What the panel ordered
Petition for Reconsideration granted; September 27, 2024 Findings and Order rescinded and substituted with a new order admitting the November 30, 2022 report of Mechel Henry, M.D., deposition transcript, trial transcript, and medical presentation to be sent to panel QMEs for review and comment.
Applicant sought reconsideration of the September 27, 2024 Findings and Order which found certain third-party civil claim materials inadmissible to be sent to panel QMEs; the WCJ had recommended denial of the petition; the Appeals Board granted reconsideration and rescinded the prior F&O.
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 Appeals Board found that Dr. Henry's materials were not solely retained to rebut QMEs and were relevant medical evidence admissible under Labor Code section 4062.3(a), distinguishing Batten and following Jacobs, thus admissible to be sent to panel QMEs for review and comment.
From the decision · page 1Applicant seeks reconsideration of the September 27, 2024 Findings and Order (F&O) wherein the workers' compensation administrative law judge (WCJ) found that materials from applicant's third party civil claim, including a November 30, 2022 report of Mechel Henry, M.D., transcript of Dr. Henry's February 21, 2023 deposition, transcript of the October 4, 2023 trial proceedings, and a medical presentation/demonstrative prepared by Dr. Henry, were inadmissible and unable to be submitted to the panel Qualified Medical Evaluators (QMEs) for review and comment. The WCJ found that the reporting, testimony, and exhibits were obtained for the sole purpose of contradicting the panel QMEs in the instant case and were not those of a consulting physician, or a treating physician, agreed medical evaluator, or panel QME, as contemplated under Labor Code1 section 4061(i).
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Henry was retained to provide a consultative report for a third-party civil claim, not solely to rebut panel QMEs.
Favours Applicant prevailed
This distinguished the case from Batten, allowing admission of her materials to panel QMEs.
From the decision · page 1Applicant seeks reconsideration of the September 27, 2024 Findings and Order (F&O) wherein the workers' compensation administrative law judge (WCJ) found that materials from applicant's third party civil claim, including a November 30, 2022 report of Mechel Henry, M.D., transcript of Dr. Henry's February 21, 2023 deposition, transcript of the October 4, 2023 trial proceedings, and a medical presentation/demonstrative prepared by Dr. Henry, were inadmissible and unable to be submitted to the panel Qualified Medical Evaluators (QMEs) for review and comment. The WCJ found that the reporting, testimony, and exhibits were obtained for the sole purpose of contradicting the panel QMEs in the instant case and were not those of a consulting physician, or a treating physician, agreed medical evaluator, or panel QME, as contemplated under Labor Code1 section 4061(i).
Dr. Henry's materials had been reviewed by the primary treating physician, Dr. Navin Mallavaram, indicating they were already part of the medical record.
Favours Applicant prevailed
Supported the finding that the materials were relevant and admissible.
From the decision · page 9Defendant argues that Dr. Henry's opinions are inherently biased since Dr. Henry was selected and her services paid, by applicant. (Answer, p. 4.) We disagree. The process by which Dr. Henry was retained to serve as an expert in his applicant's third-party claim is no different than the process highlighted under section 4605 above for consulting or attending physicians working on workers' compensation matters. Further, as indicated in defendant's Answer, QMEs are held to a code of conduct specific to workers' compensation cases. (Id.) As such, we expect that they will abide by this code of conduct and provide fair, unbiased, and impartial opinions. Additionally, Dr. Henry's reports have already been reviewed by applicant's primary treating physician, Dr. Navin Mallavaram, as evidenced by Dr. Mallavaram's permanent and stationary report dated September 12, 2023. (Exhibit 5.) As such, Dr. Henry's materials are arguably already a part of the record.
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.
Provided a consultative report, deposition testimony, trial testimony, and medical presentation relevant to the workers' compensation medical issues.
The Appeals Board found Dr. Henry's materials relevant and admissible to be reviewed by panel QMEs, distinguishing prior case law that excluded reports solely retained to rebut QMEs.
From the decision · page 1Applicant seeks reconsideration of the September 27, 2024 Findings and Order (F&O) wherein the workers' compensation administrative law judge (WCJ) found that materials from applicant's third party civil claim, including a November 30, 2022 report of Mechel Henry, M.D., transcript of Dr. Henry's February 21, 2023 deposition, transcript of the October 4, 2023 trial proceedings, and a medical presentation/demonstrative prepared by Dr. Henry, were inadmissible and unable to be submitted to the panel Qualified Medical Evaluators (QMEs) for review and comment. The WCJ found that the reporting, testimony, and exhibits were obtained for the sole purpose of contradicting the panel QMEs in the instant case and were not those of a consulting physician, or a treating physician, agreed medical evaluator, or panel QME, as contemplated under Labor Code1 section 4061(i).
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code sections 4061(i) and 4062.3(a)
Section 4061(i) prohibits admission of evaluations obtained solely to rebut panel QMEs; Section 4062.3(a) allows relevant medical records to be provided to QMEs for review.
The Board distinguished Batten and followed Jacobs to admit Dr. Henry's materials as relevant medical evidence not solely retained to rebut QMEs.
From the decision · page 1Applicant seeks reconsideration of the September 27, 2024 Findings and Order (F&O) wherein the workers' compensation administrative law judge (WCJ) found that materials from applicant's third party civil claim, including a November 30, 2022 report of Mechel Henry, M.D., transcript of Dr. Henry's February 21, 2023 deposition, transcript of the October 4, 2023 trial proceedings, and a medical presentation/demonstrative prepared by Dr. Henry, were inadmissible and unable to be submitted to the panel Qualified Medical Evaluators (QMEs) for review and comment. The WCJ found that the reporting, testimony, and exhibits were obtained for the sole purpose of contradicting the panel QMEs in the instant case and were not those of a consulting physician, or a treating physician, agreed medical evaluator, or panel QME, as contemplated under Labor Code1 section 4061(i).
What proof carried it
The evidence the panel weighed, by kind.
Dr. Henry's materials were relevant to the medical issues and had been reviewed by the primary treating physician, Dr. Navin Mallavaram, supporting their admissibility.
From the decision · page 9Defendant argues that Dr. Henry's opinions are inherently biased since Dr. Henry was selected and her services paid, by applicant. (Answer, p. 4.) We disagree. The process by which Dr. Henry was retained to serve as an expert in his applicant's third-party claim is no different than the process highlighted under section 4605 above for consulting or attending physicians working on workers' compensation matters. Further, as indicated in defendant's Answer, QMEs are held to a code of conduct specific to workers' compensation cases. (Id.) As such, we expect that they will abide by this code of conduct and provide fair, unbiased, and impartial opinions. Additionally, Dr. Henry's reports have already been reviewed by applicant's primary treating physician, Dr. Navin Mallavaram, as evidenced by Dr. Mallavaram's permanent and stationary report dated September 12, 2023. (Exhibit 5.) As such, Dr. Henry's materials are arguably already a part of the record.
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
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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