WCPanelIQ
PanelQMEMed-legalGranted

Jover, Elenita

ELENITA JOVER, Applicant vs. COUNTY OF SAN BERNARDINO DEPARTMENT OF PUBLIC HEALTH, permissibly self-insured and self-administered, Defendant

ADJ number
ADJ18210611
Decision date
May 7, 2025
District office
San Bernardino
WCJ
—
Claim administrator
County of San Bernardino Department of Public Health (permissibly self-insured and self-administered)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: cervical spine, lumbar spine, shoulders, right thumb, stress, psyche, sleep, head (headaches), eyes (vision), ears (hearing), diabetes, kidney, pulmonary

LC §5909LC §5900LC §5903LC §5952CCR §31.7

Summary

Applicant Elenita Jover, a licensed vocational nurse, claimed injury to multiple body parts during a continuous trauma period from April 1, 2000 through January 29, 2022. The orthopedic panel QME, Dr. Schaffzin, found injury and permanent disability to the cervical/lumbar spine, shoulders, and right thumb, but recommended evaluations in other specialties (pulmonology, internal medicine for diabetes, ophthalmology, ENT, and neurology) for additional disputed body parts. The WCJ denied applicant's request for additional QME panels, finding no medical evidence linking the additional body parts to employment and no diligence in pursuing panels. On reconsideration, the Board held that an applicant need not establish causation to obtain QME panels for disputed body parts and that good cause for additional panels existed based on Dr. Schaffzin's recommendation. The Board granted the petition, rescinded and substituted the F&A to defer the additional body-part issues, and found good cause for additional panels in the five recommended specialties, returning the matter to the trial level.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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