What the panel ordered
Petition for Reconsideration denied.
Petition for Reconsideration filed by lien claimant Dr. Azadeh Rahimi challenging the Findings and Order dated January 28, 2022, which found the lien claimant take nothing.
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.
Dr. Rahimi's reports were not medical-legal reports as defined by Labor Code section 4060 and related regulations, and Dr. Rahimi was not a primary treating physician, AME, or PQME. Therefore, reimbursement was not warranted.
From the decision · page 4Dr. Rahimi's reports are not medical legal repo11s. Dr. Rahimi examined the applicant on two occasion, issued two repo11s and provided no treatment. Dr. Rahimi's reports were not obtained in accordance with Labor Code section 4060, 4061 or 4062. Dr. Rahimi was not the primary treating physician nor was he an AME or PQME. There was no evidence showing Dr. Rahimi's reports were ever reviewed or commented upon by the PTP, Dr. Farsar, or the AME. They were never used to prove or disprove a claim.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Rahimi's reports were not medical-legal reports as defined by Labor Code section 4060 and related regulations.
Favours Defendant prevailed
This meant the reports were not reimbursable under the law.
From the decision · page 4Dr. Rahimi's reports are not medical legal repo11s. Dr. Rahimi examined the applicant on two occasion, issued two repo11s and provided no treatment. Dr. Rahimi's reports were not obtained in accordance with Labor Code section 4060, 4061 or 4062. Dr. Rahimi was not the primary treating physician nor was he an AME or PQME. There was no evidence showing Dr. Rahimi's reports were ever reviewed or commented upon by the PTP, Dr. Farsar, or the AME. They were never used to prove or disprove a claim.
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.
Examined applicant twice, issued two reports, provided no treatment, reports not medical-legal reports, not obtained under Labor Code sections 4060, 4061, or 4062, not reviewed or used to prove/disprove claim.
Reports were not medical-legal reports and not obtained in accordance with relevant Labor Code sections; not used to prove or disprove claim.
From the decision · page 4Dr. Rahimi's reports are not medical legal repo11s. Dr. Rahimi examined the applicant on two occasion, issued two repo11s and provided no treatment. Dr. Rahimi's reports were not obtained in accordance with Labor Code section 4060, 4061 or 4062. Dr. Rahimi was not the primary treating physician nor was he an AME or PQME. There was no evidence showing Dr. Rahimi's reports were ever reviewed or commented upon by the PTP, Dr. Farsar, or the AME. They were never used to prove or disprove a claim.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 4060
Labor Code section 4060
Defines comprehensive medical-legal examination and limits liability for such examinations.
From the decision · page 1We also note that Labor Code section 4060(b) states that "Neither the employer nor the employee shall be liable for any comprehensive medical-legal examination performed by other than the treating physician except as provided in this section." Section 4060(a) provides that "[t]his section shall apply to disputes over the compensability of any injury. This section shall not apply where injury to any part or parts of the body is accepted as compensable by the employer." In this case, section 4060 is not applicable because some body parts were accepted.
Title 8 California Code of Regulations section 9793(c)
Title 8 California Code of Regulations section 9793(c)
Defines comprehensive medical-legal evaluation requirements.
From the decision · page 3III DISCUSSION It is recommended the Petition for Reconsideration be denied. Pursuant to Title 8 of California Code of Regulations section 9793 (c), comprehensive medical-legal evaluation' means
Labor Code section 4064(d)
Labor Code section 4064(d)
Limits employer liability for comprehensive medical evaluations not authorized under specific sections.
From the decision · page 4Labor Code Section 4064(d) provides that "the employer shall not be liable for the cost of any comprehensive medical evaluations obtained by the employee other than those authorized pursuant to Sections 4060, 4061, and 4062. However, no party is prohibited from obtaining any medical evaluation or consultation at the party's own expense."
Title 8 California Code of Regulations section 9789.14
Title 8 California Code of Regulations section 9789.14
Consultation and secondary physician reports are not reimbursable unless specific conditions are met.
From the decision · page 4Consultation reports and secondary physician reports to the primary treating physician are not reimbursable unless a primary treating physician PR-2 repo11, P&S rep011, psych reports requested by the WCAB, or the Administrative director, other than a medical legal report. Title 8 of California Code of Regulations section 9789.14 (2)(3)(b(l).
Labor Code section 4605
Labor Code section 4605
Applicant may self-procure reports at own expense but not supplant medical-legal process.
From the decision · page 4Labor Code section 4605 provides that the applicant may self-procure reports by a "consulting or attending physician," at their own expense, but Labor Code section 4605 may not be used to supplant the medical-legal process. Thus, Dr. Rahimi is not entitled to reimbursement for services provided.
What proof carried it
The evidence the panel weighed, by kind.
Dr. Rahimi's reports were not medical-legal reports and were not obtained in accordance with Labor Code sections 4060, 4061, or 4062.
From the decision · page 4Dr. Rahimi's reports are not medical legal repo11s. Dr. Rahimi examined the applicant on two occasion, issued two repo11s and provided no treatment. Dr. Rahimi's reports were not obtained in accordance with Labor Code section 4060, 4061 or 4062. Dr. Rahimi was not the primary treating physician nor was he an AME or PQME. There was no evidence showing Dr. Rahimi's reports were ever reviewed or commented upon by the PTP, Dr. Farsar, or the AME. They were never used to prove or disprove a claim.
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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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