JUAN RUIZ, Applicant vs. SK FLOOR COVERING and STATE COMPENSATION INSURANCE FUND, Defendants
ADJ number
ADJ11060751
Decision date
Jan 19, 2023
District office
San Jose
WCJ
David L. Lauerman
Claim administrator
State Compensation Insurance Fund
Commissioners
—
Injury / body parts: left shoulder, chest, low back, both knees, both ankles, psyche, nose/sense of smell, throat, sternum, liver, coccyx, hips, sores on feet and hands, kidneys
Applicant Juan Ruiz, in pro per, was found to have sustained a cumulative industrial injury to multiple body parts while working as a carpet installer, resulting in a 23% permanent disability award affirmed by the Board on April 6, 2021. Ruiz then filed a December 1, 2021 Petition to Reopen claiming new and further disability and additional body parts (throat, chest/broken sternum, liver, coccyx, hips, sores on feet and hands) allegedly caused by his industrial injury and pain medication. The WCJ issued an August 22, 2022 F&O finding Ruiz failed to prove the additional body parts or any new and further disability, ordering him to take nothing. The Board granted reconsideration, finding the claims administrator failed to conduct a reasonable and timely investigation under Rule 10109 and that a DOR could not properly be filed on the Petition to Reopen without a medical evaluation by a treating physician and QME under Labor Code section 4061(i). The Board rescinded the F&O and returned the matter to the WCJ for further development of the record.
Issues
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Holding
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Analysis
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Applicant takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Defense takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Provider takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Similar decisions
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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