WCPanelIQ
PanelQMEMed-legalGranted in Part

Michael Sefick — ADJ10089970, ADJ9519787

MICHAEL SEFICK, Applicant vs. VALLEY PACIFIC PETROLEUM SERVICES, INC.; HDI GLOBAL INSURANCE COMPANY, ADJUSTED BY YORK RISK SERVICES GROUP, Defendants

ADJ number
ADJ10089970, ADJ9519787
Decision date
Sep 6, 2022
District office
Salinas
WCJ
—
Claim administrator
York Risk Services Group (TPA for HDI Global Insurance Company)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: neck, left shoulder, right knee, back

LC §5412LC §5500.5LC §5313LC §4621LC §4622

Summary

Michael Sefick sustained an admitted specific injury (neck, left shoulder) on August 9, 2012, and claimed a cumulative trauma injury (neck, left shoulder, right knee) through June 20, 2013. Both applicant and defendant sought reconsideration of the WCJ's April 29, 2020 F&A. The Board affirmed the F&A except to amend the temporary disability award, finding applicant was entitled to TTD during the period he awaited diagnostic testing requested by the QME (June 21, 2015 to May 25, 2016). The Board rejected applicant's claim of 100% permanent total disability, agreeing the vocational expert's report was not substantial evidence because it relied on a non-industrial body part (low back), age, and work restrictions not in the medical record. The Board also affirmed use of the section 5412 date of injury (June 12, 2015) to set permanent disability indemnity rates, rejecting defendant's argument for 2013 rates.

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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