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PanelQMEMed-legalDenied

Salzano, Mendy

MENDY L. SALZANO, Applicant vs. ROSS STORES; ARCH INSURANCE COMPANY, administered by SEDGWICK CMS, Defendants

ADJ number: ADJ10425538
Decision date: Jan 20, 2025
District office: San Diego
WCJ: Linda F. Atcherley
Claim administrator: Sedgwick CMS (administering Arch Insurance Company for Ross Stores)
Commissioners: —

Injury / body parts: right knee, left knee

LC §5814LC §5814.5LC §5813LC §5909LC §5900LC §5903LC §4050CCR §10964CCR §10600CCR §10650

Summary

Applicant Mendy Salzano suffered a right knee injury (DOI May 4, 2015) that was settled by Stipulations with Request for Award on July 5, 2018, then timely reopened alleging a left knee injury as a compensable consequence. Defendant deferred UR and denied the left knee claim based largely on a non-admissible Labor Code section 4050 report by Dr. Pallia (who was neither a treating physician, consulting physician, nor PQME) raising the issue of 'antalgic gait,' even though the PQME (Dr. King) and treating physician (Dr. Harris) consistently found the left knee compensable. After prolonged discovery, injury was established and the WCJ awarded section 5814 penalties of $750 and attorney's fees of $13,185 under sections 5814.5 and/or 5813 for unreasonable delay/denial of medical treatment. The Board adopted the WCJ's Report, found defendant's petition untimely and meritless, and denied reconsideration. The Board also addressed the amended section 5909 timeline, concluding it acted within 60 days of transmission.

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.