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Pantoja, Maria

MARIA PANTOJA, Applicant vs. JACK IN THE BOX / SBF FOODS, LLC; CIGA by its servicing facility SEDGWICK for CASTLEPOINT NATIONAL INSURANCE COMPANY, in liquidation, Defendants

ADJ number: ADJ9104101
Decision date: Sep 8, 2024
District office: San Luis Obispo
WCJ: —
Claim administrator: California Insurance Guarantee Association (CIGA) by its servicing facility Sedgwick for CastlePoint National Insurance Company, in liquidation
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: back, right shoulder, psyche

LC §4660.1LC §4662LC §4663LC §4664LC §4751

Summary

Maria Pantoja, a 56-year-old cook, sustained industrial injury to her back, right shoulder, and psyche on July 9, 2012, and was previously awarded 59% PD. After filing a timely petition to reopen, the WCJ found 68% permanent partial disability rather than total disability. Applicant sought reconsideration arguing she rebutted the PDRS through medical preclusion and vocational non-amenability. The Board rescinded the WCJ's F&A and found 100% permanent total disability, relying on the psychological AME's and prior QME's opinions that her untreated psychological condition precludes any work, and on applicant's vocational expert showing non-amenability to rehabilitation. The Board rejected defendant's vocational expert as equivocal and improperly based on applicant's lack of education and English skills, which are not disabilities.

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.