ADJ14784661 — California WCAB decision

ADJ14784661 · August 1, 2025

Petition for reconsideration dismissed; petition for removal granted; May 8, 2025 F&O rescinded and restated to find good cause for issuance of additional QME panels in neurology and psychiatry; Medical Director ordered to issue panels within 30 days.

Issues decided

Medical opinions weighed

Authorities named

District office

Van Nuys

What the panel ordered

Applicant sought reconsideration of the May 8, 2025 Findings of Fact and Orders (F&O) regarding issuance of additional QME panels in neurology and psychiatry; the WCJ had ordered an additional panel in neurology but denied psychiatry; the WCAB dismissed the petition for reconsideration as interlocutory but granted removal to rescind and restate the F&O to include psychiatry.

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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.

QME/AME processApplicant prevailedneurology · psychiatry

The WCAB found good cause for issuance of additional QME panels in both neurology and psychiatry based on the record, including applicant's testimony, prior QME reports documenting psychiatric complaints, and procedural history.

From the decision · page 4evaluate his claimed injury. Orthopedic QME Andrew Rah, M.D. has documented applicant's complaints of depression and anxiety in reporting dated August 30, 2021 and March 7, 2022. (Ex. X2, Report of Andrew Rah, M.D., dated August 30, 2021, at p. 7; Ex. X2, Report of Andrew Rah, M.D., dated March 7, 2022, at p. 7.) Applicant's August 9, 2024 Declaration of Readiness to Proceed indicated the disputed issues included a request for a panel of QMEs in psychiatry. (Declaration of Readiness to Proceed, dated August 9, 2024, at p. 7.) The parties proceeded to trial on February 27, 2025, and the corresponding minutes reflect applicant's claimed body parts as included psyche. (Minutes of Hearing and Summary of Evidence (Minutes), dated February 27, 2025, at p. 2:8.) Applicant testified to continued emotional difficulties related to his injury, including difficulties with focus and concentration, vertigo, and anxiety. (Id. at p. 5:12.)

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Orthopedic QME Dr. Andrew Rah documented applicant's complaints of depression and anxiety in reports dated August 30, 2021 and March 7, 2022.

Favours Applicant prevailed

Supported the existence of psychiatric issues relevant to issuance of additional QME panel in psychiatry.

From the decision · page 4evaluate his claimed injury. Orthopedic QME Andrew Rah, M.D. has documented applicant's complaints of depression and anxiety in reporting dated August 30, 2021 and March 7, 2022. (Ex. X2, Report of Andrew Rah, M.D., dated August 30, 2021, at p. 7; Ex. X2, Report of Andrew Rah, M.D., dated March 7, 2022, at p. 7.) Applicant's August 9, 2024 Declaration of Readiness to Proceed indicated the disputed issues included a request for a panel of QMEs in psychiatry. (Declaration of Readiness to Proceed, dated August 9, 2024, at p. 7.) The parties proceeded to trial on February 27, 2025, and the corresponding minutes reflect applicant's claimed body parts as included psyche. (Minutes of Hearing and Summary of Evidence (Minutes), dated February 27, 2025, at p. 2:8.) Applicant testified to continued emotional difficulties related to his injury, including difficulties with focus and concentration, vertigo, and anxiety. (Id. at p. 5:12.)

Applicant's August 9, 2024 Declaration of Readiness to Proceed included disputed issues for a panel of QMEs in psychiatry.

Favours Applicant prevailed

Indicated timely claim and dispute over psychiatric injury.

From the decision · page 4evaluate his claimed injury. Orthopedic QME Andrew Rah, M.D. has documented applicant's complaints of depression and anxiety in reporting dated August 30, 2021 and March 7, 2022. (Ex. X2, Report of Andrew Rah, M.D., dated August 30, 2021, at p. 7; Ex. X2, Report of Andrew Rah, M.D., dated March 7, 2022, at p. 7.) Applicant's August 9, 2024 Declaration of Readiness to Proceed indicated the disputed issues included a request for a panel of QMEs in psychiatry. (Declaration of Readiness to Proceed, dated August 9, 2024, at p. 7.) The parties proceeded to trial on February 27, 2025, and the corresponding minutes reflect applicant's claimed body parts as included psyche. (Minutes of Hearing and Summary of Evidence (Minutes), dated February 27, 2025, at p. 2:8.) Applicant testified to continued emotional difficulties related to his injury, including difficulties with focus and concentration, vertigo, and anxiety. (Id. at p. 5:12.)

Applicant testified at trial on February 27, 2025 to continued emotional difficulties including focus, concentration, vertigo, and anxiety.

Favours Applicant prevailed

Provided credible testimony supporting psychiatric injury claim.

From the decision · page 4evaluate his claimed injury. Orthopedic QME Andrew Rah, M.D. has documented applicant's complaints of depression and anxiety in reporting dated August 30, 2021 and March 7, 2022. (Ex. X2, Report of Andrew Rah, M.D., dated August 30, 2021, at p. 7; Ex. X2, Report of Andrew Rah, M.D., dated March 7, 2022, at p. 7.) Applicant's August 9, 2024 Declaration of Readiness to Proceed indicated the disputed issues included a request for a panel of QMEs in psychiatry. (Declaration of Readiness to Proceed, dated August 9, 2024, at p. 7.) The parties proceeded to trial on February 27, 2025, and the corresponding minutes reflect applicant's claimed body parts as included psyche. (Minutes of Hearing and Summary of Evidence (Minutes), dated February 27, 2025, at p. 2:8.) Applicant testified to continued emotional difficulties related to his injury, including difficulties with focus and concentration, vertigo, and anxiety. (Id. at p. 5:12.)

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.

QMERelied upon · orthopedic

Documented applicant's complaints of depression and anxiety in reports dated August 30, 2021 and March 7, 2022.

From the decision · page 4evaluate his claimed injury. Orthopedic QME Andrew Rah, M.D. has documented applicant's complaints of depression and anxiety in reporting dated August 30, 2021 and March 7, 2022. (Ex. X2, Report of Andrew Rah, M.D., dated August 30, 2021, at p. 7; Ex. X2, Report of Andrew Rah, M.D., dated March 7, 2022, at p. 7.) Applicant's August 9, 2024 Declaration of Readiness to Proceed indicated the disputed issues included a request for a panel of QMEs in psychiatry. (Declaration of Readiness to Proceed, dated August 9, 2024, at p. 7.) The parties proceeded to trial on February 27, 2025, and the corresponding minutes reflect applicant's claimed body parts as included psyche. (Minutes of Hearing and Summary of Evidence (Minutes), dated February 27, 2025, at p. 2:8.) Applicant testified to continued emotional difficulties related to his injury, including difficulties with focus and concentration, vertigo, and anxiety. (Id. at p. 5:12.)

otherPartially credited · psychiatry

Provided a psychiatric report dated January 23, 2025, which was marked for identification but not ruled admissible by the WCJ; the WCAB found the issue of admissibility not ripe and disagreed with dissent that the report was inadmissible under section 4605.

The report was self-procured and not reviewed by a QME, but section 4605 does not limit admissibility of such reports.

From the decision · page 5In addition, we offer the following nonbinding guidance to the parties. We observe that applicant has sought to introduce in evidence Exhibit 3, the January 23, 2025 report of David Kauss, Ph.D. (Minutes of Hearing and Summary of Evidence, dated April 28, 2025, at p. 2:6.) Defendant objected to the report's admissibility, averring it was not previously disclosed and that the body part of psyche had not previously been pleaded. (Id. at p. 2:9.) The WCJ marked Exhibit 3 for identification, but did not ultimately rule on the report's admissibility. Thus, we believe that an analysis of the admissibility of the reporting is not yet ripe. However, given our order for the issuance of a panel of QMEs in psychiatry, we acknowledge that the parties will need to determine the issue of the admissibility of the report and whether the report may be submitted for review by a QME. (See Lab. Code, § 4062.3.)

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Cal. Code Regs., tit. 8, 31.7(b)

Administrative Director Rule 31.7(b) regarding issuance of additional QME panels in different specialties upon showing of good cause.

Applied to find good cause for additional panels in neurology and psychiatry.

From the decision · page 3Administrative Director (AD) Rule 31.7(b) provides for an additional QME panel in

Lab. Code, 4062.2

Labor Code section 4062.2 governing medical-legal evaluation process from QME panels in represented cases.

Referenced in context of dispute over issuance of additional panels.

From the decision · page 4Labor 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.) Although defendant has admitted injury to the left shoulder, defendant has denied liability for all other claimed body parts. (Minutes, at p. 2:5.)

Lab. Code, 4062.3

Labor Code section 4062.3 regarding admissibility of medical reports including self-procured reports.

Applied to reject argument that Dr. Kauss's report was inadmissible under section 4605.

From the decision · page 5In addition, we offer the following nonbinding guidance to the parties. We observe that applicant has sought to introduce in evidence Exhibit 3, the January 23, 2025 report of David Kauss, Ph.D. (Minutes of Hearing and Summary of Evidence, dated April 28, 2025, at p. 2:6.) Defendant objected to the report's admissibility, averring it was not previously disclosed and that the body part of psyche had not previously been pleaded. (Id. at p. 2:9.) The WCJ marked Exhibit 3 for identification, but did not ultimately rule on the report's admissibility. Thus, we believe that an analysis of the admissibility of the reporting is not yet ripe. However, given our order for the issuance of a panel of QMEs in psychiatry, we acknowledge that the parties will need to determine the issue of the admissibility of the report and whether the report may be submitted for review by a QME. (See Lab. Code, § 4062.3.)

ADJ14784661 · August 1, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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