WCPanelIQ
PanelQMEMed-legalDenied

Eli Anaya — ADJ10483000

ELI ANAYA, Applicant vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured, adjusted by STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ10483000
Decision date
Sep 11, 2022
District office
Van Nuys
WCJ
—
Claim administrator
State Compensation Insurance Fund
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER

Injury / body parts: lumbar spine, cervical spine, left shoulder, gastrointestinal system, left leg

LC §5909LC §3600LC §3202.5LC §3208.1LC §5903LC §5952LC §4660.1LC §5705LC §4663LC §4664

Summary

Applicant Eli Anaya, a special agent for the California Department of Corrections, claimed a cumulative trauma injury through November 30, 2014 affecting his lumbar spine, cervical spine, left shoulder, left leg, and gastrointestinal system. The WCJ found injury AOE/COE to the lumbar spine, cervical spine, GI system, and left shoulder, resulting in 58% permanent disability, with non-industrial apportionment applied only to the GI system. Defendant sought reconsideration arguing that the PTP's reporting was not substantial evidence and that the QME's opinion on causation, PD, and apportionment should control. The Board granted reconsideration and affirmed the F&A, holding that the PTP Dr. Haronian's reporting on cervical spine causation and lumbar spine impairment rating constituted substantial evidence, and that the QME Dr. Etemad's apportionment opinions for the orthopedic parts were too inconsistent and unexplained to constitute substantial evidence.

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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