CHARLOTTE UTSEY, Applicant vs. NATIONAL COURIER SYSTEMS; and SUPERIOR NATIONAL INSURANCE, in liquidation, administered by CALIFORNIA INSURANCE GUARANTEE ASSOCIATION; CITY OF OAKLAND, permissibly self –insured, administered by JT2 INTEGRATED RESOURCES, Defendants
ADJ number
ADJ3762315
Decision date
Mar 28, 2024
District office
Oakland
WCJ
Lilla J. Szelenyi
Claim administrator
California Insurance Guarantee Association (CIGA) for Superior National Insurance (in liquidation); JT2 Integrated Resources for the permissibly self-insured City of Oakland
Commissioners
—
Injury / body parts: neck, back, lumbar spine, bilateral knees, bilateral wrists, right elbow, right ankle, left foot, bilateral arms, bilateral shoulders, left elbow, carpal tunnel
LC §4663
Summary
Applicant Charlotte Utsey sustained three industrial injuries: a 1994 specific injury (neck/back) while a courier for National Courier Systems (insured by Superior National Insurance, in liquidation, administered by CIGA), and a 1999 specific injury plus a cumulative trauma through May 9, 1999 while a parking technician for the self-insured City of Oakland. The WCJ found applicant 100% permanently totally disabled with no apportionment, either between the three injuries (under Benson) or to non-industrial factors (obesity and prior right knee problems) under Labor Code section 4663. Oakland petitioned for reconsideration arguing that AME Dr. Mandell's opinion required Benson apportionment between the injuries. The Appeals Board majority affirmed, holding that Dr. Mandell's apportionment opinion was not substantial evidence because of internal inconsistencies, lack of supporting medical records, and the doctor's own 'just barely' qualifications. Commissioner Razo dissented, finding Dr. Mandell's reasonable-medical-probability opinion sufficient and faulting the WCJ for demanding scientific certainty.
Issues
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Holding
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Analysis
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Applicant takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Defense takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Provider takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Similar decisions
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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