SANDRA BUENDIA, Applicant vs. HOSPITALITY STAFFING SOLUTIONS; ACE AMERICAN INSURANCE COMPANY, administered by ESIS, INC., Defendants
ADJ number
ADJ9499857
Decision date
Apr 2, 2025
District office
Anaheim
WCJ
John C. Cyprien
Claim administrator
ESIS, Inc. (administering ACE American Insurance Company)
Commissioners
—
Injury / body parts: knees, low back/lumbar spine, kidneys/renal system, left hip, right hip, neck/cervical spine, shoulders, circulatory system (hypertension), internal organs (GERD/gastritis), head (headaches), psyche, sleep disorder, excretory system
Applicant Sandra Buendia suffered an admitted industrial injury on May 13, 2014 to her knees and low back. After trial on the limited issue of which additional body parts and systems were injured, the WCJ found compensable injury to the kidneys/renal system, left hip, circulatory system (hypertension), internal organs (GERD/gastritis), sleep disturbance, headaches, and psyche, largely stemming from the chronic use of NSAIDs prescribed for the orthopedic injuries; further development of the record was ordered for the right hip, cervical spine, and shoulders. Defendants petitioned for reconsideration, arguing the WCJ exceeded his powers by finding the medication effects industrial when there was allegedly no evidence the NSAIDs were authorized or certified by Utilization Review. The Appeals Board denied reconsideration, adopting the WCJ's report, which demonstrated that Defendants ignored their own Exhibit D—a UR certification of naproxen dated March 31, 2015. The Board admonished defense counsel for violating WCAB Rule 10945 by failing to fairly state all material evidence.
Issues
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Holding
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Analysis
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Applicant takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Defense takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Provider takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Similar decisions
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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