WCPanelIQ
PanelQMEMed-legalLienGranted

Lopez, Ofelia

OFELIA LOPEZ, Applicant vs. ALBERTSONS, permissibly self-insured, administered by SEDGWICK, Defendants

ADJ number
ADJ13811313
Decision date
Nov 7, 2023
District office
Van Nuys
WCJ
—
Claim administrator
Sedgwick (administering for Albertsons, permissibly self-insured)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: cervical spine, thoracic spine, lumbar spine, shoulders, knees, left foot, wrists (bilateral carpal tunnel syndrome)

LC §4650LC §5814LC §4061LC §4062LC §5903LC §5952LC §5313LC §5701LC §5906LC §5310LC §123.7LC §5309LC §5907LC §5908LC §5908.5LC §5803LC §5901LC §5950CCR §10787

Summary

Ofelia Lopez was awarded findings of industrial injury during a cumulative trauma period (August 7, 2002 to March 23, 2020) to multiple body parts, temporary total disability, 74% permanent disability, future medical care, a section 4650(d) increase, and a section 5814 penalty. Defendant Albertsons (self-insured, administered by Sedgwick) petitioned for reconsideration, challenging the admissibility and substantiality of treating physician Dr. Rubanenko's report, arguing the PQME Dr. Wilson's reporting should control, and contesting the TTD period, PD/occupational group findings, and the section 5814 penalty awarded without a penalty petition. The WCAB granted reconsideration on preliminary review, noting concerns about whether the record contains substantial evidence, including that Dr. Rubanenko failed to review prior treatment records and Dr. Wilson's reporting contained inconsistencies and failed to address apportionment and certain body parts. The Board deferred a final decision after reconsideration and ordered the matter set for a status conference to determine whether further development of the record is needed.

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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