WCPanelIQ
PanelQMEMed-legalLienGranted in Part

Tovar, Karina

KARINA TOVAR, Applicant vs. PACIFIC DENTAL SERVICES; INSURED BY ARCH INDEMNITY INSURANCE administered by GALLAGHER BASSETT, INC., Defendants

ADJ number
ADJ12777220
Decision date
Oct 28, 2024
District office
Los Angeles
WCJ
Edgar Medina
Claim administrator
Gallagher Bassett, Inc. (administering for Arch Indemnity Insurance)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: cervical spine, bilateral wrists, lumbar spine

LC §5909LC §5900LC §5902LC §5903LC §5904LC §5813LC §5703LC §4620LC §4621LC §5307.1LC §139.3CCR §10868CCR §10832CCR §10955CCR §9795CCR §10629CCR §10390CCR §10400CCR §10401CCR §10402CCR §10421

Summary

Karina Tovar, a benefits coordinator, claimed injury to her cervical spine, bilateral wrists, and lumbar spine during employment from January 17, 2017 through November 25, 2019 with Pacific Dental Services. After the case in chief was resolved by Compromise and Release, the lien of Bell Community Medical Group proceeded to trial, where the WCJ found AOE/COE injury, found certain reports to be reasonable medical-legal expenses and others reasonable medical treatment, excluded Exhibit 5, and issued what was labeled a Notice of Intent to sanction MMCK Litigation and Translations $2,500 for failing to timely file a notice of representation under WCAB Rule 10868. Defendant and lien claimant both sought reconsideration. The Board denied defendant's petition, affirming the AOE/COE and medical-legal/treatment findings, but granted lien claimant's petition solely to defer the sanctions issue, holding that the WCJ's NIT failed to provide adequate due process because it lacked a clear statement of reasons and a deadline to respond.

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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