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PanelQMEMed-legalDismissed

Espinoza, Jose

JOSE ESPINOZA, Applicant vs. ARIANA AUTO BODY; NATIONAL CASUALTY COMPANY, administered by ILLINOIS MIDWEST, Defendants

ADJ number: ADJ16740659
Decision date: Oct 21, 2024
District office: Oakland
WCJ: —
Claim administrator: Illinois Midwest (administering for National Casualty Company)
Commissioners: KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: left knee, left ankle, lumbar spine

LC §5909LC §5900LC §5902LC §5903LC §4064LC §5705LC §3202.5LC §3600CCR §10955CCR §9811

Summary

Applicant Jose Espinoza, an auto detailer, sustained an admitted industrial injury on September 13, 2022 to his left knee and left ankle, and claimed additional injury to his lumbar spine. The WCJ's May 28, 2024 F&A found no industrial injury to the lumbar spine, found applicant permanent and stationary as of March 21, 2023, and awarded 12% PD. On August 13, 2024, the Appeals Board granted applicant's petition for reconsideration, rescinded the F&A, and returned the matter for further development of the record because the QME's opinions on P&S status and lumbar causation were equivocal and did not constitute substantial medical evidence. Defendant then petitioned for reconsideration of that August 13, 2024 Decision, arguing the QME findings were substantial evidence. The Board dismissed defendant's petition, holding the rescission order was an interlocutory, non-final decision not subject to reconsideration, and would have denied it as a petition for removal because defendant showed no irreparable harm.

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.