WCPanelIQ
PanelQMEMed-legalGranted in Part

Swift, Amy

AMY SWIFT, Applicant vs. CITY OF CHULA VISTA, Permissibly Self-Insured, Administered By INTERCARE HOLDINGS INSURANCE SERVICES, INC., Defendant

ADJ number
ADJ9247606
Decision date
Oct 28, 2021
District office
San Diego
WCJ
—
Claim administrator
Intercare Holdings Insurance Services, Inc.
Commissioners
—

Injury / body parts: right knee, right elbow, right shoulder, neck, back, left hip, right hip

LC §4850

Summary

Amy Swift, a self-represented Fire Investigator II for the City of Chula Vista, sought reconsideration of an August 5, 2021 Findings and Award that found industrial injury only to her right knee, right elbow, and right shoulder (with 4% PD after apportionment) but denied injury to her neck, back, and hips, and denied her request for a new orthopedic QME panel. The WCJ's own Report acknowledged that if treating orthopedist Dr. Muldoon's February 3, 2020 report constituted substantial evidence of left hip injury, the findings should be amended. The Appeals Board reviewed Dr. Muldoon's report, found it to be substantial evidence under the McAllister/Lamb contributing-cause standard, and granted reconsideration to add the left hip as an industrially injured body part with need for further medical treatment. The Board deferred the issues of permanent disability and self-procured medical treatment for the left hip, and otherwise affirmed the WCJ's decision, including the denial of a replacement QME panel and the finding of no injury to the neck, back, and right hip.

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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