tenet/centinela Hosp. v. Wcab

95 Cal. Rptr. 2d 858, 80 Cal. App. 4th 1041
CourtCalifornia Court of Appeal
DecidedMay 18, 2000
DocketB133678
StatusPublished
Cited by7 cases

This text of 95 Cal. Rptr. 2d 858 (tenet/centinela Hosp. v. Wcab) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
tenet/centinela Hosp. v. Wcab, 95 Cal. Rptr. 2d 858, 80 Cal. App. 4th 1041 (Cal. Ct. App. 2000).

Opinion

95 Cal.Rptr.2d 858 (2000)
80 Cal.App.4th 1041

TENET/CENTINELA HOSPITAL MEDICAL CENTER, Petitioner,
v.
WORKERS' COMPENSATION APPEALS BOARD and Carolyn Rushing, Respondents.

No. B133678.

Court of Appeal, Second District, Division Three.

May 18, 2000.
Review Denied August 9, 2000.[*]

*860 Lister, Martin, Thompson & Secia and David E. Lister, Glendale, for Petitioner.

John A. Mendoza, Santa Ana, for Respondent Carolyn Rushing.

Vincent Bausano for Respondent Workers' Compensation Appeals Board.

*859 ALDRICH, J.

INTRODUCTION

Employer, Tenet/Centinela Hospital Medical Center (the hospital), seeks a writ of review directing the Workers' Compensation Appeals Board (the WCAB) to vacate its order denying reconsideration of the findings and award of the workers' compensation judge (WCJ) based on the report of Edward G. Stokes, M.D. In pursuit of its petition, the hospital contends that Dr. Stokes's report is inadmissible because Ronald Glousman, M.D., was the primary treating physician pursuant to California Code of Regulations, section 9785, subdivision (b) (section 9785).[1] We issued the writ. We hold that where the primary physician has declared the employee's injury to be permanent and stationary, released the employee to return to work, and prescribed no further doctor-involved treatment or visits, the employee was discharged and was thus required to comply with the provisions of section 9785, subdivision (b) and Labor Code sections 4061 and 4062, to change primary treating doctors. Accordingly, we annul the award of the WCAB.

FACTUAL AND PROCEDURAL

BACKGROUND

Carolyn Rushing sustained an injury to her right knee on July 12, 1995, in the course of her employment with the hospital as a home health aide. Dr. Glousman treated Rushing continuously beginning in August 1995, performing surgery twice on her right knee and conducting follow-up care.

Dr. Glousman declared Rushing's injury to be permanent and stationary in October 1996, and imposed no work restriction. In his final report, dated January 23, 1998, Dr. Glousman declared Rushing's injury to be permanent and stationary. In the category of "Treatment Recommendations," Dr. Glousman wrote that Rushing "will continue on a home exercise program." (Italics added.) Under the heading of "Future Medical Care," Dr. Glousman opined, "I do feel that provisions should be made for future medical care. With reasonable medical probability I feel the patient will have a flare-up of her underlying symptoms, requiring the need for future physician visits, anti-inflammatory medications, and possible physical therapy. The patient may also require knee surgery at a later date, if conservative methods do not alleviate her recurrent knee pain." (Italics added.)

Rushing objected to Dr. Glousman's permanent disability opinion. As Rushing was not represented at the time, the hospital followed the requirements of Labor Code section 4061, subdivision (d), and provided her with a three-physician panel. Rather than select a qualified medical examiner (QME) pursuant to Labor Code sections 4061 and 4062, Rushing retained an attorney and began treatment with Dr. *861 Stokes, five months after Dr. Glousman's final report issued.

At her hearing before the WCJ, Rushing relied on the report of Dr. Stokes as her primary treating doctor, and on the rebuttable presumption contained in Labor Code section 4062.9,[2] of the correctness of Dr. Stokes's opinion. The hospital objected to Dr. Stokes's report, promoting instead that of Dr. Glousman. The hospital argued that Rushing was not allowed to select a new primary treating physician based on section 9785, subdivision (b), which precludes a change of treating doctor where the primary treating physician has discharged the employee from further treatment and there is a dispute concerning the need for continuing treatment. The hospital further insisted that Dr. Stokes's report was inadmissible under Labor Code sections 4061 and 4062. These sections of the Labor Code prescribe the procedures to follow when an employee is dissatisfied or disagrees with the treating physician's medical determination.

The WCJ effectively ruled that Dr. Stokes was the primary treating physician, rationalizing that Rushing was entitled to change treating physicians when future medical care is warranted. Because Dr. Glousman stated that Rushing required future medical treatment, the WCJ concluded, Rushing had not been discharged from active care, with the result that she was free to and did validly change treating physicians.

The WCAB denied the hospital's motion for reconsideration affirming the views of the WCJ. The WCAB ruled that because Dr. Glousman had recommended "continued and further medical treatment" (italics added), Rushing had not been discharged from active care when she exercised her right to seek further treatment with Dr. Stokes. Thus, the WCAB ruled Labor Code sections 4061 and 4062 were not implicated.

The hospital filed the instant petition for writ of review, seeking an order directing the WCAB to vacate its order denying reconsideration. We issued the writ.

DISCUSSION

1. Standard of review.

When considering a petition for writ "`"[t]his court must determine whether the evidence, when viewed in light of the entire record, supports the award of the WCAB. This court may not reweigh the evidence or decide disputed questions of fact. [Citations.] However, this court is not bound to accept the WCAB's factual findings if determined to be unreasonable, illogical, improbable or inequitable when viewed in light of the overall statutory scheme. [Citation.] Questions of statutory interpretation are, of course, for this court to decide. [Citations.]"' [Citations.]" (Keulen, Jr. v. Workers' Comp. Appeals Bd. (1998) 66 Cal.App.4th 1089, 1095-1096, 78 Cal.Rptr.2d 500.)

2. Rushing was discharged from Glousman's care and could not change physicians.

Section 9785, subdivision (b) provides, "There shall be no more than one primary treating physician at a time. Where the primary treating physician discharges the employee from further treatment and there is a dispute concerning the need for continuing treatment, no other primary treating physician shall be identified unless and until the dispute is resolved. If it is determined that there is no further need for continuing treatment, then the physician who discharged the employee shall remain the primary treating physician. If *862 it is determined that there is further need for continuing treatment, a new primary treating physician may be selected." (Italics added.)

Section 9785, subdivision (b)'s restriction on changing treating physicians applies when the "primary treating physician discharges" the employee. Stated differently, the injured employee is entitled to change treating doctors until the primary treating doctor "discharges" that worker. Although Dr. Glousman's report does not use the term "discharge," under the facts here, we conclude Rushing was discharged and therefore was precluded from seeking treatment from Dr. Stokes.

First, the WCJ's rationale that Rushing was entitled to change her primary treating doctor because "[t]he applicant may change treating physicians when future medical [treatment] is warranted" (italics added), misinterprets section 9785, subdivision (b).

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Bluebook (online)
95 Cal. Rptr. 2d 858, 80 Cal. App. 4th 1041, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tenetcentinela-hosp-v-wcab-calctapp-2000.