Sacramento, CA (WorkersCompensation.com) – In what is viewed as a win for the Applicants Bar and injured workers' in the state of California, the Supreme Court there today upheld a lower court decision that allows injured workers to enter and use medical reports from doctors they have hired independently, even if the employer uses a recognized Medical Provider Network.
In the case of Valdez vs. WCAB and Warehouse Demo Services, the Supreme Court simply affirmed the Court of Appeal's decision that granted writ review and annulled decisions by the Workers' Compensation Appeals Board restricting the admission of reports from a doctor retained by petitioner Elayne Valdez. Valdez was originally injured in a fall at work. She was dissatisfied with her treatment provided by a physician within her employers MPN. According to court records she “did not exercise her right to change physicians within the network, or seek a second or third opinion from an MPN doctor. “ Instead, she began receiving treatment from a doctor who was recommended by her attorney. That doctor, Dr. Nario, was not within the network.
She eventually applied for temporary disability benefits, relying on reports by Dr. Nario. Her employer objected to those reports, saying they were inadmissible under section 4616.6 for purposes of the disability hearing. The employer was overruled by the workers' compensation judge. The judge pointed out that the employer could have objected to Valdez's request for a hearing and sought a qualified medical evaluation to resolve the dispute over temporary disability, but “appear[ed] to have been so certain that non-MPN reports are inadmissible that it looked forward to the trial and establishing the MPN, rather than objecting.”
The Workers' Compensation Appeals Board then overturned the judge, and set the stage for Valdez' successful appeal. The WCAB recognized that section 4605 permits employees to consult with any doctor at their own expense, also noting that section 4605 does not address the admissibility of “unauthorized” medical reports. The Court of Appeal granted Valdez's petition for review and annulled the WCAB's decisions. The Supreme Court decision today clears the way for Applicant hired doctors reports to be fully utilized in the workers' compensation dispute process in the state.