What the panel ordered
The WCAB denied defendant's petition for reconsideration, upholding the WCJ's order for an additional QME panel in psychology.
Defendant sought reconsideration of the WCJ's Findings of Facts and Order and Opinion on Decision issued November 8, 2023, challenging the order for an additional QME panel in psychology to determine causation.
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 WCJ found insufficient medical evidence on causation and ordered the additional QME panel to develop the record. The WCAB found no significant prejudice or irreparable harm to defendant and upheld the order.
From the decision · page 3Here, the WCJ determined that there is insufficient medical evidence upon which the threshold issue of causation may be determined. (Report, p. 3.) Where there is insufficient evidence on a threshold issue, the WCJ has a duty to further develop the record. (Lab. Code, § 5701, 5906; McClune v. Workers' Comp. Appeals Bd. (McClune) (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261]; Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396, 404 [65 Cal.Comp.Cases 264]; Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389, 394 [62 Cal.Comp.Cases 924].) The WCJ has the authority to order additional medical evidence when required for substantial evidence. (Lab. Code, § 5701, 5906; Old Republic Ins. Co. v. Workers' Comp. Appeals Bd. (2020) 85 Cal.Comp.Cases 504, 508 (writ den.); McDuffie v. Los Angeles County Metropolitan Transit Authority (2001) 67 Cal.Comp.Cases 138 (Appeals Board en banc); McClune, supra.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The WCJ found insufficient medical evidence on the threshold issue of causation.
Favours Applicant prevailed
This finding justified ordering an additional QME panel in psychology to develop the record.
From the decision · page 3Here, the WCJ determined that there is insufficient medical evidence upon which the threshold issue of causation may be determined. (Report, p. 3.) Where there is insufficient evidence on a threshold issue, the WCJ has a duty to further develop the record. (Lab. Code, § 5701, 5906; McClune v. Workers' Comp. Appeals Bd. (McClune) (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261]; Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396, 404 [65 Cal.Comp.Cases 264]; Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389, 394 [62 Cal.Comp.Cases 924].) The WCJ has the authority to order additional medical evidence when required for substantial evidence. (Lab. Code, § 5701, 5906; Old Republic Ins. Co. v. Workers' Comp. Appeals Bd. (2020) 85 Cal.Comp.Cases 504, 508 (writ den.); McDuffie v. Los Angeles County Metropolitan Transit Authority (2001) 67 Cal.Comp.Cases 138 (Appeals Board en banc); McClune, supra.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, §§ 5701, 5906
The WCJ has a duty to further develop the record when there is insufficient evidence on a threshold issue such as causation.
The WCJ ordered an additional QME panel in psychology to develop the record on causation.
From the decision · page 3Here, the WCJ determined that there is insufficient medical evidence upon which the threshold issue of causation may be determined. (Report, p. 3.) Where there is insufficient evidence on a threshold issue, the WCJ has a duty to further develop the record. (Lab. Code, § 5701, 5906; McClune v. Workers' Comp. Appeals Bd. (McClune) (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261]; Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396, 404 [65 Cal.Comp.Cases 264]; Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389, 394 [62 Cal.Comp.Cases 924].) The WCJ has the authority to order additional medical evidence when required for substantial evidence. (Lab. Code, § 5701, 5906; Old Republic Ins. Co. v. Workers' Comp. Appeals Bd. (2020) 85 Cal.Comp.Cases 504, 508 (writ den.); McDuffie v. Los Angeles County Metropolitan Transit Authority (2001) 67 Cal.Comp.Cases 138 (Appeals Board en banc); McClune, supra.)
What proof carried it
The evidence the panel weighed, by kind.
The current state of the record demonstrated the necessity of the QME panel in psychology to determine causation.
From the decision · page 3With respect to the WCJ's order to develop the record using an additional QME panel in psychology, we are not persuaded that substantial prejudice or irreparable harm will result if removal is denied and/or that reconsideration will not be an adequate remedy if the matter ultimately proceeds to a final decision adverse to defendant. As explained in the WCJ's Report, not only does the current state of the record demonstrate that the QME panel in psychology is necessary to determine causation, but this very issue was also put before the WCJ for decision by the parties during a hearing on October 24, 2023. (Report, p. 3; Minutes of Hearing, October 24, 2023, p. 2 [Issue No. 1: "Applicant's entitlement to a QME panel in psychology to evaluate cause of stroke."].) Based on the foregoing, we will not disturb the WCJ's interlocutory decision to order the additional QME panel in the specialty of psychology.
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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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