WCPanelIQ
PanelQMEMed-legalDenied

Casarez, Yesenia

YESENIA CASAREZ, Applicant vs. THE CHEESECAKE FACTORY; ACE AMERICAN INSURANCE COMPANY, administered by CORVEL CORP., Defendants

ADJ number
ADJ11969576
Decision date
Sep 11, 2023
District office
Van Nuys
WCJ
—
Claim administrator
CorVel Corp. (administering ACE American Insurance Company)
Commissioners
ANNE SCHMITZ, DEPUTY COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: low back, left elbow, left hip, circulatory system, hypertension, blood infection (cellulitis)

LC §5502LC §5904CCR §31.7CCR §10955CCR §9792.20CCR §9792.26

Summary

Applicant Yesenia Casarez claimed industrial injury from a February 6, 2019 fall while doing food prep, including injuries to her arm, back, circulatory system, worsening hypertension, and a blood infection after cutting her elbow. The WCJ initially found industrial injury to the low back and left elbow (including cellulitis) but not to the hips or hypertension, and denied applicant's request for an additional PQME in internal medicine. On reconsideration, the Board rescinded that decision, found injury to the low back and left elbow, deferred all other body parts, and ordered an additional internal medicine panel. Defendant then sought reconsideration of that order, arguing applicant lacked diligence and that no dispute warranted an additional PQME. The Board, applying the removal standard since defendant only challenged an interlocutory finding, denied defendant's petition, finding good cause and substantial evidence supported the additional internal medicine panel.

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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