Home/Case Law/JULIA GALICIA vs. CHRISTOPHER AND JAIME SIMON, STATE FARM INSURANCE
Regular DecisionReconsideration

JULIA GALICIA vs. CHRISTOPHER AND JAIME SIMON, STATE FARM INSURANCE

Filed: Mar 03, 2016
Los Angeles
ADJ9398863

CompFox AI Summary

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration because it was filed late and sought review of an interlocutory, procedural decision, not a final order. The WCAB also denied the petition for removal, finding no showing of substantial prejudice or irreparable harm that reconsideration could not remedy. The WCJ's report, which the WCAB adopted, correctly determined that the applicant was not entitled to a QME panel in chiropractic, as the primary treating physician was an M.D. and the applicant failed to provide sufficient documentation for a different specialty, thus a QME panel in orthopedics was appropriate. The WCJ's decision was based on regulations requiring documentation for requests outside the treating physician's specialty and the medical nature of the injury.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration because it was filed late and sought review of an interlocutory, procedural decision, not a final order. The WCAB also denied the petition for removal, finding no showing of substantial prejudice or irreparable harm that reconsideration could not remedy. The WCJ's report, which the WCAB adopted, correctly determined that the applicant was not entitled to a QME panel in chiropractic, as the primary treating physician was an M.D. and the applicant failed to provide sufficient documentation for a different specialty, thus a QME panel in orthopedics was appropriate. The WCJ's decision was based on regulations requiring documentation for requests outside the treating physician's specialty and the medical nature of the injury.

Read the full decision

Join + legal professionals. Create a free account to access the complete text of this decision and search our entire database.

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.