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PanelQMEMed-legalDenied

Joseph Hernandez — ADJ11604315

JOSEPH HERNANDEZ, Applicant vs. PLEASANT VALLEY STATE PRISON / CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILATION, LEGALLY UNINSURED, ADJUSTED BY STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ11604315
Decision date
Mar 19, 2023
District office
Fresno
WCJ
Jeffry B. Diamond
Claim administrator
State Compensation Insurance Fund (for CDCR, legally uninsured)
Commissioners
—

Injury / body parts: heart

LC §3212LC §3212.2

Summary

Joseph Hernandez, a corrections officer at Pleasant Valley State Prison, filed a cumulative trauma claim for heart injury (left ventricular hypertrophy) over a period of employment from July 1, 2000, through October 15, 2018. After an initial F&A favoring the defendant was rescinded on applicant's reconsideration, a second trial produced an F&A favoring applicant on December 29, 2022, finding the Labor Code section 3212/3212.2 heart trouble presumption was triggered and not rebutted. The dispute centered on the PQME's opinion that applicant had pre-existing hypertension, which was based on a non-existent Kaiser medical record dated February 10, 2018, and faulty date calculations. The WCJ found the PQME's rebuttal opinion was not substantial medical evidence because it rested on a phantom record and unsupported inference, and that hypertension alone is not 'heart trouble.' The WCAB adopted the WCJ's Report and denied defendant's Petition for Reconsideration.

Issues

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Holding

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Analysis

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