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PanelQMEMed-legalGranted

Delao, Michelle

MICHELLE DELAO, Applicant vs. STATE OF CALIFORNIA, IHSS, and INTERCARE HOLDING INSURANCE, Defendants

ADJ number: ADJ14950155
Decision date: Mar 23, 2025
District office: San Jose
WCJ: —
Claim administrator: Intercare Holding Insurance
Commissioners: JOSÉ H. RAZO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: COVID-19/Long Haul COVID (respiratory/systemic infection)

LC §5909LC §5900LC §5701LC §5906CCR §10945CCR §10600

Summary

Michelle Delao, an IHSS caregiver, claimed she contracted COVID-19/Long COVID from her November 18, 2020 exposure to a care recipient who tested positive on November 19, 2020. The WCJ found no industrial injury (AOE/COE), relying on QME Dr. Baum's opinion that applicant could not have contracted COVID-19 on November 18 because she first tested positive on December 23, 2020—roughly 40 days later—well beyond the 14-day maximum latency period. The WCAB granted reconsideration, finding Dr. Baum's reporting did not constitute substantial medical evidence because it was inconsistent with applicant's clinical history and failed to explain key conclusions. The Board also found that applicant's treating physicians (Drs. Cervenka and Bonilla) relied on inaccurate histories. The Board rescinded the F&O and returned the matter to the trial level for further development of the medical record.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.