SINDY SETO, Applicant vs. PINE GROVE HEALTHCARE AND WELLNESS CENTRE; XL SPECIALTY INSURANCE COMPANY, Administered By INTERCARE HOLDINGS INSURANCE, INC., Defendants
ADJ number
ADJ16445262
Decision date
Jan 4, 2026
District office
Pomona
WCJ
—
Claim administrator
Intercare Holdings Insurance, Inc. (administering for XL Specialty Insurance Company)
Commissioners
—
Injury / body parts: head, brain, neck, right arm, right wrist, right fingers, back, right shoulder, hips, legs, knees, feet, right ankle, psyche, circulatory system
Applicant Sindy Seto, a licensed vocational nurse, sought reconsideration of a WCJ's October 3, 2025 Joint Findings and Order denying both a specific injury claim (head, brain, neck) of June 28, 2022 and a cumulative trauma claim (multiple body parts) for February 1 through July 7, 2022. The WCJ found applicant not credible regarding her alleged fall and head injury, found no industrial injury, and barred the psyche claim under Labor Code section 3208.3(d) for less than six months of employment. The Board majority granted reconsideration, rescinded the decision, and returned the matter to the trial level, finding the record needed further development—specifically, a more direct analysis of the husband's credibility independent of applicant's, completion of QME Dr. Chodakiewitz's neurological reporting, and analysis of potential concurrent/prior employment contribution under section 5500.5. Commissioner Razo dissented, arguing the WCJ's credibility determinations were entitled to great deference and should not be disturbed, and that the Board overstepped by raising cumulative trauma issues sua sponte.
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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