WCPanelIQ
PanelQMEMed-legalRemanded

Vernon, Belinda

BELINDA VERNON, Applicant vs. KAWEAH DELTA HEALTH CARE DISTRICT, permissibly self-insured; adjusted by INTERCARE HOLDING INSURANCE SERVICES, Defendants

ADJ number
ADJ9375862
Decision date
May 22, 2024
District office
Fresno
WCJ
—
Claim administrator
Intercare Holding Insurance Services (for permissibly self-insured Kaweah Delta Health Care District)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: right knee, chronic pain syndrome, sleep (insomnia), gastrointestinal/upper digestive tract

LC §4660.1LC §4663LC §4621LC §4622LC §5313LC §5903LC §5952

Summary

Applicant Belinda Vernon, an HR analyst, sustained an industrial injury to her right knee on December 9, 2013, developing chronic pain syndrome, insomnia, and gastrointestinal intolerance as compensable consequences. The WCJ awarded 56% PPD, declined to find 100% permanent total disability, excluded the sleep disorder impairment under Labor Code section 4660.1(c), and issued a vague out-of-pocket medical reimbursement award. On reconsideration, the Board agreed that applicant's vocational expert reporting was not substantial evidence because the expert improperly interjected his own medical opinions and relied on applicant's subjective beliefs, and held that SSDI findings have no res judicata effect on industrial total disability. The Board affirmed exclusion of the sleep disorder because it was a compensable consequence of the orthopedic injury rather than a direct injury. The Board rescinded the F&A and returned the matter for further development of the record, including clarification of the disputed $8,000 husband's lost wages reimbursement.

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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