What the panel ordered
Findings of Fact issued on October 31, 2013, are affirmed; applicant is entitled to a new panel QME for his two new injury claims; matter returned to trial level.
Defendant sought removal after the WCJ found applicant entitled to a new panel QME for two new injury claims and that Rule 35.5(e) did not apply. The WCAB granted removal, issued a notice of intention, received responses, and now issues its en banc decision affirming the WCJ's findings.
This docket was decided more than once. Shown here is the latest released decision; we also hold February 27, 2014.
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 Labor Code requires that an employee return to the same evaluator only when a new medical issue arises in the same claim of injury, not for subsequent claims of injury. Rule 35.5(e) is inconsistent with the Labor Code and invalid to the extent it requires return to the same evaluator for new injuries involving the same parties and body parts.
From the decision · page 24 Based upon our review of the relevant statutes and case law, we hold that:
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant's two claims of specific injury were reported after the original evaluation but before a subsequent evaluation by a new evaluator.
Favours Applicant prevailed
This timing meant the new claims were not subject to the requirement to return to the original QME under the Labor Code.
From the decision · page 1116 claims of specific injury were reported after the original evaluation but before a subsequent evaluation by
The statutes make no distinction between claims or injuries to same or different body parts and same or different parties for purposes of QME selection.
Favours Applicant prevailed
This statutory interpretation invalidated Rule 35.5(e)'s requirement to return to the same evaluator for new injuries involving the same parties/body parts.
From the decision · page 1114 injuries involve some of the same body parts and the same parties, the statutes make no distinction
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.
Dr. Yogaratnam evaluated applicant for the original injury claim; the issue was whether applicant must return to Dr. Yogaratnam for subsequent claims. The WCAB held applicant is not required to return to Dr. Yogaratnam for new injury claims.
Dr. Yogaratnam was the original panel QME; the dispute was whether applicant must return to him for subsequent claims. The WCAB found the Labor Code does not require this.
From the decision · page 220 by panel QME J. Yogaratnam, M.D., in that case.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code sections 4062.1, 4062.2, 4062.3(j), 4064(a)
The Labor Code requires that an employee return to the same evaluator only when a new medical issue arises in the same claim of injury, not for subsequent claims of injury. Rule 35.5(e) is invalid to the extent it requires otherwise.
Applied to hold applicant entitled to a new panel QME for subsequent claims of injury, not required to return to original QME.
From the decision · page 24 Based upon our review of the relevant statutes and case law, we hold that:
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.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
- If you are named in this decision and want this page removed, write to privacy@similarcase.com.