WCPanelIQ
PanelQMEMed-legalLienGranted

Gordillo, Bonifeicio

BONIFEICIO GORDILLO, Applicant vs. CAMILLE'S, INC.; SECURITY NATIONAL INSURANCE COMPANY, administered by AMTRUST NORTH AMERICA, INC.; ARCH INSURANCE COMPANY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., Defendants

ADJ number
ADJ10404221
Decision date
Dec 15, 2024
District office
Van Nuys
WCJ
—
Claim administrator
AmTrust North America, Inc. (administering Security National Insurance Company); Sedgwick Claims Management Services, Inc. (administering Arch Insurance Company)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: cervical spine, thoracic spine, lumbar spine, cardiovascular system (hypertension), psychiatric system

LC §3208.1LC §5313LC §5412LC §5500.5LC §5900LC §5909CCR §10600

Summary

Applicant, a general manager, claimed cumulative trauma injury to the cervical, thoracic, and lumbar spine, cardiovascular system (hypertension), and psychiatric system over a period running from 1994 to 2019. The WCJ found a single cumulative trauma injury for all body parts ending October 9, 2019, awarded 26% PD with apportionment, and concluded that liability under Labor Code sections 5412 and 5500.5 fell in the period October 9, 2018 to October 9, 2019. Defendant Arch Insurance sought reconsideration, arguing the WCJ failed to make a proper Labor Code section 5412 date-of-injury finding, impairing Arch's right to seek contribution from co-defendant Security National under section 5500.5. The Board granted reconsideration, finding the WCJ failed to apply the requisite analytical framework distinguishing three separate issues: the end date of injurious exposure, the section 5412 date of injury, and the section 5500.5 period of liability. The Board rescinded the F&A and substituted findings deferring all three issues, returning the matter to the trial level for further development of the record, particularly in light of the QME's reporting that spinal exposure ended May 4, 2016 with P&S status reached August 15, 2017.

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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