The WCAB has applied Dubon in two recent noteworthy panel decisions finding material procedural defects in the UR process when the defendants did not provide medical records reasonably needed for the UR physicians to make a valid determination. In the first case, the WCAB affirmed the WCJ's finding that the applicant was entitled to medical treatment as requested by his treating physician, including surgery, for an admitted right ankle injury. The WCAB found that...read more.

Navarro En Banc, Which Applied to QMEs, Also Applies Equally to AMEs

The WCAB, in a recent noteworthy panel decision, noted that the holding in Navarro, which applied to QMEs, also applies equally to AMEs. In this case, the WCAB affirmed the WCJ's ruling that the applicant was not required to return to the prior agreed medical examiner for an evaluation of his new injury claim, when the parties had agreed to utilize the same orthopedic agreed medical examiner in three of the applicant's cases but not in the applicant's subsequently filed fourth injury case. The WCAB found that...read more.