WCPanelIQ
PanelQMEMed-legalDenied

Hale, Mari Luz

MARI LUZ HALE, Applicant vs. SUPER STORES INDUSTRIES; THE NORTH RIVER INSURANCE COMPANY, administered by CRUM AND FORSTER, Defendants

ADJ number
ADJ11387739
Decision date
Sep 9, 2024
District office
Lodi
WCJ
—
Claim administrator
Crum and Forster (administering for The North River Insurance Company)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: bilateral wrists, elbows, thoracic outlet syndrome

LC §5701LC §5909LC §5900LC §5902LC §5903CCR §10600CCR §10955

Summary

Applicant Mari Luz Hale, an accountant, sustained a cumulative trauma injury to her bilateral wrists, elbows, and in the form of thoracic outlet syndrome over her April 3, 2001 to April 3, 2017 employment. The parties stipulated to injury, future medical care, and the scheduled rating, leaving apportionment as the sole issue for trial. The WCJ found that QME Dr. Gregorius's apportionment analysis did not constitute substantial evidence—noting the QME omitted apportionment in his first three reports, opined 100% to cumulative trauma in his fourth report, then changed to 50% preexisting at deposition, and repeatedly disclaimed expertise in thoracic outlet syndrome—and appointed Dr. Rutchik as a regular physician under Labor Code section 5701. Defendant sought reconsideration, arguing the QME's reporting should be relied upon for all issues including apportionment. The Board treated the petition under the removal standard (since the only challenged finding was interlocutory) and denied it, concurring with the WCJ's weighing of the evidence and finding no substantial prejudice or 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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