WCPanelIQ
PanelQMELienDenied

Zhang, Heidi

HEIDI ZHANG, Applicant vs. CALIFORNIA STATE UNIVERSITY LONG BEACH RESEARCH FOUNDATION; permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number
ADJ9051748
Decision date
Jan 5, 2025
District office
Los Angeles
WCJ
—
Claim administrator
Sedgwick Claims Management Services (administering for permissibly self-insured California State University Long Beach Research Foundation)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: back, bilateral hips, teeth, nervous system

LC §4603.2LC §5909LC §5900LC §10868LC §5705LC §3202.5LC §4600LC §5903LC §5952LC §4622CCR §10964CCR §10600

Summary

Applicant Heidi Zhang, a director for CSU Long Beach Research Foundation, claimed industrial injury on October 31, 2012 to her back, bilateral hips, and later amended to include teeth among other body parts. After settling the case-in-chief via Compromise and Release, the lien of The Dental Trauma Center proceeded to trial on whether applicant sustained industrial injury to her teeth and defendant's liability for self-procured dental treatment. The WCJ found industrial injury to the teeth and that the self-procured dental treatment was reasonable and required, with the value based on the OMFS. Defendant sought reconsideration, arguing that the reports of Dr. Schames (dentist) and Dr. Pietruszka did not constitute substantial medical evidence because they failed to review prior treating doctors' and QMEs' records. The WCAB denied reconsideration, holding the dental reports were substantial evidence and that under section 4600 there is no apportionment of medical treatment once industrial causation is established.

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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