What the panel ordered
Petition for Reconsideration denied
Petition for Reconsideration of the Findings and Order issued on July 22, 2025, treated as Petition for Removal and denied under removal standard
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
Dr. Kim prescribed narcotic pain medication to applicant, violating AD Rule 41(a)(4), causing reasonable doubt about his impartiality and integrity, leading to disqualification as QME.
From the decision · page 1Applicant seeks removal of the Findings and Order (F&O) issued on July 22, 2025, wherein the workers' compensation administrative law judge (WCJ) found that (1) while employed as a professional athlete during the period of June 16, 2004 through July 15, 2010, applicant claims to have sustained injury arising out of and in the course of employment to the shoulders, elbows, wrists, hands, fingers, thoracic spine, lumbar spine, cervical spine, hips, feet, ankles, knees, and head; (2) at the time of injury, the employer's workers' compensation earner was Ace American Insurance, administered by Sedgwick Claims Management Services, Inc.; (3) Dr. David Kim is disqualified as the Qualified Medical Examiner (QME) for violating AD Rule 41(a)(4); and (4) the reports of Dr. Kim can be sent to a subsequent examiner.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Kim prescribed narcotic pain medication to applicant on January 31, 2020, which was undisclosed in his medical report and inconsistent with his findings on treatment needs.
Favours Defendant prevailed
This conduct violated AD Rule 41(a)(4) and caused reasonable doubt about Dr. Kim's impartiality and integrity, leading to his disqualification as QME.
From the decision · page 1Applicant seeks removal of the Findings and Order (F&O) issued on July 22, 2025, wherein the workers' compensation administrative law judge (WCJ) found that (1) while employed as a professional athlete during the period of June 16, 2004 through July 15, 2010, applicant claims to have sustained injury arising out of and in the course of employment to the shoulders, elbows, wrists, hands, fingers, thoracic spine, lumbar spine, cervical spine, hips, feet, ankles, knees, and head; (2) at the time of injury, the employer's workers' compensation earner was Ace American Insurance, administered by Sedgwick Claims Management Services, Inc.; (3) Dr. David Kim is disqualified as the Qualified Medical Examiner (QME) for violating AD Rule 41(a)(4); and (4) the reports of Dr. Kim can be sent to a subsequent examiner.
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Dr. Kim prescribed narcotic pain medication to applicant, which was undisclosed in his report and inconsistent with his findings on current and future treatment needs, leading to his disqualification as QME for conflict of interest.
Violation of AD Rule 41(a)(4) by prescribing narcotic medication and failure to disclose treatment in report, causing reasonable doubt about impartiality.
From the decision · page 1Applicant seeks removal of the Findings and Order (F&O) issued on July 22, 2025, wherein the workers' compensation administrative law judge (WCJ) found that (1) while employed as a professional athlete during the period of June 16, 2004 through July 15, 2010, applicant claims to have sustained injury arising out of and in the course of employment to the shoulders, elbows, wrists, hands, fingers, thoracic spine, lumbar spine, cervical spine, hips, feet, ankles, knees, and head; (2) at the time of injury, the employer's workers' compensation earner was Ace American Insurance, administered by Sedgwick Claims Management Services, Inc.; (3) Dr. David Kim is disqualified as the Qualified Medical Examiner (QME) for violating AD Rule 41(a)(4); and (4) the reports of Dr. Kim can be sent to a subsequent examiner.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Cal. Code Regs., tit. 8, 41(a)(4)
AD Rule 41(a)(4) prohibits QMEs from treating or soliciting to provide medical treatment to the injured worker.
Dr. Kim's prescription of narcotic medication violated this rule, leading to disqualification.
From the decision · page 1Applicant seeks removal of the Findings and Order (F&O) issued on July 22, 2025, wherein the workers' compensation administrative law judge (WCJ) found that (1) while employed as a professional athlete during the period of June 16, 2004 through July 15, 2010, applicant claims to have sustained injury arising out of and in the course of employment to the shoulders, elbows, wrists, hands, fingers, thoracic spine, lumbar spine, cervical spine, hips, feet, ankles, knees, and head; (2) at the time of injury, the employer's workers' compensation earner was Ace American Insurance, administered by Sedgwick Claims Management Services, Inc.; (3) Dr. David Kim is disqualified as the Qualified Medical Examiner (QME) for violating AD Rule 41(a)(4); and (4) the reports of Dr. Kim can be sent to a subsequent examiner.
Cal. Code Regs., tit. 8, 41.5(d)(4)
A disqualifying conflict of interest exists where a QME's actions raise reasonable doubts about their ability to act with integrity and impartiality.
Dr. Kim's undisclosed treatment caused reasonable doubt about his impartiality, justifying disqualification.
From the decision · page 1Applicant seeks removal of the Findings and Order (F&O) issued on July 22, 2025, wherein the workers' compensation administrative law judge (WCJ) found that (1) while employed as a professional athlete during the period of June 16, 2004 through July 15, 2010, applicant claims to have sustained injury arising out of and in the course of employment to the shoulders, elbows, wrists, hands, fingers, thoracic spine, lumbar spine, cervical spine, hips, feet, ankles, knees, and head; (2) at the time of injury, the employer's workers' compensation earner was Ace American Insurance, administered by Sedgwick Claims Management Services, Inc.; (3) Dr. David Kim is disqualified as the Qualified Medical Examiner (QME) for violating AD Rule 41(a)(4); and (4) the reports of Dr. Kim can be sent to a subsequent examiner.
Cal. Code Regs., tit. 8, 31.5(a)(13)
Petition for removal of a QME may be granted if there is a disqualifying conflict of interest as defined by AD Rule 41.5.
The petition was evaluated under this standard and denied as removal was not warranted.
From the decision · page 1Applicant seeks removal of the Findings and Order (F&O) issued on July 22, 2025, wherein the workers' compensation administrative law judge (WCJ) found that (1) while employed as a professional athlete during the period of June 16, 2004 through July 15, 2010, applicant claims to have sustained injury arising out of and in the course of employment to the shoulders, elbows, wrists, hands, fingers, thoracic spine, lumbar spine, cervical spine, hips, feet, ankles, knees, and head; (2) at the time of injury, the employer's workers' compensation earner was Ace American Insurance, administered by Sedgwick Claims Management Services, Inc.; (3) Dr. David Kim is disqualified as the Qualified Medical Examiner (QME) for violating AD Rule 41(a)(4); and (4) the reports of Dr. Kim can be sent to a subsequent examiner.
What proof carried it
The evidence the panel weighed, by kind.
Dr. Kim prescribed narcotic pain medication to applicant, which was undisclosed in his report and inconsistent with his findings on current and future treatment needs.
From the decision · page 1Applicant seeks removal of the Findings and Order (F&O) issued on July 22, 2025, wherein the workers' compensation administrative law judge (WCJ) found that (1) while employed as a professional athlete during the period of June 16, 2004 through July 15, 2010, applicant claims to have sustained injury arising out of and in the course of employment to the shoulders, elbows, wrists, hands, fingers, thoracic spine, lumbar spine, cervical spine, hips, feet, ankles, knees, and head; (2) at the time of injury, the employer's workers' compensation earner was Ace American Insurance, administered by Sedgwick Claims Management Services, Inc.; (3) Dr. David Kim is disqualified as the Qualified Medical Examiner (QME) for violating AD Rule 41(a)(4); and (4) the reports of Dr. Kim can be sent to a subsequent examiner.
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
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