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PanelQMEMed-legalRemanded

Caravez, Juan

JUAN CARAVEZ, Applicant vs. RED BLUFF MEADOWS and NATIONAL UNION FIRE INSURANCE COMPANY, administered by AMERICAN INTERNATIONAL GROUP, INC., Defendants

ADJ number: ADJ9626208
Decision date: Oct 22, 2023
District office: Redding
WCJ: —
Claim administrator: American International Group, Inc. (administering National Union Fire Insurance Company)
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: cervical spine, right shoulder, low back

LC §4663LC §4664LC §5903LC §5952

Summary

Applicant Juan Caravez claimed a specific injury (10/23/13) to his cervical spine, right shoulder, and low back, and a cumulative trauma injury to his low back (4/13/13-4/13/14) while working as a maintenance manager. AME Dr. Sommer offered inconsistent apportionment opinions across multiple reports regarding the low back, variously assigning 40%, 100%, and 60% to a prior 2000 industrial injury. The WCJ found Dr. Sommer's apportionment opinions were not substantial evidence under Escobedo and awarded a combined 64% disability under Benson. The WCAB agreed Dr. Sommer's opinions were not substantial evidence but held that this alone does not establish that the physician 'cannot parcel out' disability so as to justify a combined Benson award. The Board rescinded the F&A and remanded for further development of the record, directing Dr. Sommer to clarify his apportionment opinions and provide an AMA Guides WPI estimate for the 2000 injury.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.