What the panel ordered
Petition for Reconsideration denied by the Appeals Board on September 10, 2024.
Defendant North River Insurance Company seeks reconsideration of the June 17, 2024 Findings of Fact, Award and Orders (F&O) regarding apportionment analysis by QME Dr. Gregorius, challenging the WCJ's appointment of a regular physician and rejection of QME's apportionment opinion as substantial evidence.
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 the QME's apportionment analysis inconsistent and not substantial evidence, leading to appointment of a regular physician with expertise in thoracic outlet syndrome. The Appeals Board concurred and denied reconsideration, finding no error in the WCJ's weighing of evidence.
From the decision · page 2The parties have selected F. Karl Gregorius, M.D., as the QME in neurosurgery. On April 24, 2024, the parties proceeded to trial. The parties stipulated therein to applicant's injury as having arisen out of and in the course of employment, and to injury to the bilateral wrists, elbows, and in the form of thoracic outlet syndrome. (Minutes of Hearing (Minutes), dated April 24, 2024, at p. 2:8.) The parties further stipulated, in relevant part, to the scheduled rating of the reporting of QME Dr. Gregorius, and to applicant's entitlement to future medical care to the bilateral wrists, elbow, and for applicant's thoracic [outlet] syndrome. (Id. at p. 2:38.) The sole issue framed by the parties was the "applicable apportionment" of QME Dr. Gregorius. The WCJ provided the parties with additional time in which to file trial briefs, and ordered the matter submitted for decision on May 22, 2024. On June 17, 2024, the WCJ issued the F&O, ordering in relevant part the appointment of Jonathan Rutchik, M.D., as a regular physician pursuant to Labor Code section 5701. The WCJ's Opinion on Decision notes that while the WCJ found the opinions of QME Dr. Gregorius to be well-reasoned, the QME stated in his deposition testimony that he was not an expert, and that the QME's reports and testimony did not rise to the level of substantial evidence.