CA WCAB En Banc Decision on Reconsideration in Messele v Pitco Foods

In California, the Workers’ Compensation Appeals Board holds that the timeliness of seeking a Qualified Medical Evaluator (QME) panel applies prospectively to panel QME requests made after the date of its prior decision, Sept. 26, 2011.

The Appeals Board wrote in its opinion:

“Having invited comments from the community on our proposed modification and having received no comments in response to our notice of intention, we now amend our September 26, 2011 decision to clarify that it shall apply prospectively from September 26, 2011. Specifically, if prior to our September 26, 2011 decision, a panel was prematurely but otherwise properly requested and there was no objection on the ground of prematurity, then the resulting panel may not later be challenged on that ground. In other words, if an objection based on prematurity was not made prior to our September 26, 2011 decision, neither party may challenge the request, the ensuing panel, the remaining QME following the striking of names, or the resulting report for prematurity. Of course, other grounds for challenge may exist and are not affected by this modification of our decision. Moreover, our September 26, 2011 decision does not constitute good cause to reopen any order, decision, or award.” http://www.dir.ca.gov/wcab/EnBancdecisions2011/Messele_Tsegay-3.pdf

We advise any patient, attorneys or insurance companies to discuss QME selections with Medical Legal Experts Medical Inc., to ensure that a Functional Capacity Evaluation (FCE) is ordered during this exam process.