WCPanelIQ
PanelQMEMed-legalRemanded

Martin Schmidt — ADJ12311590

MARTIN SCHMIDT, Applicant vs. FREMONT SWIM SCHOOL, SECURITY NATIONAL INSURANCE COMPANY, administered by AMTRUST N.A., Defendants

ADJ number
ADJ12311590
Decision date
Dec 6, 2022
District office
Sacramento
WCJ
—
Claim administrator
AmTrust N.A. (administering Security National Insurance Company)
Commissioners
MARGUERITE SWEENEY, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: abdomen/hernia, abdominal wall, surgical scarring

LC §4660LC §4658.7LC §5705

Summary

Applicant Martin Schmidt sustained an industrial hernia injury on September 15, 2015, underwent surgery, returned to modified duty, then voluntarily resigned in June 2018. The PQME, Dr. Davidson, found 0% WPI under a strict AMA Guides analysis but 10% WPI under an Almaraz/Guzman analysis citing surgical scarring and persistent pain. The WCJ found Dr. Davidson's Almaraz/Guzman analysis was not substantial medical evidence because he analogized to the same Table 6-9 he applied strictly, and thus denied the SJDB voucher. On reconsideration, the Board disagreed, finding Dr. Davidson's analysis to be substantial medical evidence and clarifying that a voucher is owed upon proof of permanent partial disability where the employer fails to offer work, regardless of resignation or absence of the Physician's Return to Work form. The Board rescinded the Findings of Fact and remanded for further proceedings.

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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