WCPanelIQ
PanelLienGranted in Part

Augusto Garcia — ADJ9693769

AUGUSTO GARCIA, Applicant vs. SIERRA TRAFFIC SERVICE; STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ9693769
Decision date
Sep 25, 2022
District office
Oxnard
WCJ
—
Claim administrator
State Compensation Insurance Fund
Commissioners
JOSÉ H. RAZO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: head, back, left knee, left ankle, neck, heat stroke, dehydration, exhaustion, sleep disorder

LC §5900LC §5903LC §5909LC §5315LC §5952CCR §10507CCR §10605CCR §10845CCR §10940CCR §10392CCR §10615CCR §10840

Summary

Augusto Garcia claimed a September 17, 2014 industrial injury while employed by Sierra Traffic Service. The WCJ found industrial injury in the form of heat stroke, dehydration, exhaustion, and a sleep disorder, but no orthopedic injury to the head, back, left knee, left ankle, or neck, and awarded temporary disability from March 15, 2015 through March 17, 2016 with EDD reimbursement. Defendant SCIF challenged the temporary disability award for lack of substantial medical evidence, and lien claimant Spine and Ortho Center challenged the finding of no orthopedic injury. On reconsideration, the Appeals Board affirmed the no-orthopedic-injury finding and disallowance of the lien, but rescinded the temporary disability award and EDD reimbursement because Dr. Lipper's reporting (a secondary treating physician) did not constitute substantial medical evidence of industrial temporary disability. The temporary disability had been based on orthopedic treatment by Dr. Moelleken for injuries found to be non-industrial.

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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