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PanelQMEMed-legalGranted

Espinoza, Jose

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

ADJ number: ADJ16740659
Decision date: Aug 12, 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 §5705LC §3202.5LC §3600CCR §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 found the lumbar spine non-industrial, found applicant permanent and stationary as of March 21, 2023, and awarded 12% permanent partial disability. Applicant sought reconsideration arguing the P&S finding and the non-industrial low back finding were not supported by substantial medical evidence. The WCAB granted reconsideration, finding that QME Dr. Stark unambiguously testified that applicant was not permanent and stationary because his condition was slowly progressing and treatment (a functional restoration program) remained available, and that Dr. Stark's causation opinion on the low back was equivocal and failed to apply the contributory causation standard. The Board rescinded the F&A and returned the matter to the trial level for further development of the record and credibility determinations.

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.