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Juana Leyva — ADJ10353716

JUANA LEYVA, Applicant vs. MILLENEUM BILTMORE HOTEL; INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA, ADMINISTERED BY BROADSPIRE, Defendants

ADJ number
ADJ10353716
Decision date
Feb 5, 2023
District office
Van Nuys
WCJ
Jeffrey Marrone
Claim administrator
Broadspire (administering for Insurance Company of the State of Pennsylvania)
Commissioners
—

Injury / body parts: head, cervical spine, right upper extremity, right elbow, wrists, hands, arms, left upper extremity, shoulder, neck

LC §3208.1LC §5412

Summary

Applicant Juana Leyva worked for Millennium Biltmore Hotel and had a prior cumulative trauma claim (ADJ6746882) for the period 12/1/2006 through 12/16/2008, in which the WCJ found in 2012 that only the right elbow was industrial, relying on PQME Dr. Timothy Ross who deemed her other complaints non-industrial. Applicant continued working through 9/13/2013 and later filed a new claim, returning to the same PQME (Dr. Ross), who in a 2021 report and deposition found a new cumulative trauma. The WCJ found that the statute of limitations had not run because, under Labor Code 5412, Applicant did not know and could not reasonably have known her condition was industrial until the PQME confirmed it in 2021. Defendant petitioned for reconsideration arguing the statute of limitations barred the claim. The WCAB adopted and incorporated the WCJ's report and denied reconsideration.

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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