WCPanelIQ
PanelQMEMed-legalLienGranted

Martinez, Sergio

SERGIO MARTINEZ, Applicant vs. GIANT JIM PEST CONTROL, INC.; EVEREST NATIONAL INSURANCE COMPANY, administered by GALLAGHER BASSETT SERVICES, Defendants

ADJ number
ADJ10933797
Decision date
Date unavailable
District office
Lodi
WCJ
—
Claim administrator
Gallagher Bassett Services (administering for Everest National Insurance Company)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: lumbar spine, bilateral knees, bilateral shoulders, bilateral hips, respiratory system

LC §3208.1LC §5412LC §5500.5LC §5500.6LC §5803LC §5901LC §5907LC §5908LC §5908.5LC §5950LC §5952

Summary

Sergio Martinez, a long-term pest control worker (employed since approximately 1992), claimed cumulative trauma injury to his lumbar spine, bilateral knees, shoulders, hips, and respiratory system during a CT period ending November 1, 2016. The orthopedic injuries were admitted, but defendant Everest National denied the respiratory injury. The parties stipulated PD would rate 89% on orthopedic injuries alone, or 100% if the respiratory system was found industrial. The WCJ found the respiratory injury industrial and awarded 100% PD. Everest petitioned for reconsideration, arguing it was not the liable carrier because applicant's injurious chemical exposure began in the 1990s, decades before its 2015-2016 coverage period, and that no proper date of injury under section 5412 was established. The Appeals Board granted reconsideration and deferred a final decision pending further review of whether substantial evidence supports the finding and whether the record needs further development on the date of injury and period of exposure.

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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