WCPanelIQ
PanelLienDenied

Ortiz, Deborah

DEBORAH ORTIZ, Applicant vs. KAISER PERMANENTE HOSPITAL/SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP, permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number
ADJ2609190
Decision date
Date unavailable
District office
Van Nuys
WCJ
Robert Sommer
Claim administrator
Sedgwick Claims Management Services
Commissioners
—

Injury / body parts: upper extremities, wrist, bilateral hands, bilateral wrists, nervous system/brain, psyche, other body systems

LC §5705LC §3202.5LC §4600LC §5307.1LC §5708LC §4603.2CCR §9790CCR §9790.1CCR §9792CCR §9792.1

Summary

Lien claimant David Silver, M.D., sought reconsideration of a WCJ's Third Amended Finding of Fact and Order finding he failed to prove applicant Deborah Ortiz sustained an injury AOE/COE, a threshold element of his lien claim for medical treatment provided from February 2004 through November 2011. The underlying cumulative trauma claim (ADJ2609190) had been denied by defendant and ultimately resolved by a $800,000 Compromise and Release that expressly disclaimed any admission of liability for the bilateral hands, wrists, and psych. The lien claimant argued the AOE/COE issue was waived because it was not raised at trial, and that defendant's Exhibit H and the Kiefer presumption established industrial causation. The Board rejected each argument, noting the lien claimant himself had previously acknowledged AOE/COE was part of his burden, that Exhibit H was never admitted into evidence and pertained to a different claim, and that Kiefer had been superseded by the 1993 legislative amendments as explained in Torres. The Board affirmed the F&O.

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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