WCPanelIQ
PanelMed-legalDenied

Michael Cardoza — ADJ15807564, ADJ15807527

MICHAEL CARDOZA, Applicant vs. COUNTY OF ALAMEDA SHERIFF’S DEPARTMENT; Permissibly Self-Insured; administered by YORK RISK SERVICES GROUP, INC., a Sedgwick Company, Defendants

ADJ number
ADJ15807564, ADJ15807527
Decision date
Nov 17, 2022
District office
Oakland
WCJ
Tammy Homen
Claim administrator
York Risk Services Group, Inc., a Sedgwick Company (administering for permissibly self-insured County of Alameda Sheriff's Department)
Commissioners
—

Injury / body parts: low back, lumbar spine

Summary

Applicant Michael Cardoza, a deputy sheriff for the County of Alameda Sheriff's Department, sustained an admitted low back injury on January 16, 2022. AME Dr. James Stark found that a strict application of the AMA Guides yielded only 8% whole person impairment (DRE Lumbar Category II), but concluded this did not accurately reflect applicant's disability, which prevented certain lifting activities. Using an Almaraz/Guzman analysis, Dr. Stark rated by analogy to Table 6-9 (abdominal hernia impairment) because it was the only table within the AMA Guides referencing 'lifting,' arriving at 15% WPI, which translated to 31% permanent partial disability. Defendant sought reconsideration, arguing Dr. Stark's report was not substantial evidence and that strict application produced 18% PD. The WCAB denied reconsideration, finding the AME report constituted substantial evidence and was a proper Almaraz/Guzman rebuttal.

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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