WCPanelIQ
PanelQMEMed-legalLienDenied

Navarro, Rafael

RAFAEL NAVARRO, Applicant vs. BITECH INC.; ACCIDENT FUND INSURANCE OF AMERICA, administered by UNITED WISCONSIN INSURANCE OF NEW BERLIN, Defendants

ADJ number
ADJ11413860
Decision date
Apr 20, 2025
District office
Marina del Rey
WCJ
Daniel L. Ter Veer
Claim administrator
United Wisconsin Insurance of New Berlin (administering Accident Fund Insurance of America)
Commissioners
—

Injury / body parts: right knee, lumbar spine, bilateral wrists, bilateral hands, neck, left knee, bilateral ankles, sleep

LC §5909LC §5900LC §4656LC §4909LC §5952LC §5502LC §5401LC §5402LC §3550LC §3551

Summary

Applicant Rafael Navarro, a bicycle mechanic, claimed a specific injury (05/30/2018) to his right knee and a cumulative trauma (12/01/2016–05/31/2018) to his lumbar spine and bilateral wrists. The WCJ found the right knee and CT injuries industrial, awarded TTD for the right knee from 07/09/2018 to 05/05/2021 (subject to the 104-week cap), assigned Occupational Group Number 360, denied defendant credit for an alleged TTD overpayment, denied defendant's late request for tax-return discovery, and rejected defendant's fraud/double-dipping and restitution claims, while deferring several issues (P&S date, PD, apportionment, causation for the hands) for further development of the record. Defendant petitioned for reconsideration on six grounds. The Appeals Board adopted and incorporated the WCJ's Report and Opinions on Decision and denied reconsideration, also addressing the timeliness of its action under amended Labor Code section 5909.

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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