WCPanelIQ
PanelQMEMed-legalGranted

Mora, Karina

KARINA MORA, Applicant vs. FRONTIER COMMUNICATIONS, AMERICAN ZURICH INSURANCE COMPANY, Defendants

ADJ number
ADJ12630887
Decision date
Feb 2, 2025
District office
San Bernardino
WCJ
Petty
Claim administrator
American Zurich Insurance Company
Commissioners
JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: cervical spine, right shoulder, right arm, circulatory system, diabetes, psyche

LC §3202.5LC §3600LC §4061LC §4062.2LC §5313LC §5701LC §5702LC §5705LC §5708LC §5806LC §5807LC §5813LC §5900LC §5906LC §5909LC §5952LC §5953CCR §31.7CCR §10421

Summary

Applicant Karina Mora sustained an admitted cumulative industrial injury to her cervical spine and right shoulder while working as a BDL Specialist for Frontier Communications. After she amended her claim to include psyche and diabetes, defendant denied those body parts, refused to authorize a treating physician's request for an internal medicine evaluation, and filed a DOR asserting no further discovery was needed. The WCJ closed discovery over applicant's repeated objections, and after applicant did not testify at trial, found she failed to meet her burden of proving injury to the right arm, circulatory system, diabetes, and psyche. The WCAB majority granted reconsideration, holding applicant had exercised reasonable diligence in seeking medical and medical-legal evaluations and that, where no substantial evidence addressed the framed issues, the WCJ had a duty to develop the record. The Board rescinded the F&A and remanded for development of the record, including additional QME panels in internal medicine and psychology. Commissioner Razo dissented, arguing applicant failed to meet her burden and the WCAB has no duty to develop the record where a party recognizes the deficiency but fails to act.

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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