The Workers'
Compensation practice
you've been meaning to build.
Or the one you've been
meaning to scale.

Hi Melissa:

I hope you are well. Please find my demand in the above-referenced case.

I have laid out my estimates as to how I think this case will proceed. If your client would like to discuss resolution, please review my estimates on temporary disability, permanent disability, deferred conditions, and future medical and let me know if you would like to provide a counter.

Please note that I have gone through a comprehensive assessment and I am willing to hear a counter on the PD, buyout of the deferred conditions, and the future medical.

Please speak to your adjuster, and perhaps there is a manner by which we can reach a settlement that is mutually beneficial to both parties.

I am pretty good at working with these applicants to come to settlement.

Here are my thoughts:

Injury History

Applicant worked for Cornerstone Restaurant Group, LLC dba Riverside Grill beginning in October 2018 in food preparation with heavy, repetitive demands including chopping lettuce, cutting meats, assembling machines, stocking, cleaning, and continuous standing. She reports a cumulative trauma beginning around May 2019 with neck tension from understaffing and harassment, then progressive pain in the back, shoulders, elbows, and wrists/hands from rapid repetitive prepping and cooking tasks involving gripping, grasping, and torqueing wrist movements.

By September 2019, she developed bilateral upper extremity symptoms with numbness, tingling, and grip loss from the forceful hand use and rapid prep/cook demands. Knee and right foot pain began around January 2020 from constant weightbearing and prolonged standing. She last worked for Cornerstone Restaurant Group around January 1, 2026, resigning due to severe pain and stress. The cumulative trauma period extended through January 1, 2026, and then she continued working at another restaurant location.

Pending Panel Evaluations & Deferred Conditions

The chiropractic panel QME Dr. Michael Bennett has completed multiple evaluations but has expressly NOT declared MMI and cannot determine impairment until updated diagnostics and specialty evaluations are completed.

Dr. Bennett has already deferred cervical and lumbar spine surgical evaluation to Neurosurgery, comprehensive orthopedic evaluation of the spine, shoulders, knees, wrists, and hands to Orthopedic Surgery, pain management interventions including lumbar epidural injections to Pain Management, and bilateral carpal tunnel syndrome surgical consideration to Hand Surgery/Orthopedics.

Given what I have seen in the records, I will also be pursuing Internal Medicine, Psychiatry, Neurology, and Urology panels to address the documented hypertension, diabetes, GERD, anxiety, insomnia, headaches, and urinary incontinence.

We are also still awaiting the updated MRI of the lumbar spine and cervical spine that Dr. Bennett ordered, which will be necessary to complete the medical workup.

Temporary Disability

TTD is owed as follows at $460.00/week based on AWE of $690.00 per week:

• 01/01/2026–12/30/2027 (104 weeks): $47,840.00

Total TTD: $47,840.00

For purposes of settlement, I will agree to one year of TD = $23,920.00

Permanent Disability

I have reviewed the reporting, diagnostic studies, and analyzed the examination findings, as well as the subjective and objective medical evidence.

Here are my thoughts:

Cervical Spine: MRI dated November 15, 2021, showed straightening of cervical lordosis with osteophytes and disc desiccation at multiple levels. Specific findings include mild diffuse disc bulges at C3-C4 (2.7 mm) indenting the thecal sac with bilateral foraminal compromise, C4-C5 (2.7 mm) with bilateral foraminal compromise, C5-C6 (3.1 mm) with mild broad-based posterior protrusion and bilateral foraminal compromise, and C6-C7 (3.0 mm) with mild broad-based posterior protrusion and bilateral foraminal compromise.

Dr. Bennett's examination documented loss of cervical lordosis with slight kyphosis, positive cervical compression on the right and positive Spurling's on the left, and pinwheel sensation changes at left C6/C7.

These multilevel disc abnormalities with foraminal compromise and objective neurological findings support cervical DRE Category III impairment.

I have estimated the WPI at 10% (DRE III).

Rating string: 100% (15.01.03.00 - 10 - [1.4] 14 - 322G - 13 - 11%) 11%

Lumbar Spine: MRI dated October 1, 2021, revealed straightening of lumbar lordosis with beginning disc desiccation at L5-S1. Notable findings include broad-based disc protrusion at L2-L3 (1.6 mm) abutting the thecal sac, disc bulge at L3-L4 (0.9 mm) with mild bilateral foraminal narrowing and lateral recess stenosis, broad-based protrusion at L4-L5 (2.2 mm) with mild-moderate bilateral foraminal narrowing and lateral recess stenosis showing contact on bilateral exiting and transiting nerve roots, and broad-based protrusion at L5-S1 (4.0 mm) with moderate bilateral foraminal narrowing and deviation of bilateral exiting nerve roots. Dr. Bennett documented loss of lordosis with paravertebral spasm and guarding, reduced ROM with forward flexion limited to 50 degrees, and pain with movement.

The multilevel protrusions with nerve root contact and deviation establish lumbar DRE Category III.

I have estimated the WPI at 10% (DRE III).

Rating string: 100% (15.03.03.00 - 10 - [1.4] 14 - 322G - 13 - 11%) 11%

Bilateral Carpal Tunnel Syndrome: EMG/NCV studies dated July 29, 2022, confirmed median nerve entrapment at the wrist bilaterally with right moderate carpal tunnel syndrome and left mild-to-moderate carpal tunnel syndrome. The studies showed increased distal motor latency of the right median nerve, increased distal sensory latencies bilaterally, and abnormal median versus radial thumb latency differences exceeding 0.3 ms on both sides.

Dr. Bennett documented positive Finkelstein's testing bilaterally and grip weakness was noted in neurosurgical consultation records. The confirmed bilateral median neuropathy with motor and sensory involvement justifies conservative hand impairment ratings.

• Right Hand (Carpal Tunnel Syndrome): I have estimated the WPI at 5%.
• Left Hand (Carpal Tunnel Syndrome): I have estimated the WPI at 5%.

Combined PD: 31% PD = $40,020.00

Deferred Conditions / Additional Exposure

As discussed above, the records reflect additional conditions/exposures not included in the PD demand total that increase potential liability.

Psychiatry: Records document that the Applicant reports experiencing anxiety and easily becoming stressed in connection with her industrial injuries, and has difficulty sleeping and feels tired during the day.

Neurology: Dr. David Carter's orthopedic evaluation noted that Ms. Ramirez's neck pain is associated with headaches.

Urology: Dr. Carter's evaluation documented that Ms. Ramirez has some incontinence in the setting of her spinal complaints.

Future Medical Care

Based on the multilevel cervical and lumbar spine pathology with nerve root contact and deviation, confirmed bilateral carpal tunnel syndrome, and the ongoing need for comprehensive specialty care, future medical treatment will be extensive and costly.

Dr. Bennett has specifically recommended updated cervical and lumbar MRIs, repeat EMG/NCV studies, and evaluations by neurosurgery, orthopedic surgery, and pain management with consideration of epidural injections and possible surgery.

Based on the foregoing, I am willing to recommend a buyout of future medical for $75,000.00.

SJDB: $6,000.00 voucher.

Return-to-Work Supplement: $5,000.00 supplement.

Summary

• TD: $23,920.00
• PD: 31% = $40,020.00
• Deferred Conditions / Additional Exposure: $50,000.00
• Future Medical: $75,000.00

Total = $129,020 plus the TD owed.

With the specialty panel evaluations still required to complete the medical workup (Internal Medicine, Psychiatry, Neurology, Urology) and ongoing supplemental reports from panels already on file, your incremental panel-development costs alone will run roughly $15,000 to $25,000, on top of the deposition fees for the panels already reported.

Each new panel triggers the full panel process including initial QME panel examination at approximately $2,015, comprehensive records review at $1,500 to $3,000, cross-examination deposition at $2,500 to $3,000.

Declining to settle now will cost your carrier significantly more than the current demand, and these litigation costs accrue on top of whatever liability ultimately attaches to the underlying claim.

I hope we can reach a settlement that is mutually beneficial to both parties.

If you would like to discuss, please email me or contact me at (555) 847-2916.

Thanks,

Steven Marshall

Dear Dr. Ghayoumi:

Please be advised that this office represents the applicant in the above-referenced matter. We are writing to request supplementation of your medical-legal report dated December 10, 2025, regarding the following issues, which are essential to a complete and accurate evaluation of our client's injury and resulting disability.

Your report assigns 1% Whole Person Impairment (WPI) for the applicant's right shoulder based on range of motion (ROM) findings under the AMA Guides 5th Edition, Chapter 16. Specifically, you reference flexion of 170°, which yields 1% Upper Extremity Impairment (UEI) and converts to 1% WPI. However, this rating does not fully account for the applicant's documented functional limitations and persistent symptoms.

The MRI findings of the right shoulder reveal significant pathology, including partial insertional tears of the supraspinatus and infraspinatus tendons, biceps tenosynovitis, small subacromial/subdeltoid bursitis, and a possible superior glenoid labral lesion. Clinically, you documented positive Neer and Hawkins impingement tests, mild tenderness in the bicipital groove, and persistent pain complaints affecting activities of daily living (ADLs), such as lifting, reaching, and overhead activities. These findings support functional limitations beyond the ROM-based impairment you assigned.

Under AMA Guides Chapter 18, chronic pain that significantly interferes with ADLs warrants an additional pain-related impairment of 1–3% WPI. Given the applicant's documented ADL limitations and positive impingement signs, a conservative pain add-on of 1% WPI is appropriate.

Question: Doctor, would you agree that the correct WPI for the applicant's right shoulder is at least 2%, reflecting 1% WPI for ROM and an additional 1% WPI for chronic pain under Chapter 18? If you disagree, please: 1) identify the AMA Guides authority that precludes a pain add-on in this case; and 2) explain why the applicant's documented ADL limitations and positive impingement findings do not warrant additional impairment.

Your report assigns 0% WPI for the applicant's right wrist and hand despite documented clinical findings consistent with mild median nerve sensory deficit. Specifically, you noted positive Phalen, Tinel, and Durkan tests, decreased sensation to light touch in the median nerve distribution, and MRI findings of TFCC and ligament tears, degenerative radiocarpal narrowing, and cystic changes. These findings indicate objective pathology and functional impairment that should be rated under AMA Guides Chapter 16.

AMA Guides Table 16-10 and Table 16-11 provide impairment ratings for sensory deficits based on severity and distribution. A mild sensory deficit in the median nerve distribution, as documented here, warrants at least 1% WPI. Additionally, the applicant reports difficulty with gripping, fine manipulation, and ADLs such as folding laundry, which further supports functional impairment.

Question: Doctor, would you agree that the correct WPI for the applicant's right wrist and hand is at least 1%, reflecting mild sensory deficit under Tables 16-10 and 16-11? If you disagree, please: 1) identify the AMA Guides authority that supports assigning 0% WPI despite positive clinical findings; and 2) reconcile the applicant's documented symptoms and ADL limitations with your conclusion.

Your report apportions the applicant's right shoulder impairment as follows: 40% to the current cumulative trauma, 40% to a prior cumulative trauma at El Pollo Loco, and 20% to preexisting degenerative factors. However, this apportionment does not comply with the substantial evidence standard under Escobedo v. Marshalls (2005) 70 CCC 604.

Under Escobedo, apportionment must include a reasoned “how and why” analysis explaining the contribution of each factor to the applicant's current permanent disability. Your report references “degenerative changes” and a “history of prior cumulative trauma” but does not explain how these factors contribute to the applicant's current 1% WPI or functional loss. Percentages alone are insufficient without a pathophysiologic allocation correlating imaging findings with functional impairment.

Question: Doctor, would you agree that the apportionment opinion provided in your report does not meet the substantial evidence standard under Escobedo? If you disagree, please: 1) provide a detailed “how and why” analysis explaining the contribution of each factor to the applicant's current permanent disability; and 2) identify the specific clinical metrics supporting your apportionment percentages.

Your report recommends future medical care for the applicant's right shoulder and right wrist/hand, including physician visits, medications, physical therapy, chiropractic care, occupational therapy, and possible corticosteroid injections. However, the scope of future medical care should also include repeat diagnostic studies, such as EMG/NCV testing, ultrasound-guided injections, and surgical consultation if conservative measures fail.

Given the applicant's ongoing symptoms and MRI-documented pathology (TFCC tear, ulnotriquetral ligament tear, degenerative radiocarpal narrowing), future medical care must remain open to address potential progression of her condition and the need for advanced interventions.

Question: Doctor, would you agree that future medical care for the applicant's right upper extremity should include repeat EMG/NCV testing, ultrasound-guided injections, and surgical consultation if conservative measures fail? If you disagree, please: 1) explain why these interventions are not medically necessary; and 2) clarify the scope of future care you believe is appropriate.

Your report confirms that the applicant reached Maximum Medical Improvement (MMI) as of November 15, 2025. However, you do not address the applicant's temporary disability (TD) status during the cumulative trauma period (08/21/2022–08/21/2023) or the period leading up to MMI.

The applicant ceased working at Imperial Crest Healthcare Center on September 5, 2025, due to increasing hand pain and began lighter work at Speed X on October 22, 2025. Presumed TD should extend from the last date of injury (08/21/2023) through the MMI date (11/15/2025), consistent with disability payments noted in the record from October 2023 to October 2024.

Question: Doctor, would you agree that the applicant was temporarily totally disabled from 08/21/2023 through 11/15/2025? If you disagree, please: 1) provide the basis for concluding the applicant was not disabled during this period; and 2) clarify the TD periods you believe are supported by the medical evidence.

Your report does not address several conditions documented in the applicant's medical records, including headaches, sleep disturbance, and psychiatric sequelae. These conditions fall outside the scope of your orthopedic specialty and should be deferred to appropriate specialists for evaluation.

Question: Doctor, would you agree to defer your opinion on causation, impairment, and treatment for these conditions to a Panel QME Neurology and a Panel QME in Psychology? If you disagree, please: 1) explain why these conditions do not warrant deferral; and 2) clarify whether you would recommend specialty referrals for further evaluation.

Your report references MRI findings suggesting a possible superior glenoid labral lesion in the right shoulder, with degenerative change versus tear. You recommend MR arthrogram correlation but do not request this study. Additionally, repeat EMG/NCV testing may be warranted to evaluate the progression of the applicant's right wrist/hand neuropathy.

Question: Doctor, would you agree that the following diagnostic studies are medically necessary: 1) MR arthrogram of the right shoulder to evaluate the superior glenoid labral lesion; and 2) repeat EMG/NCV testing for the right wrist/hand neuropathy? If you agree, would you like to re-evaluate this applicant once these studies are completed so that you can determine accurate whole person impairment?

Your report does not assign any additional WPI for chronic pain under AMA Guides Chapter 18 despite the applicant's documented ADL limitations and persistent symptoms. Chronic pain that significantly interferes with daily activities warrants an additional pain-related impairment of 1–3% WPI.

Question: Doctor, would you agree that the applicant's chronic pain warrants at least 1% WPI under Chapter 18? If you disagree, please: 1) explain why chronic pain does not warrant additional impairment; and 2) reconcile the applicant's documented ADL limitations with your conclusion.

Your report assigns minimal WPI (1% for the right shoulder and 0% for the right wrist/hand) and states that the applicant has no work restrictions. However, the applicant reports significant ADL limitations, including difficulty gripping, fine manipulation, and overhead activities. These functional limitations are inconsistent with the minimal WPI assigned.

Question: Doctor, would you agree that the applicant's documented ADL limitations indicate greater functional impairment than reflected in the assigned WPI? If you disagree, please: 1) reconcile the applicant's ADL limitations with your impairment rating; and 2) clarify whether work restrictions should be imposed based on the applicant's functional capacity.

Thank you for your time and consideration in providing these clarifications. We respectfully request a supplemental report addressing the above-referenced conditions and look forward to your response.

Sincerely,
Jonathan Sintel
Applicant Attorney

Case: Rosa Mendoza v. Sterling Hospitality Services, LLC
Case Nos.: ADJ19284736; ADJ19362145
Witness: Anthony Saldana, M.D., Orthopedic Surgery (Panel QME)
Examining Counsel: Steven Marshall, Applicant Attorney

Strategic Overview

This is a buttress deposition. Dr. Saldana issued MMI/P&S on 08/16/2025 with full industrial causation findings and 100% industrial apportionment across six body parts. His opinions are applicant-favorable and trial-ready. The goal is to lock in every favorable finding, eliminate ambiguity, and build an unassailable record. This is not a change deposition; we are reinforcing the foundation the doctor has already built.

• Lock MMI/P&S. Confirm that despite a later supplemental acknowledging another evaluator's not-MMI view, Dr. Saldana has not rescinded his 08/16/2025 MMI determination.
• Fortify Causation. Industrial mechanism for all injuries: specific assault (left shoulder) and cumulative trauma (lumbar, bilateral wrists, bilateral hips). Anchor to deposition testimony.
• Confirm 100% Industrial Apportionment. No preexisting pathology; defendant has not met its Labor Code § 4663 burden.
• WPI Lockdown. Conservative, defensible, AMA Guides-anchored.
• TD Lockdown. TTD from 10/06/2024 (date of assault/termination) through 08/16/2025 (MMI).
• Future Medical. Updated lumbar MRI, injections, surgical consults.

I. Foundation: Qualifications, Records, Legal Standards

1. Doctor, you are Anthony Saldana, M.D., board certified in Orthopedic Surgery, correct?
2. You have performed hundreds of California Workers' Compensation evaluations during your career, correct?
3. You are familiar with the AMA Guides 5th Edition as the governing impairment standard under Labor Code § 4660, correct?
4. You understand that causation in Workers' Compensation must be stated to reasonable medical probability, not scientific certainty, correct? McAllister v. WCAB (1968) 33 CCC 660.
5. You are familiar with the contributing-cause standard: an injury is compensable if employment is a contributing cause, not necessarily the sole or predominant cause, correct? South Coast Framing v. WCAB (Clark) (2015) 80 CCC 489.
6. You reviewed Ms. Mendoza's deposition transcript of 08/30/2025 before issuing your 06/02/2026 supplemental report, correct?
7. In that deposition, Ms. Mendoza testified under oath that on 10/06/2024, a coworker punched her in the left upper chest and clavicle region, causing her to stumble backwards into a door, correct?
8. She also testified she filed a police report regarding the assault that same day, and that she was terminated the same day she reported the assault to management, correct?
9. She testified her housekeeping duties at Sterling Hospitality required pushing and pulling carts exceeding 50 pounds, mopping, vacuuming, moving heavy furniture, and climbing ladders, correct?
10. She testified she worked 11-hour shifts, six days per week, for approximately eight months from February 2024 through October 6, 2024, correct?
11. You considered all of this deposition testimony when forming your opinions, correct?
12. Your opinions on causation and apportionment are consistent with her sworn testimony, correct?
13. You also reviewed a report from Dr. Marcus Whitfield, D.C., dated 09/21/2025, in which he opined that Ms. Mendoza was not permanent and stationary as of that date, correct?
14. Despite reviewing Dr. Whitfield's opinion, you have NOT rescinded your 08/16/2025 determination that Ms. Mendoza reached MMI/P&S on that date, correct?
15. Your 08/16/2025 report remains your controlling orthopedic opinion in this case, correct?

II. Records Not Reviewed: Flagging Gaps

16. You did not review the emergency room records from St. Bernardine Medical Center for Ms. Mendoza's 10/06/2024 visit following the assault, correct?
17. You did not review any Human Resources or termination records from Sterling Hospitality regarding her employment, correct?
18. You did not review the police report filed by Ms. Mendoza on 10/06/2024, correct?
19. If those records were provided to you and contained information supporting the industrial mechanisms described in her deposition, that would strengthen your causation opinions, correct?

III. History & Mechanism: Cumulative Trauma

20. Ms. Mendoza reported to you a history of heavy, repetitive housekeeping duties from February 2024 through October 6, 2024, correct?
21. She described pushing and pulling heavy linen and trash carts exceeding 50 pounds, repetitive mopping and vacuuming, bending, lifting, and ladder use, correct?
22. She worked 11-hour shifts, six days per week, for approximately eight months, correct?
23. That history is consistent with cumulative trauma to the lumbar spine, bilateral wrists, and bilateral hips, correct?
24. You opined that the cumulative trauma from this heavy housekeeping work was the industrial cause of her lumbar spine condition, her bilateral wrist conditions, and her bilateral hip conditions, correct?

IV. History & Mechanism: Specific Assault (Left Shoulder)

25. Ms. Mendoza reported to you that on 10/06/2024, a coworker punched her in the left upper chest and clavicle region, causing her to fall backwards into a door, correct?
26. This was a violent physical assault that occurred in the workplace during her shift, correct?
27. She went to the emergency room that same day due to severe pain and was diagnosed with an injury to the left clavicle, correct?
28. A violent workplace assault is a recognized mechanism of injury in California Workers' Compensation, correct?
29. The mechanism you relied upon, a punch causing backward fall into a door, is consistent with the left shoulder injury you diagnosed, correct?

V. Body Part 1: Lumbar Spine (DRE II, 8% WPI, 100% Industrial)

30. On examination, Ms. Mendoza exhibited antalgic pain behaviors with toe and heel walking and with squatting, correct?
31. She had paravertebral muscle spasm, correct?
32. Her lumbar range of motion was limited: flexion to 60° with pain and spasm, extension to 25° with pain and spasm, correct?
33. You noted sensory decrease at the L5 distribution on the left, which is an objective neurological finding consistent with nerve involvement, correct?
34. X-rays showed maintained lordosis and disc spaces, but X-rays do not visualize disc herniations, annular tears, or nerve compression, correct?
35. An MRI is the gold standard for evaluating disc pathology and nerve compression, correct?
36. You assigned DRE Category II for the lumbar spine, corresponding to 8% Whole Person Impairment under AMA Guides Chapter 15, correct?
37. Using the contributing-cause standard, Ms. Mendoza's industrial employment as a housekeeper was a contributing cause of her lumbar spine condition to reasonable medical probability, correct?
38. You assigned 100% industrial apportionment for the lumbar spine because you found no evidence of preexisting lumbar pathology or disability, correct?
39. Defendant has not provided you with any evidence establishing preexisting lumbar disability, correct?

VI. Body Part 2: Left Shoulder (9% WPI, 100% Industrial, Assault Mechanism)

40. On examination, Ms. Mendoza had tenderness at the anterior deltoid, biceps tendon, and AC joint of the left shoulder, correct?
41. You documented left shoulder ROM by inclinometer: flexion 135°, abduction 75°, extension 20°, internal rotation 58°, external rotation 10°, adduction 7°, correct?
42. Those measurements reflect reduced range of motion compared to normal values, correct?
43. Left shoulder X-ray showed a type 2 acromion with no fracture or dislocation; type 2 acromion is a recognized predisposing factor for impingement but does not make the impairment non-industrial, correct?
44. The assault lit up or aggravated any predisposing condition, causing disability and the need for treatment, correct? Lamb v. WCAB (1974) 39 CCC 310.
45. You rated the left shoulder using the ROM method, yielding 15% Upper Extremity Impairment converted to 9% Whole Person Impairment under AMA Guides Chapter 16, correct?
46. The specific assault on 10/06/2024 was a contributing cause of Ms. Mendoza's left shoulder injury to reasonable medical probability, correct?
47. Even if there were some preexisting asymptomatic condition, the assault aggravated it to cause disability, correct? Tanenbaum v. IAC (1935) 4 Cal.2d 615.
48. You assigned 100% industrial apportionment for the left shoulder; you found no evidence of preexisting shoulder pathology, correct?

VII. Body Parts 3-6: Wrists and Hips (Summary Lockdown)

49. Left Wrist. Positive Phalen's bilaterally; positive Finkelstein's on the left; ROM by inclinometer flexion 15° / extension 10°. Diagnosis: tendinitis. ROM method yields 16% UEI converted to 10% WPI, 100% industrial, correct?
50. Right Wrist. Positive Phalen's; ROM by inclinometer reduced. Diagnosis: tendinitis. ROM method yields 11% UEI converted to 7% WPI, 100% industrial, correct?
51. Left Hip. Antalgic gait, tenderness over greater trochanter; reduced ROM. Diagnosis: trochanteric bursitis with ROM impairment. 16% Lower Extremity Impairment converted to 16% WPI, 100% industrial, correct?
52. Right Hip. Tenderness over greater trochanter; mildly reduced ROM. Diagnosis: trochanteric bursitis. 2% WPI, 100% industrial, correct?
53. For each of these four body parts, you found no preexisting pathology and assigned 100% industrial apportionment, correct?

VIII. Apportionment Lockdown (Labor Code § 4663)

54. Doctor, you understand that under Labor Code § 4663, the burden is on the defendant to prove apportionment by substantial medical evidence, correct? Escobedo v. Marshalls (2005) 70 CCC 604.
55. To support apportionment to non-industrial factors, there must be a reasoned how-and-why analysis tied to specific medical evidence, correct?
56. You found no medical evidence in this record supporting apportionment of any of the six body parts to non-industrial causes, correct?
57. You found no preexisting disability, no preexisting pathology of disability-causing significance, and no asymptomatic degenerative process that meets the Escobedo standard, correct?
58. Type 2 acromion alone, without symptoms, treatment, or functional limitation before 10/06/2024, does not support apportionment under Escobedo, correct?
59. Defendant has not provided you with any substantial medical evidence establishing preexisting disability for any of the six body parts, correct?
60. Accordingly, 100% industrial apportionment is the correct conclusion for each body part you rated, correct?

IX. Temporary Disability Lockdown

61. Ms. Mendoza last worked at Sterling Hospitality on 10/06/2024, the date of the assault and the date she was terminated, correct?
62. From that date forward through your 08/16/2025 MMI determination, she was unable to perform her usual and customary work as a housekeeper, correct?
63. That period, 10/06/2024 through 08/16/2025, is a period of temporary total disability, correct?
64. Her subsequent lighter employment at Coastal Janitorial does not change the orthopedic basis for TTD during the buttress period, correct?

X. MMI / P&S Lockdown

65. You determined that Ms. Mendoza reached MMI/P&S on 08/16/2025, correct?
66. That determination is based on your physical examination, imaging, history, and review of records, correct?
67. You reviewed Dr. Whitfield's 09/21/2025 not-MMI opinion in your 06/02/2026 supplemental, but you did not rescind your MMI determination, correct?
68. Dr. Whitfield is a chiropractor, not an orthopedic surgeon, and the orthopedic MMI determination is yours, correct?
69. As of today, your MMI/P&S date of 08/16/2025 remains your controlling orthopedic opinion, correct?

XI. Future Medical Care

70. You recommend lifetime future medical care for the lumbar spine, including updated MRI, physical therapy, pain management with consideration of epidural injections, and orthopedic surgical consultation if conservative measures fail, correct?
71. You recommend future medical care for the left shoulder including imaging, injections, and orthopedic surgical consultation if symptoms progress, correct?
72. You recommend future medical care for the bilateral wrists including ongoing conservative care, splinting, and surgical consultation if symptoms progress, correct?
73. You recommend future medical care for the bilateral hips including ongoing conservative care, injections, and orthopedic consultation, correct?
74. Future medical care must remain open to address potential progression and the need for advanced interventions, correct?

XII. Deferrals: Non-Orthopedic Conditions

74. Ms. Mendoza reports headaches, sleep disturbance, and psychiatric sequelae arising out of the assault and the workplace environment, correct?
75. These conditions fall outside your orthopedic specialty, correct?
76. You defer evaluation of causation, impairment, and treatment for these conditions to a Panel QME in Neurology and a Panel QME in Psychology, correct?

XIII. Kite / Vigil: Add Impairments, Do Not Combine

77. Doctor, the impairments to Ms. Mendoza's six body parts each result from distinct anatomical injuries with distinct industrial mechanisms, correct?
78. You agree that her lumbar, left shoulder, bilateral wrist, and bilateral hip impairments affect different physical functions and do not overlap in their effect on her activities of daily living, correct?
79. Under Athens Administrators v. WCAB (Kite) (2013) 78 CCC 213 and Vigil v. County of Kern (2013) 78 CCC 1062, where multiple impairments do not overlap, they may be added rather than combined under the Combined Values Chart, correct?
80. Your opinion that these impairments affect distinct functions supports addition rather than combination, correct?

XIV. Final Lockdown

81. Doctor, all of your opinions today are stated to a reasonable degree of medical probability, correct?
82. Nothing in your supplemental reports has changed your 08/16/2025 MMI determination, your causation findings, your WPI ratings, or your 100% industrial apportionment conclusions, correct?
83. Your 08/16/2025 report, as supplemented, is your controlling orthopedic opinion, correct?
84. Thank you, Doctor. No further questions.

Generated by FleetIx Legal drafting agents from the 08/16/2025 orthopedic Panel QME report, the 06/02/2026 supplemental, applicant's 08/30/2025 deposition transcript, and the Coastal Janitorial subsequent-employer records. Attorney reviewed and approved before deposition.

SHORT SCRIPT

Your Honor, applicant requests an order compelling defendant to agree to the requested psych and internal QME panels or proceed to trial on June 25, 2026.

Under WCAB panel decisions Morfin, Muldrow, Mangan, and Tovar, an applicant is entitled to a QME evaluation even where the claim is denied; the denial does not have to be decided before the panel issues.

Moreover, under 8 CCR § 31.7 and the seven good-cause pathways articulated in Salcido v. Waste Management Collection and Recycling (2024) 89 CCC 846, applicant has the right to additional specialty panels where the disputed issues fall outside the existing evaluator's competence.

Here, the orthopedic panel has deferred to psych and internal, which is itself substantial evidence that the existing panel is medically inadequate under McDuffie v. LACMTA (2002) 67 CCC 138.

Finally, the defendant's failure to timely object to the DOR waives its objection to this hearing proceeding under 8 CCR § 10251.

Applicant requests an order that defendant agree to the psych and internal panels by [specific date] or stipulate to trial.

LONG SCRIPT

Opening – Issue and Relief Requested. Your Honor, applicant respectfully requests an order compelling defendant to agree to the requested psych and internal medicine QME panels, or alternatively, stipulate to proceed to trial on the compensability and medical issues on June 25, 2026.

Diligence Timeline. On June 1, 2026, applicant served a DOR requesting panels in psychology and internal medicine based on the orthopedic panel's deferral of those body systems. Defendant did not object within 10 days under 8 CCR § 10251. That failure to object waives defendant's right to contest this proceeding being set. The hearing is now scheduled for June 25, 2026.

Controlling Authority – Panel Rights in Denied Claims. Defendant has denied this claim. That denial does not suspend applicant's right to obtain QME evaluations. Under WCAB panel decisions Morfin v. Araujo's Mexican Grill (2015) Cal. Wrk. Comp. P.D. LEXIS 601, Muldrow v. AMS Outsourcing/Staffchex (2019) Cal. Wrk. Comp. P.D. LEXIS 452, Mangan v. Oakdale Inn, LLC dba Holiday Inn Express (2022) Cal. Wrk. Comp. P.D. LEXIS 219, and Tovar v. United Pacific (2025) Cal. Wrk. Comp. P.D. LEXIS 338, the length-of-employment issue under LC § 3208.3(d) and other threshold defenses need not be determined before an applicant is entitled to a QME evaluation.

Defendant may preserve and later litigate its defenses at trial, but those defenses cannot be used to block access to the QME process.

Good Cause Under 8 CCR § 31.7 – Specialty Deferral. Good cause for the additional panels exists under 8 CCR § 31.7. The orthopedic QME deferred evaluation of the psych and internal medicine issues to those specialties.

That deferral is itself substantial evidence that the existing panel is medically inadequate. Under McDuffie v. LACMTA (2002) 67 CCC 138, the Board has an independent duty to develop the record where the existing evaluator cannot decide a material disputed issue. The proper remedy is an additional panel in the deferred-to specialty, not waiver of the issue.

Additionally, under Jover v. County of San Bernardino Department of Public Health (2025) Cal. Wrk. Comp. P.D. LEXIS 125 and Vietmeier v. Northrop Grumman Systems Corp. (2025) Cal. Wrk. Comp. P.D. LEXIS 280, applicant does not need to prove industrial causation before requesting additional QME panels.

The existence of alleged injuries, symptoms, and disputed medical issues outside the existing evaluator's specialty is sufficient. That standard is met here.

Waiver of Objection to DOR. Under 8 CCR § 10251, defendant had 10 days to object to the DOR. Defendant did not object. That failure waives defendant's objection to this matter proceeding. While waiver does not foreclose defendant from raising substantive defenses at trial, it does foreclose defendant from blocking the issuance of the panels and forcing an improper threshold hearing before the medical record can be developed.

Concrete Prejudice if Denied. If defendant's position is upheld, applicant will be forced to trial on an incomplete and inadequate medical record. The Court will lack substantial medical evidence on the psych and internal medicine issues, the very issues the orthopedic QME expressly deferred. Under McDuffie, that outcome violates the Board's duty to develop the record.

Moreover, applicant will be denied the neutral QME process guaranteed by statute and regulation.

Concrete Plan. If the Court orders issuance of the panels today, applicant proposes the following: defendant shall agree to issuance of the psych and internal panels within 7 days; the evaluations shall be completed within 90 days; and the matter shall return for a status conference in 120 days.

If defendant refuses to stipulate to this plan, applicant requests the Court set the matter for trial on June 25, 2026 on all compensability, medical, and penalty issues.

Closing. Your Honor, applicant has met every procedural requirement. Defendant waived its objection to the DOR.

Applicant is entitled to the panels under Morfin, Muldrow, Mangan, Tovar, Jover, and Vietmeier. The orthopedic deferral establishes good cause under 8 CCR § 31.7 and triggers the Board's record-development duty under McDuffie.

Applicant respectfully requests an order compelling defendant to agree to the panels or proceed to trial.

CITATION APPENDIX

1. 8 CCR § 10251. 10-day objection window to a DOR; failure to object within 10 days generally waives objection to the proceeding being set.
2. Morfin v. Araujo's Mexican Grill (2015) Cal. Wrk. Comp. P.D. LEXIS 601. The length-of-employment issue under LC § 3208.3(d) need not be determined before an applicant is entitled to a QME evaluation.
3. Muldrow v. AMS Outsourcing/Staffchex (2019) Cal. Wrk. Comp. P.D. LEXIS 452. Same; defense cannot block QME panel on threshold psyche-bar grounds.
4. Mangan v. Oakdale Inn, LLC dba Holiday Inn Express (2022) Cal. Wrk. Comp. P.D. LEXIS 219. Same.
5. Tovar v. United Pacific (2025) Cal. Wrk. Comp. P.D. LEXIS 338. Same (most recent authority on the sequencing rule).
6. 8 CCR § 31.7. Additional panel procedure; Administrative Director may issue an additional panel upon a showing of good cause where doing so will assist in reaching an expeditious and just resolution of disputed medical issues.
7. Salcido v. Waste Management Collection and Recycling (2024) 89 CCC 846. Additional panels may be appropriate when new body systems or conditions arise during litigation and the existing evaluator cannot adequately address all disputed medical issues; the standard is whether the additional evaluation will assist in reaching an expeditious and just resolution.
8. McDuffie v. LACMTA (2002) 67 CCC 138 (en banc). The Board has an independent duty to develop the record where the existing evaluator cannot decide a material disputed issue; that duty overrides procedural waiver where medical evidence is inadequate.
9. Jover v. County of San Bernardino Department of Public Health (2025) Cal. Wrk. Comp. P.D. LEXIS 125. Applicant does not need to prove industrial causation to disputed body parts before requesting additional QME panels in the relevant specialty; the existence of alleged injuries, symptoms, and disputed medical issues outside the existing evaluator's specialty is sufficient.
10. Vietmeier v. Northrop Grumman Systems Corp. (2025) Cal. Wrk. Comp. P.D. LEXIS 280. Same (one of the two most current and powerful authorities on the no-proof-of-causation-required rule).
11. Labor Code § 4060 / § 4061 / § 4062. Panel-evaluation framework.
12. Orozco v. Healthview Inc. dba Harbor View House (2025) Cal. Wrk. Comp. P.D. LEXIS 368. Additional panels warranted when new body systems or conditions arise and the existing evaluator cannot adequately address all disputed medical issues.
13. Labor Code § 3202. Liberal construction supports relief from procedural default where injustice would otherwise result.

DISTINGUISHING CASES

1. Defense will argue Martinez v. Santa Clarita Community College District (2015) Cal. Wrk. Comp. P.D. LEXIS 2 and Dekay v. Lowe's Home Centers LLC (2016) Cal. Wrk. Comp. P.D. LEXIS 551 (requests for multiple initial panels simultaneously are generally improper). Distinguish: Those cases address initial panel requests made simultaneously before any evaluation has occurred. Here, the orthopedic panel has already been issued and has completed its evaluation. That evaluation resulted in an express deferral to psych and internal medicine. This is a classic additional-panel scenario under 8 CCR § 31.7, not a simultaneous initial-panel request. Martinez and Dekay do not apply.
2. Defense will argue applicant must prove AOE/COE and compensability before obtaining additional specialty panels. Distinguish: Jover (2025) and Vietmeier (2025) explicitly reject this argument. Applicant does not need to prove industrial causation before requesting additional QME panels. The existence of alleged injuries, symptoms, and disputed medical issues outside the existing evaluator's specialty is sufficient. These are the two most current and controlling authorities on this point.
3. Defense will argue that because the claim is denied, applicant cannot obtain QME panels until the denial is litigated. Distinguish: Morfin, Muldrow, Mangan, and Tovar flatly reject this position. The threshold defense (here, the denial) need not be determined before an applicant is entitled to a QME evaluation. The defense may be preserved and litigated at trial, but it cannot be used to block access to the QME process. Tovar (2025) is the most recent authority on this sequencing rule.
4. Defense will argue the orthopedic deferral means applicant can "choose to live with it" and does not establish good cause. Distinguish: The deferral is itself substantial evidence that the existing panel is medically inadequate. Allowing applicant to "live with" the deferral would deprive the Court of substantial medical evidence on material disputed issues, the psych and internal medicine body systems, in direct violation of McDuffie's record-development duty. The proper remedy under 8 CCR § 31.7 is an additional panel in the deferred-to specialty, not waiver of the issue.
5. Defense will argue that applicant waived the right to additional panels by failing to act sooner or by not proving diligence. Distinguish: Applicant served a timely DOR. Defendant had 10 days to object under 8 CCR § 10251 and did not. That failure waives defendant's objection to this matter proceeding. Moreover, McDuffie's record-development duty overrides procedural waiver where the medical record is inadequate. The orthopedic deferral only became apparent after the evaluation was completed; applicant acted promptly thereafter.