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Woods, Tamyia

TAMYIA WOODS, Applicant vs. ALAMEDA-CONTRA COSTA TRANSIT DISTRICT, permissibly self-insured, administered by YORK RISK SERVICES GROUP, INC./SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number: ADJ11310005
Decision date: Jul 19, 2023
District office: Oakland
WCJ: —
Claim administrator: York Risk Services Group, Inc./Sedgwick Claims Management Services (administering for permissibly self-insured Alameda-Contra Costa Transit District)
Commissioners: ANNE SCHMITZ, DEPUTY COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: head, neck, shoulders, lumbar spine, cervical spine, trapezius

LC §3208.1LC §5412LC §5701LC §5906

Summary

Applicant Tamyia Woods, a bus driver, claimed cumulative injury to her head, neck, shoulders, and lumbar spine. The WCJ relied on pain medicine QME Dr. Shaw's reports to find no industrial injury and ordered applicant take nothing. Applicant sought reconsideration arguing Dr. Shaw's reports were not substantial medical evidence. The Appeals Board agreed, finding Dr. Shaw's opinions were based on an inadequate medical history (he requested treating physician records that were never provided), contained unexplained internal inconsistencies (his summary acknowledged AOE/COE injury to cervical spine and both shoulders while the order found no injury), and improperly relied on flawed terminology reasoning regarding 'sprain' versus 'strain.' The Board rescinded the F&O and returned the matter to the WCJ to develop the record, strongly recommending the parties obtain an AME or appoint a regular physician.

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.