Requesting a PQME panel in a specialty different than the specialty of the Primary treating Physician

The Brown case summarized below stands for the proposition that if defendant’s are the first to make a request for a panel and it is in a specialty different than the Primary Treating Physician, that request is proper as long as it is supported by relevant documentation as required by regulation 31.1 (b).

Section 31.1 (b) provides that in the event a party in a represented case wishes to request a QME panel pursuant to LC 4062.2 in a specialty other than the specialty of the treating physician, the parties shall submit with the panel request any relevant documentation supporting the reason for requesting a different panel.

Brown V. Alameda Unified School District (BPD) (2014 Cal. Wrk com. P.D. LEXIS 347):

The WCJ found that the defendant’s December 2, 2013 request for a QME panel in the specialty of psychiatry was not defective because defendants choose a specialty different than that of the Primary Treating Physician. The WCJ ruled that the parties were bound to use the first panel assigned by the the medical unit that was requested by the defendants in the field of psychiatry and not a second QME panel in the specialty of psychology pursuant to applicant’s panel request which was made months after defendants request for a panel in psychiatry.

Applicant filed a petition for removal which was denied.

The applicant’s attorney argued the first panel in psychiatry was invalid on the basis that the specialty was different from the treating physician’s specialty of psychology.

The WCAB found that in cases such as this were the applicant is represented, any party may request a qualified medical evaluator in any specialty pursuant to Labor Code § 4062.2 and there is no requirement the qualified medical evaluator panel be the same specialty as the specialty of the treating physician.

There is no requirement that the qualified medical evaluator panel be the same specialty as the treating physician. Labor Code § 4062.2 has no provision to determine specialty of a qualified medical evaluator.

Regulation 31.1 (a) setting forth the tie-breaking procedure when two or more panel selection forms designate different specialties are received by the medical unit on the same day does not apply in this case because the parties stipulated that the defendant was the first to send its request for a psychiatric panel and the psychiatric panel was issued first.

Defendant’s request for a panel in a different specialty than the treating physician was supported by relevant documentation as required by regulation 31.1 (b) which was applicable here, because defendant submitted a letter with the panel request indicating that the applicant was hospitalized and treated by a psychiatrist earlier this year and the letter was supported by Kaiser records, and because the first qualified medical evaluator panel was valid and not revoked pursuant to rule § 30 (c), the second qualified medical panel issued by the Medical Unit in specialty of psychology was issued in error.

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