QMEs; Replacement Panel; Ex Parte Communications. WCAB held defendant was not entitled to replacement QME panel under LC 31.5(a)(2) to evaluate applicant's left knee injury based upon original QME's failure to schedule first appointment within 60 days as required under LC 33(e), when new appointment with same QME scheduled after defendant objected to initial appointment was scheduled within 60 days so as to cure any non-compliance with applicable rules, and applicant would suffer undue delay and significant prejudice by being required to undergo evaluation with a new panel QME; Counsel's communications with QME's staff regarding scheduling of appointment with QME to evaluate applicant did not constitute a prohibited ex parte communication. See O'Reilly panel decision.

 

Spinal Surgery; Utilization Review. WCAB affirmed WCJ's award of medical treatment in form of three level disc replacement surgery recommended by treating physician to be performed in Germany, when uncontroverted evidence indicated that this type of surgery was not available in United States, that fusion surgery available in United States was a less desirable option from a cost and recovery perspective than surgery available in Germany, and that recommended surgery was reasonably required to cure or relieve effects of applicant's industrial injury; WCAB held that effect of treating physician's failure to submit request for authorization of surgery in proper format as set forth in Administrative Director's rules meant that 10-day period for defendant to object to request for authorization under LC 4062(b) and utilization review process described in Cervantes v. El Aguila Food Products were never triggered, but since matter proceeded to expedited hearing on applicant's request for spinal surgery without objection from defendant that it was not provided with an opportunity to obtain UR of request, issue of defendant's need for UR was waived. See Pappas panel decision.