WCPanelIQ
PanelQMEMed-legalLienGranted

Cook, Kenneth

KENNETH COOK, Applicant vs. MID VALLEY GRINDING COMPANY; OAK RIVER INSURANCE COMPANY, care of BERKSHIRE HATHAWAY HOMESTATE COMPANIES, Defendants

ADJ number
ADJ12055950
Decision date
Jan 20, 2025
District office
Los Angeles
WCJ
—
Claim administrator
Berkshire Hathaway Homestate Companies (administering for Oak River Insurance Company)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: back, neck, shoulders, knees, legs, feet, head (headaches), psyche (stress), internal/gastrointestinal, teeth/dental, TMJ, gums, facial muscles

LC §5950LC §5909LC §5900LC §5313LC §3202.5LC §5701LC §5906LC §5907LC §5908LC §5908.5LC §5803LC §5901CCR §10600CCR §10566

Summary

Lien claimant Dental Trauma Center (DTC) sought reconsideration of a WCJ's October 10, 2024 Findings and Order that found DTC failed to prove an industrial injury occurred and failed to establish valid medical-legal services, ordering it to take nothing on its lien. The underlying case had settled by Compromise and Release for $87,500 in 2022 with defendant disputing injury AOE/COE based on PQME Dr. Brourman's deferred causation opinion pending a formal job analysis. DTC argued the WCJ erred by relying solely on Del Carmen Medical Center reporting and ignoring the reports of Dr. Schames and PQME Dr. Brourman. The Appeals Board granted reconsideration on a preliminary basis, finding the record incomplete and noting that DTC's lien stipulations and issues did not appear to have been properly placed at issue, and that not all of Dr. Brourman's reporting appeared in evidence. The Board deferred a final decision pending further review of the merits and possible development of the record.

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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