WCPanelIQ
PanelQMEMed-legalDenied

Cabrera, Agustina

AGUSTINA CABRERA, Applicant vs. AG FORCE, LLC; permissibly self-insured member of CALIFORNIA FARM MANAGEMENT, INC.; administered by INTERCARE HOLDINGS, Defendants

ADJ number
ADJ18102810
Decision date
Aug 11, 2024
District office
Fresno
WCJ
Debra Sandoval
Claim administrator
Intercare Holdings (administering AG Force, LLC, permissibly self-insured member of California Farm Management, Inc.)
Commissioners
—

Injury / body parts: lumbar spine, neck, bilateral shoulders, bilateral wrists, bilateral hands, bilateral arms, right wrist, psyche, headaches

LC §3600LC §3208.1LC §5412

Summary

Agustina Cabrera, a 52-year-old farm laborer, filed a cumulative trauma claim against her permissibly self-insured employer after being laid off on July 3, 2023, alleging injury to her neck, low back, bilateral shoulders, bilateral wrists, bilateral hands, and psyche. PQME Dr. Allen Fonseca opined that her symptoms were consistent with the described industrial mechanism, and the WCJ found her injury industrial, set the date of injury at 11/7/23 under Labor Code section 5412, and rejected the post-termination defense under section 3600(a)(10)(D). Defendant petitioned for reconsideration, arguing Dr. Fonseca's report was not substantial medical evidence because it was internally inconsistent, based on inadequate history and speculation, and could not support a post-termination date of injury. The WCAB adopted and incorporated the WCJ's Report and denied reconsideration, finding Dr. Fonseca's reporting constituted substantial medical evidence. The Board emphasized that defendant failed to controvert the QME's reasoning and did not pursue the diagnostic studies the doctor recommended.

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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