WCPanelIQ
PanelQMEMed-legalGranted

Marchante Ortiz, Yolanda

YOLANDA MARCHANTE-ORTIZ, Applicant vs. UNIVERSITY OF CALIFORNIA, BERKELEY, permissibly self-insured, adjusted by SEDGWICK CMS, Defendants

ADJ number
ADJ11396713
Decision date
Aug 15, 2024
District office
Oakland
WCJ
Miller
Claim administrator
Sedgwick CMS (for permissibly self-insured University of California, Berkeley)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: head, back, neck, tinnitus, post-concussive syndrome, traumatic brain injury, brain

LC §4662LC §5900LC §5903LC §5907LC §5908LC §5908.5LC §5950LC §5901LC §5952LC §5803CCR §10628CCR §10629CCR §10605CCR §10400CCR §10401

Summary

Applicant Yolanda Marchante-Ortiz sustained an industrial injury on March 13, 2016 while working as a science specialist for the University of California, Berkeley, affecting her head, back, neck, and resulting in tinnitus, post-concussive syndrome, and traumatic brain injury. The WCJ found 95% permanent disability based on QME Dr. Wayne Anderson's findings, applying a 5% apportionment to a pre-existing genetic tendency toward headaches. Applicant petitioned for reconsideration, arguing for 100% permanent total disability under Labor Code section 4662(a)(4) (injury to the brain resulting in permanent mental incapacity), supported by the QME and vocational evaluator Jeff Malmuth. The Board first resolved a timeliness dispute in applicant's favor due to defective service of the F&A. The Board then granted reconsideration, deferring its final decision to further review the merits, including whether the brain-injury presumption applies (which would preclude apportionment) and whether the record requires further development.

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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