WCPanelIQ
PanelQMEMed-legalGranted in Part

Ramirez, Jose

JOSE RAMIREZ, Applicant vs. QUALITY SCALES UNLIMITED; INSURANCE COMPANY OF THE WEST, adjusted by ICW GROUP, Defendants

ADJ number
ADJ10518881
Decision date
Mar 16, 2025
District office
San Jose
WCJ
—
Claim administrator
ICW Group (adjusting for Insurance Company of the West)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, PAUL F. KELLY, COMMISSIONER

Injury / body parts: head, neck, low back, left hip, left knee, left shoulder, psyche

LC §5909LC §5900LC §5313LC §5903LC §5952LC §4660.1LC §4660CCR §10600CCR §10166

Summary

Jose Ramirez, in pro per, sought reconsideration of a December 17, 2024 F&A in which the WCJ found a non-catastrophic industrial injury to multiple body parts and psyche, awarded 40% PD based on PQME Dr. Chang's reports and a DEU consultative rating determination, and excluded any psychiatric component under Labor Code section 4660.1(c)(1). The WCAB granted reconsideration, finding the WCJ's Opinion on Decision and Report failed to comply with section 5313 because they did not identify the medical reports, WPIs, AMA Guides analysis, or rating strings supporting the 40% PD finding, and failed to explain the catastrophic-injury determination. The Board also found the WCJ improperly relied on a DEU consultative rating determination, which is inadmissible under CCR section 10166(b). As its decision after reconsideration, the Board amended the F&A to defer the PD impairment rating, all section 4660.1(c) issues, permanent-and-stationary status, and attorney's fees, while otherwise affirming the WCJ's decision.

Issues

Member is $25/month or $250/year and includes full case search.

Holding

Member is $25/month or $250/year and includes full case search.

Analysis

Member is $25/month or $250/year and includes full case search.

Applicant takeaway

Member is $25/month or $250/year and includes full case search.

Defense takeaway

Member is $25/month or $250/year and includes full case search.

Provider takeaway

Member is $25/month or $250/year and includes full case search.

Similar decisions

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.