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Ana R Sanchez — ADJ11573028

ANA R. SANCHEZ, Applicant vs. FOREVER 21, INC.; ACE AMERICAN INSURANCE COMPANY C/O BROADSPIRE, Defendants

ADJ number: ADJ11573028
Decision date: Dec 4, 2022
District office: Marina del Rey
WCJ: —
Claim administrator: Broadspire (TPA for ACE American Insurance Company)
Commissioners: MARGUERITE SWEENEY, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: hand, back, musculoskeletal/orthopedic (repetitive use injuries)

LC §4600LC §4658.7LC §5313LC §5705LC §5903LC §5952LC §3202CCR §10566CCR §10133.31

Summary

Applicant Ana R. Sanchez was awarded a Supplemental Job Displacement Benefit (SJDB) voucher and reasonable attorney's fees by the WCJ in an August 17, 2021 Order. Defendants Forever 21 and ACE American Insurance c/o Broadspire sought reconsideration, arguing the treating physician was not predesignated, his report was not substantial medical evidence and lacked a Physician's Return to Work & Voucher Report (Form DWC-AD 10133.36), and that they had offered a return to regular work per PQME Dr. Washington. The Appeals Board found the WCJ's Opinion on Decision and Report devoid of analysis, making it impossible to ascertain the basis for the decision under Labor Code section 5313. The Board rescinded the August 17, 2021 Order and returned the matter to the trial level for further proceedings, while providing guidance that the SJDB voucher is owed absent a bona fide offer of regular, modified, or alternative work regardless of whether a Physician's RTW form was submitted.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.