What the panel ordered
The WCAB granted defendant's petition for reconsideration, rescinded the June 28, 2022 Findings and Order, and substituted new Findings affirming that Dr. Wellborn's reports are not substantial medical evidence but must remain part of the record and Dr. Wellborn is not disqualified as PQME.
Defendant sought reconsideration of the June 28, 2022 Findings and Order by the WCJ, which found applicant sustained industrial injury and struck PQME Dr. Wellborn's reports as not substantial medical evidence and disqualified him. The WCAB granted reconsideration, rescinded the June 28, 2022 order, affirmed the finding that Dr. Wellborn's reports are not substantial medical evidence, but reversed the striking of the reports and disqualification of Dr. Wellborn.
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.
The WCAB agreed with the WCJ that Dr. Wellborn's reports are not substantial medical evidence and the WCJ may assign the reports whatever weight she deems appropriate, but there are no legal grounds for disqualification or replacement of the PQME, so the reports must remain part of the record.
From the decision · page 3Whether or not a medical report is substantial evidence is a determination regarding the weight of the evidence, not its admissibility. (Cal. Code Regs., tit. 8, § 10682(c).) Moreover, there has been no finding of grounds for replacement of the PQME pursuant to Labor Code section 4062.3 or Administrative Director (AD) Rule 31.5 and the WCJ has not cited any legal authority for disqualifying him. Therefore, while we agree with the WCJ that Dr. Wellborn's reports are not substantial medical evidence, that the WCJ may assign the reports whatever weight she deems appropriate, and that the WCJ has the discretion to appointment a regular physician pursuant to Labor Code section 5701 if the parties cannot or will not agree to an agreed medical examiner (AME), Dr. Wellborn's reports, which were admitted at the February 7, 2022 trial, must remain part of the record and there are presently no legal grounds for disqualification or replacement of the PQME.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Wellborn's reports do not constitute substantial medical evidence.
Favours Defendant prevailed
The WCAB affirmed the WCJ's finding that the reports lack substantiality, which affected the weight given to the medical evidence.
From the decision · page 3Whether or not a medical report is substantial evidence is a determination regarding the weight of the evidence, not its admissibility. (Cal. Code Regs., tit. 8, § 10682(c).) Moreover, there has been no finding of grounds for replacement of the PQME pursuant to Labor Code section 4062.3 or Administrative Director (AD) Rule 31.5 and the WCJ has not cited any legal authority for disqualifying him. Therefore, while we agree with the WCJ that Dr. Wellborn's reports are not substantial medical evidence, that the WCJ may assign the reports whatever weight she deems appropriate, and that the WCJ has the discretion to appointment a regular physician pursuant to Labor Code section 5701 if the parties cannot or will not agree to an agreed medical examiner (AME), Dr. Wellborn's reports, which were admitted at the February 7, 2022 trial, must remain part of the record and there are presently no legal grounds for disqualification or replacement of the PQME.
There are no legal grounds for disqualification or replacement of Dr. Wellborn as PQME.
Favours Applicant prevailed
This prevented the striking of the reports and disqualification of Dr. Wellborn, affecting the procedural outcome.
From the decision · page 3Whether or not a medical report is substantial evidence is a determination regarding the weight of the evidence, not its admissibility. (Cal. Code Regs., tit. 8, § 10682(c).) Moreover, there has been no finding of grounds for replacement of the PQME pursuant to Labor Code section 4062.3 or Administrative Director (AD) Rule 31.5 and the WCJ has not cited any legal authority for disqualifying him. Therefore, while we agree with the WCJ that Dr. Wellborn's reports are not substantial medical evidence, that the WCJ may assign the reports whatever weight she deems appropriate, and that the WCJ has the discretion to appointment a regular physician pursuant to Labor Code section 5701 if the parties cannot or will not agree to an agreed medical examiner (AME), Dr. Wellborn's reports, which were admitted at the February 7, 2022 trial, must remain part of the record and there are presently no legal grounds for disqualification or replacement of the PQME.
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.
Reports do not constitute substantial medical evidence.
The WCJ found Dr. Wellborn's reports lack substantiality and ordered them stricken and the doctor disqualified, but the WCAB reversed the striking and disqualification while affirming the lack of substantiality.
From the decision · page 1Defendant seeks reconsideration of the June 28, 2022 Findings and Order wherein the workers' compensation administrative law judge (WCJ) found, based on the parties' stipulations, that applicant, while employed as a dresser on December 27, 2017, sustained industrial injury to her hips. As relevant here, the WCJ further found that the reports of panel qualified medical examiner (PQME) John Wellborn, M.D., do not constitute substantial medical evidence. Based on this finding, the WCJ ordered Dr. Wellborn's reports stricken from the record and Dr. Wellborn removed and disqualified as PQME.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Cal. Code Regs., tit. 8, 10682(c)
Whether a medical report is substantial evidence is a determination regarding the weight of the evidence, not its admissibility.
The WCAB agreed that Dr. Wellborn's reports are not substantial medical evidence but must remain part of the record.
From the decision · page 3Whether or not a medical report is substantial evidence is a determination regarding the weight of the evidence, not its admissibility. (Cal. Code Regs., tit. 8, § 10682(c).) Moreover, there has been no finding of grounds for replacement of the PQME pursuant to Labor Code section 4062.3 or Administrative Director (AD) Rule 31.5 and the WCJ has not cited any legal authority for disqualifying him. Therefore, while we agree with the WCJ that Dr. Wellborn's reports are not substantial medical evidence, that the WCJ may assign the reports whatever weight she deems appropriate, and that the WCJ has the discretion to appointment a regular physician pursuant to Labor Code section 5701 if the parties cannot or will not agree to an agreed medical examiner (AME), Dr. Wellborn's reports, which were admitted at the February 7, 2022 trial, must remain part of the record and there are presently no legal grounds for disqualification or replacement of the PQME.
Labor Code section 4062.3
No finding of grounds for replacement of the PQME pursuant to Labor Code section 4062.3 or Administrative Director Rule 31.5 and no legal authority cited for disqualification.
The WCAB found no legal grounds for disqualification or replacement of Dr. Wellborn as PQME.
From the decision · page 3Whether or not a medical report is substantial evidence is a determination regarding the weight of the evidence, not its admissibility. (Cal. Code Regs., tit. 8, § 10682(c).) Moreover, there has been no finding of grounds for replacement of the PQME pursuant to Labor Code section 4062.3 or Administrative Director (AD) Rule 31.5 and the WCJ has not cited any legal authority for disqualifying him. Therefore, while we agree with the WCJ that Dr. Wellborn's reports are not substantial medical evidence, that the WCJ may assign the reports whatever weight she deems appropriate, and that the WCJ has the discretion to appointment a regular physician pursuant to Labor Code section 5701 if the parties cannot or will not agree to an agreed medical examiner (AME), Dr. Wellborn's reports, which were admitted at the February 7, 2022 trial, must remain part of the record and there are presently no legal grounds for disqualification or replacement of the PQME.
What proof carried it
The evidence the panel weighed, by kind.
The WCJ's finding that Dr. Wellborn's reports lack substantial medical evidence
From the decision · page 1Defendant seeks reconsideration of the June 28, 2022 Findings and Order wherein the workers' compensation administrative law judge (WCJ) found, based on the parties' stipulations, that applicant, while employed as a dresser on December 27, 2017, sustained industrial injury to her hips. As relevant here, the WCJ further found that the reports of panel qualified medical examiner (PQME) John Wellborn, M.D., do not constitute substantial medical evidence. Based on this finding, the WCJ ordered Dr. Wellborn's reports stricken from the record and Dr. Wellborn removed and disqualified as PQME.
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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.
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