ADJ5787628 — California WCAB decision

What the panel ordered

Petition for reconsideration granted; Findings, Award and Order rescinded and substituted; additional QME panel in neurology ordered; matter returned to trial level for further proceedings.

Petition for reconsideration granted, Findings, Award and Order issued January 30, 2025 rescinded and substituted with new findings; matter remanded for further proceedings.

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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

The AME Dr. Wood testified that a neurologist may add additional functional loss that he was missing, establishing good cause for an additional neurology QME panel.

From the decision · page 10Here, the parties obtained a medical-legal evaluation from the orthopedic AME, Dr. Wood. But when Dr. Wood was asked under oath whether his final opinions accurately reflected applicant's condition orthopedically, he testified that they did but added that "a neurologist may add additional functional loss that I was missing." (Jt. Ex. Q, Deposition Transcript of David Wood, July 28, 2020, p. 18:9-23.)

Other disputed issue

The facts that decided it

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

Dr. Wood testified that a neurologist may add additional functional loss that he was missing.

Favours Applicant prevailed

This testimony established good cause for an additional neurology QME panel, leading to the Board granting the petition for reconsideration and ordering the additional panel.

From the decision · page 10Here, the parties obtained a medical-legal evaluation from the orthopedic AME, Dr. Wood. But when Dr. Wood was asked under oath whether his final opinions accurately reflected applicant's condition orthopedically, he testified that they did but added that "a neurologist may add additional functional loss that I was missing." (Jt. Ex. Q, Deposition Transcript of David Wood, July 28, 2020, p. 18:9-23.)

Applicant testified to increased upper extremity symptoms and diagnoses of carpal tunnel syndrome and shoulder rupture.

Favours Applicant prevailed

This testimony showed new symptoms not evaluated by Dr. Wood, justifying deferral of these issues for further evaluation.

From the decision · page 11Here, applicant testified that his upper extremities symptoms have increased since he was evaluated by Dr. Wood and that he received a diagnosis of carpal tunnel syndrome which he believes resulted from his use of canes and a walker. (Minutes of Hearing and Summary of Evidence, October 3, 2024, pp. 6:8-11, 7:13-20.) He further testified that he was injured in early 2024 while treating with a physical therapist and was diagnosed with a shoulder muscle rupture. (Id., p. 6:19-24.)

Defendant's Declaration of Readiness dated May 14, 2024 referenced prior settlement efforts and MSCs, complying with section 10742 and found valid.

Favours Defendant prevailed

This supported the Board's finding that the DOR was proper, rejecting applicant's contention of impropriety.

From the decision · page 5In this instance, the language in the Declaration of Readiness specifically references a prior MSC, as well as the specific date of 12-29-23 along with the AME re- evaluation and MMI reporting by multiple evaluators and without any evidence offered to the contrary, the undersigned finds the Declaration of Readiness dated 5- 14-24 complies with section 10742 and is valid. Furthermore, considering the

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.

AMERelied upon · orthopedics

Dr. Wood testified that his final opinions accurately reflected applicant's orthopedic condition but acknowledged that a neurologist may add additional functional loss that he was missing.

Dr. Wood's testimony established good cause for an additional neurology QME panel because he acknowledged potential additional functional loss outside his expertise.

From the decision · page 10Here, the parties obtained a medical-legal evaluation from the orthopedic AME, Dr. Wood. But when Dr. Wood was asked under oath whether his final opinions accurately reflected applicant's condition orthopedically, he testified that they did but added that "a neurologist may add additional functional loss that I was missing." (Jt. Ex. Q, Deposition Transcript of David Wood, July 28, 2020, p. 18:9-23.)

AMERelied upon · orthopedics

Dr. Wood did not request another panel specialty but was open to another opinion.

Dr. Wood's testimony during cross-examination showed he was comfortable with his rating but open to another opinion, supporting the need for an additional panel.

From the decision · page 6Petitioner contends that the AME testified that a neurological evaluation would be relevant during his cross-examination.... Petitioner further argues that when an AME/QME identifies a medical dispute that falls outside of his/her expertise, an additional panel is appropriate.... [I]n review of Dr. Wood cross-examination, Dr. Wood stated "... I'm comfortable with my rating." (Jnt Ex Q pg 9, line 10-16). Dr. Wood went on to state that he is "always happy to have another opinion.." but did not request another panel specialty.... New and Different Symptoms... Petitioner fails to acknowledge that upper extremities/carpal tunnel were not alleged nor included in either Pre-Trial Conference Statement nor issues at Trial. Petitioner is now attempting to include an issue not raised at the MSC or Trial.

ADJ5787628 · May 5, 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

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