WCPanelIQ
PanelQMEMed-legalLienDenied

Skaggs, Kenneth

KENNETH SKAGGS, Applicant vs. GRIMWAY ENTERPRISES, Permissibly Self-Insured, Defendant

ADJ number
ADJ12328983
Decision date
Oct 26, 2023
District office
Bakersfield
WCJ
—
Claim administrator
Grimway Enterprises, Permissibly Self-Insured
Commissioners
—

Injury / body parts: teeth/dental

LC §5402LC §5703LC §3202LC §3202.5CCR §10109CCR §10682

Summary

Kenneth Skaggs claimed an industrial dental injury arising from a cumulative period ending May 24, 2019, while employed by Grimway Enterprises (permissibly self-insured). The WCJ found no industrial injury and ordered applicant to take nothing. Applicant sought reconsideration, arguing he was entitled to the Labor Code section 5402(b) presumption of compensability because defendant failed to deny liability within 90 days. The WCJ found that although the denial was untimely, the presumption was rebutted by medical evidence (regarding complex chemical exposures) not reasonably obtainable within the 90-day period, and that all medical reporting unanimously found the condition non-industrial. The Appeals Board denied reconsideration, adopting the WCJ's Report and Recommendation.

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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