explained that another way is to ask the currently serving QME(s) whether they are capable of commenting on all disputed issues in the case, and if they are not capable of resolving all disputed medical issues, good cause exists to order an additional panel.

The WCAB recognized that although that could allow an applicant to obtain an additional panel by simply alleging a body part without any medical evidence of industrial injury, in many cases, the applicant’s initial QME appointment is obtained based solely on allegations of injury, without any reporting of a primary treating physician. Allegations of injury to other body systems should be treated the same.

The WCAB added that the need for expeditious resolution of cases is paramount, and sufficient remedies exist to combat the rare cases in which a litigant requests additional panels frivolously or in bad faith.

The WCAB concluded that because the orthopedic physician already explained that the applicant’s internal medical complaints were outside his area of expertise, there was good cause for an additional panel in internal medicine.