Authorities as the decision cited them, with how this panel applied each one.
Cal. Code Regs., tit. 8, 31.7
Administrative Director Rule 31.7(b) regarding issuance of additional QME panels in different specialties upon showing of good cause.
The Board found good cause for additional QME panels in neurology and psychology based on the orthopedic QME's deferral.
From the decision · page 4Administrative Director (AD) Rule 31.7(b) provides for an additional QME panel in
another specialty as follows in relevant part:
Lab. Code, 4062.2
Labor Code section 4062.2 governing medical-legal evaluation process when parties do not agree on AME.
The Board applied this statute in the context of denied liability and need for additional panels.
From the decision · page 5Labor Code section 4062.2 governs the process to obtain a medical-legal evaluation from
a panel QME in a represented case if the parties do not agree on an agreed medical evaluator
(AME). (Lab. Code, § 4062.2.) Defendant has denied liability for applicant's claimed injuries. (Ex
A, Notice of Denial of Claim, dated November 9, 2020.) In the absence of additional panels in
neurology and psychology, applicant is prevented from conducting the medical-legal discovery
necessary to determine compensability for the claimed injury. We therefore agree with applicant
that additional QME panels in neurology and psychology are appropriate. (See McClune v.
Workers' Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261];
Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389, 394 [62 Cal.Comp.Cases 924];
Lab. Code, § 5701, 5906 [the Appeals Board has the discretionary authority to develop the record
when the medical record is not substantial evidence or when appropriate to provide due process or
fully adjudicate the issues].)
Lab. Code, 5701
Labor Code sections 5701 and 5906 authorizing the Appeals Board to develop the record and provide due process.
The Board exercised discretionary authority to issue additional panels to fully adjudicate the issues.
From the decision · page 5Labor Code section 4062.2 governs the process to obtain a medical-legal evaluation from
a panel QME in a represented case if the parties do not agree on an agreed medical evaluator
(AME). (Lab. Code, § 4062.2.) Defendant has denied liability for applicant's claimed injuries. (Ex
A, Notice of Denial of Claim, dated November 9, 2020.) In the absence of additional panels in
neurology and psychology, applicant is prevented from conducting the medical-legal discovery
necessary to determine compensability for the claimed injury. We therefore agree with applicant
that additional QME panels in neurology and psychology are appropriate. (See McClune v.
Workers' Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261];
Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389, 394 [62 Cal.Comp.Cases 924];
Lab. Code, § 5701, 5906 [the Appeals Board has the discretionary authority to develop the record
when the medical record is not substantial evidence or when appropriate to provide due process or
fully adjudicate the issues].)