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Saline Augafa — ADJ11500538, ADJ11344274

SALINE AUGAFA, Applicant vs. WAL-MART, INC; ACE AMERICAN INSURANCE COMPANY, Defendants

ADJ number
ADJ11500538, ADJ11344274
Decision date
May 30, 2022
District office
San Diego
WCJ
—
Claim administrator
ACE American Insurance Company
Commissioners
—

Injury / body parts: left thumb, left elbow, left wrist, lumbar spine, left knee

Summary

Applicant Saline Augafa sought reconsideration of a WCJ's Findings, Award, and Order that adopted PQME Dr. Thompson's impairment findings and awarded 23% permanent disability after apportionment. Applicant argued the WCJ should have relied on treating physician Dr. Kupfer's higher rating, and that Dr. Thompson failed to adequately explain apportionment of the lumbar spine and left knee impairments. The Board affirmed reliance on Dr. Thompson's impairment ratings, finding the WCJ properly chose among conflicting medical opinions, but held that Dr. Thompson's apportionment opinion did not constitute substantial medical evidence under Escobedo. The Board granted reconsideration, rescinded the WCJ's decision, and issued a new decision awarding 25% unapportioned permanent disability for the cumulative injury in ADJ11500538. The Board also cleaned up the defective decision by clarifying which body parts and disability corresponded to each date of injury and set a 15% attorney fee.

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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