WCPanelIQ
PanelQMEMed-legalLienDenied

Robinson, Kerri

KERRI ROBINSON, Applicant vs. FRANK D. LANTERMAN DEVELOPMENTAL SERVICES; STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ643599
Decision date
Jan 20, 2025
District office
Pomona
WCJ
—
Claim administrator
State Compensation Insurance Fund
Commissioners
CRAIG SNELLINGS, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: neck, back, psyche, dental, TMJ, teeth, face, headaches, jaw, knees, shoulders

LC §5909LC §5900LC §5950LC §4709LC §112LC §115LC §5301LC §5901LC §5908.5LC §5950LC §5906LC §5908LC §5315LC §5701LC §5911LC §5951LC §110LC §111LC §5903LC §5952LC §5953LC §4600LC §4616LC §5952CCR §10600CCR §10940CCR §10320CCR §10330CCR §10961CCR §10962CCR §10995CCR §10205CCR §10205.4

Summary

Lien claimant Dental Trauma Center treated applicant Kerri Robinson for industrial dental/TMJ injuries arising from two 2004 workplace assaults; defendant's QME Dr. Peterson opined that 50% of the jaw condition was attributable to a pre-existing 1987 gunshot injury and that no future treatment was needed. The WCJ found treatment before October 11, 2005 reasonable but apportioned treatment after that date to the non-industrial 1987 injury. On reconsideration, the Board held that medical treatment is not apportionable under Granado, found Dr. Peterson's reports were not substantial evidence because they rested on an incorrect legal theory and an inadequate (stale) medical history, and amended the F&O to defer the post-October 11, 2005 treatment issue, returning the matter to the WCJ. Defendant then filed a second petition for reconsideration based on the Mayor decision, arguing former section 5909 deemed-denial and no equitable tolling; the Board denied that petition, applying Shipley equitable tolling and noting the matter was already considered and that defendant's petition was procedurally defective and improperly successive.

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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