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Medical Expert Report's Outside of AME-QME Process are Inadmissible

Dated-October 2015

Sacramento, CA - Margaret Batten injured her jaw, shoulders, knees, neck, and low back while working as a registered nurse for Long Beach Memorial Hospital. She also claims that she injured her psyche as a result of these physical injuries. 

Dr. Joseph Stapen as the agreed psychiatric panel qualified medical examiner found that 47 percent of her psychiatric condition was caused by industrial factors, which was below the required "predominant cause" threshold for a compensable psychiatric injury.

The WCJ authorized Batten to retain her own qualified medical expert, Dr. Gary Stanwyck, at her own expense pursuant to LC 4064(d). Stanwyck found that over 51 percent of her psychiatric condition was due to her work-related injuries. The WCJ admitted Stanwyck's report into evidence and found Stanwyck to be "convincing and persuasive" and thus found Batton sustained injury to her psyche. The WCAB granted reconsideration and concluded that Stanwyck's report was not admissible and the WCJ should have relied on the opinion of Stapen. The Court of Appeal affirmed the WCAB in the published case of Batton v WCAB.

Although not expressly mentioned by the WCAB, section 4061, subdivision (i) prohibits the admission of privately retained reports, unless they are prepared by a treating physician. Section 4061, subdivision (i) precludes admission of an independently retained expert opinion as follows: "With the exception of an evaluation or evaluations prepared by the treating physician or physicians, no evaluation of permanent impairment and limitations resulting from the injury shall be obtained, except in accordance with Section 4062.1 or 4062.2. Evaluations obtained in violation of this prohibition shall not be admissible in any proceeding before the appeals board."