WCPanelIQ
PanelQMEMed-legalGranted

Casarez, Yesenia

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

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

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

LC §4060LC §4061LC §4062LC §4062.2LC §4062.3LC §5701LC §5903LC §5906LC §5952CCR §31.7CCR §32.6CCR §35.5CCR §10628

Summary

Applicant Yesenia Casarez, a prep cook, claimed industrial injury on February 6, 2019, to multiple body parts after a fall, including her arm, back, circulatory system, worsening hypertension, and a blood infection. The WCJ found industrial injury to her low back and left elbow (including cellulitis) but not to her hips or hypertension, and denied her request for an additional QME panel in internal medicine and to develop the record. The WCAB granted reconsideration, finding good cause for an additional internal medicine QME panel because the orthopedic AME, Dr. Newton, failed to address the claimed internal/circulatory injuries or advise the parties of disputed issues outside his scope of practice. The Board rescinded the FA&O and substituted a new F&A finding injury to the low back and left elbow but deferring injury to all other body parts, ordering an additional internal medicine panel and further development of the record. Temporary disability, attorney's fees, and future medical care findings were left substantively unchanged.

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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