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Dolores Eduardo Gomez Sanchez — ADJ11167250

DOLORES EDUARDO GOMEZ SANCHEZ, Applicant vs. CONCO COMPANIES; SWINTERTON, INC.; ZURICH AMERICAN INSURANCE COMPANY, Defendants

ADJ number
ADJ11167250
Decision date
Nov 7, 2022
District office
Stockton
WCJ
—
Claim administrator
Zurich American Insurance Company
Commissioners
MARGUERITE SWEENEY, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: cervical spine, thoracic spine, lumbar spine, left elbow, rib cage, abdomen, left shoulder, left wrist

LC §5701LC §5906

Summary

Applicant Dolores Eduardo Gomez Sanchez claimed two separate injuries while working as a laborer for Conco Companies: one on January 15, 2014 (resolved by Compromise and Release), and one on March 18, 2014. In a December 1, 2020 Findings of Fact, the WCJ determined that applicant sustained a separate and distinct industrial injury on March 18, 2014 to the cervical spine, thoracic spine, lumbar spine, left elbow, rib cage, and abdomen; no party sought reconsideration so this became final. QME Dr. Wayne Anderson subsequently issued reports characterizing the March 18, 2014 event as 'at most an exacerbation' with no permanent disability, which formed the basis of the August 24, 2022 F&O finding no permanent disability and no future medical. The Board granted reconsideration, holding that Dr. Anderson's later reports failed to account for the legally operative and final finding of a distinct injury, and impermissibly relied on speculation about the settlement amount and the applicant's symptom 'baseline.' The Board rescinded the F&O and remanded for development of the record.

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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