WCPanelIQ
PanelQMEMed-legalGranted

Alcantar, Magdalena

MAGDALENA ALCANTAR, Applicant vs. SALINAS VALLEY HEALTH, Permissibly Self-Insured, adjusted by ACCLAMATION INSURANCE MANAGEMENT SERVICES, Defendants

ADJ number
ADJ10755277
Decision date
May 19, 2024
District office
Salinas
WCJ
—
Claim administrator
Acclamation Insurance Management Services (for Salinas Valley Health, Permissibly Self-Insured)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: neck/cervical spine, headaches, bilateral shoulders, gastroesophageal reflux (GERD), irritable bowel syndrome (IBS), psyche, ribs

LC §5410LC §5950LC §5903LC §5952LC §4060LC §4061LC §4062.3LC §5705LC §5313LC §5907LC §5908LC §5908.5LC §5803LC §5901LC §5900CCR §10787

Summary

Magdalena Alcantar, in pro per, sustained an industrial CT injury through August 22, 2016 to her neck (with headaches), bilateral shoulders, GERD, IBS, and psyche, and was awarded 13% PD in a September 21, 2020 F&A. She filed a Petition to Reopen for New & Further Disability under Labor Code section 5410 in July 2021, alleging worsening. After a February 2024 trial, the WCJ denied the petition, finding no new and further disability, that a new 5% rib injury (found by the QME) did not become disabling until after December 16, 2021 (more than five years after the injury date), that the rib injury was not shown to be industrial, and that the claims were barred by section 5410's five-year limitation. The Appeals Board granted reconsideration, finding it unclear whether the legal issues were properly identified, whether the record sufficiently supported the WCJ's conclusions, and whether further development of the record was needed, and deferred a final decision pending further review.

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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