Workers’ Compensation · Primary-source case analysis

Suon: Controlling QME Information and Ex Parte Communications

Decision: Workers’ Compensation Appeals Board, ADJ9013590, ADJ9014316, and ADJ9489408, decided October 23, 2018. Document: WCAB en banc opinion and decision after reconsideration.

Suon supplies a practical framework for controlling what reaches a qualified medical evaluator and for responding when a party believes the statutory communication rules were violated.

Three claims and a disputed QME record

Sandab Suon filed three injury claims arising from his work as a machine operator for California Dairies. The cases were consolidated, multiple carriers were involved, and the parties disputed records and correspondence sent in connection with a cardiovascular QME evaluation. The judge found violations and imposed remedies; one carrier sought review.

Unresolved information disputes belong before the WCAB

The Board held that parties should first try to resolve disagreements about information proposed for a QME. If they cannot, the dispute must be presented to the WCAB rather than decided unilaterally by sending or withholding the material. Section 4062.3 governs both information provided to the evaluator and communications about the evaluation.

Reasonable-time rules protect the process

Although section 4062.3(b) does not state a fixed deadline for objecting to medical records, the opposing party must object within a reasonable time to preserve the issue. Likewise, a party that discovers a prohibited ex parte communication and elects to terminate the evaluation and seek a new one must act within a reasonable time.

Remedy and disposition

The trial judge has broad discretion to select an appropriate remedy for a violation. Because rulings about QME information and ex parte communication are interlocutory, removal was the proper avenue for immediate review. The WCAB treated the petition as one for removal, rescinded the findings, and returned the matter for further proceedings.

Key takeaways

Discuss the procedural record

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