WCPanelIQ
PanelQMEMed-legalGranted in Part

Ceja, Santina

SANTINA CEJA, Applicant vs. MORGAN HILL UNIFIED SCHOOL DISTRICT, presumably self-insured, administered by KEENAN ASSOCIATES, Defendants

ADJ number
ADJ11236772
Decision date
Apr 3, 2025
District office
San Jose
WCJ
—
Claim administrator
Keenan Associates (TPA for self-insured Morgan Hill Unified School District)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: head, right upper extremity, neck, back, upper extremities, lower extremities, jaw/TMJ, left foot, left shoulder

LC §5909LC §5900

Summary

Applicant Santina Ceja, in pro per, sought reconsideration of a WCJ's December 16, 2024 F&O finding she did not sustain injury AOE/COE in either a specific claim (ADJ11236772) or cumulative trauma claim (ADJ11236942). The Board granted reconsideration to amend the decision because the parties had stipulated that applicant sustained a specific injury to the head and right upper extremity only on June 24, 2015, which the WCJ's finding of no injury contradicted. However, the Board affirmed that the specific injury caused no disability and required no future medical care, and affirmed the WCJ's finding of no cumulative trauma injury. Relying on QME Dr. Moore and IME Dr. Feinberg, the Board found no substantial medical evidence supported additional body parts, disability, or industrial causation for the cumulative claim, and found Dr. Chen's contrary reports unreliable due to his failure to review the extensive Kaiser records and a conflict of interest. The net result was applicant taking nothing despite the amended finding of the accepted specific injury.

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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