vampireinthenight wrote:It is interesting, but not all that surprising. The WCAB has long held that chiros can evaluate anything physical. The theory is that the chiro will refer out something complicated like hand disability to a specialist with more experience in hand surgery and arthritic conditions in the hand. As if multiple QMEs are the best way to handle these cases. But this rarely happens anyway. Usually the chiro will attempt to rate everything which can work, except it is no secret that chiros generally provide liberal ratings, which lead to depositions about the extent of their knowledge and experience with things like upper extremity surgical outcomes, which then leads to trials on substantiality.
So, neither result is great, but that is what the WCAB insists is fair and contemplated by the QME Panel system.
To answer your last question, this is a panel decision and holds no binding authority at all. It shouldn't carry any weight at all and we used to get threatened with sanctions for even citing to panel decisions. But clearly it is the norm now (see footnote 2 of the decision you attached). I still think it is hilarious that the WCAB accepts a citation to their own non-binding panel decision and then states that they find their own opinion "persuasive".

Anecdotally, I have been doing this for 17 years (Chiropractic panels) and I have not gotten deposed for the issue you make note of on referring or not referring to the correct specialty. Maybe it is happening with the other chiropractors, I don't know -- not my colleagues that I know of. I feel that I have been deposed a lot less than the orthopedists that I know. I think I am deposed in 1 out of 30 or 40 panels, maybe even higher, though more are scheduled, they are invariably cancelled prior. Whenever I have been deposed it has been to clarify restrictions, diagnoses or something much less monumental than I was concerned about going in. It is interesting in all my 17 years I have not had a challenge on substantiality - not one letter from a carrier or their counsel that my report did not meet evidentiary standards. I really do the think the flip side is that chiro's try harder to acquit themselves well, whereas many MD's blow through the work as quick as they can. I really do feel that the cynical column that was posted several months ago about trying to derail the chiro QME based on medications is just an attempt to find doctors that are more conservative. You hit the nail on the head: Chiro's are perceived to yield more PD. And for that, they (defense) want chiro's out of the system. It always comes down to the baseness of money and nothing more noble than that.
I disagree also with the notion that WCAB cannot sight a panel case: what they are doing is pulling logic to refer to. The judge found some rationale that made sense to him/her and brought it out. Of course I could be wrong on that. I am not a lawyer. This whole thing this last few years in QME's and everything else has made me so sick sometimes that it caused me to complete my first year in law school (which I always wanted to do nonetheless. And yea there they just cite all the top cases from the state supreme court, Learned Hand and whoever. But they also cite rationale from other sources -- it is just not binding. It shows why the justice is arriving at his (they were all hims. not hers back in the day) opinion.
But based on what you are saying about this case,there really isn't any progress on the issue since there are no binding decisions. So we plow on...