WCPanelIQ
PanelQMEMed-legalGranted

Robasciotti, Karen

KAREN ROBASCIOTTI, Applicant vs. MAXIM HEALTHCARE; ACE AMERICAN INSURANCE COMPANY, c/o ESIS, Defendants

ADJ number
ADJ12265574
Decision date
Oct 13, 2024
District office
Santa Barbara
WCJ
—
Claim administrator
ESIS (administering for ACE American Insurance Company)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: mouth/teeth, cranial nerve, digestive tract, psyche, headaches, lumbar spine, cervical spine, head, speech impairment

LC §5909LC §5900LC §4453LC §4622CCR §10600CCR §10325

Summary

Karen Robasciotti, a psyche technician, sustained industrial injury on January 16, 2019 to multiple body parts including her mouth/teeth, cranial nerve, digestive tract, psyche, and headaches. The PWCJ found permanent total disability without apportionment, calculated average weekly wages at $1,750 using a wage capacity analysis based on testimony of occasional 60-hour weeks, and added (rather than combined) the dental/head/facial disabilities. Defendant sought reconsideration challenging the wage capacity calculation, the addition of facial/dental disabilities, and the lack of nonindustrial apportionment. The Board granted reconsideration, agreed a wage capacity analysis under section 4453(c)(4) was appropriate but reduced the AWW to $1,050 (based on 36 credible weekly hours including 12 overtime hours), and found the dental QME's opinion failed to satisfy the ADL analysis required by Vigil for adding rather than combining disabilities. The Board rescinded the F&A and deferred permanent disability, apportionment, and attorney fees pending development of the record.

Issues

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Holding

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Analysis

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Defense takeaway

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