Garcia v Yirae Fashions

In Garcia v Yirae Fashions 2017 Cal. Wrk. Comp. P.D. LEXIS 30, the Court addressed the proper procedure for challenging the specialty designated in a QME panel request. Garcia claimed a CT injury to his skin and contents. Prior to the rejection of the claim, Garcia sought treatment from an orthopaedic surgeon. After the rejection of the claim and the assertion of an Application, Garcia’s attorney sought from the Executive Medical Director a QME panel in the field of pain medicine. Defendant objected to the panel, claiming that it was improperly issued and that the reports of the QME should be deemed inadmissible. During the course of Trial, it was revealed that applicant’s counsel failed to indicate, in his request for a QME panel, the reason that the QME should be in a specialty other than the treating physician. This requirement was mandated by the prior version of CCR Section 31.1, which was applicable to Garcia’s date of injury. The Court rejected applicant’s counsel’s argument that the current law should be deemed applicable to the prior date of injury, holding that the law in effect at the time that the QME panel is requested governs. Thus, for all requests for QME panels issued after 9/1/15, CCR Section 31.5(a)(10) must be adhered to, which requires that the aggrieved party’s objection be lodged before the Executive Medical Director, specifying the reasons that the specialty requested is not appropriate and provision of all existing medical reports.

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