WCPanelIQ
PanelQMEMed-legalDenied

Lee, Connie

CONNIE LEE, Applicant vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND, Defendant

ADJ number
ADJ9999707
Decision date
Feb 13, 2023
District office
Santa Ana
WCJ
Richard Brennen
Claim administrator
—
Commissioners
—

Injury / body parts: neck/cervical spine, bilateral upper extremities, bilateral shoulders, bilateral hips, pelvis, bilateral feet, bilateral lower extremities, psyche/depression

LC §4751LC §4060LC §4062.2LC §4064LC §4068LC §4664LC §5703

Summary

Connie Lee, a marketing representative for Barilla America, sustained a cumulative trauma injury ending June 8, 2015 to her neck, bilateral upper extremities, and bilateral hips, with a pre-existing 2012 specific injury (pelvic fracture) and longstanding peripheral neuropathy. After settling the underlying claims by Compromise and Release, she applied for SIBTF benefits. The WCJ found she qualified for SIBTF benefits under Labor Code section 4751 and was 100% permanently totally disabled, relying on the reporting of SIBTF QME Dr. Michael Sinel and vocational evaluator Dr. Luis Mas. The SIBTF petitioned for reconsideration arguing collateral estoppel, inadmissibility of Dr. Sinel's report, improper use of the 1.4 DFEC adjustment factor, and improper addition (rather than CVC combination) of impairments. The WCAB panel denied reconsideration, adopting the WCJ's Report, holding that none of the collateral estoppel threshold requirements were met (and the defense was waived), that an applicant may obtain a separate SIBTF medical-legal evaluation, that section 4751 permits DFEC adjustment, and that impairments may be added under Kite where supported by substantial medical evidence.

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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