WCPanelIQ
PanelQMEMed-legalGranted in Part

Rodarte, Sandra

SANDRA RODARTE, Applicant vs. LERETA, LLC; CHUBB GROUP OF INSURANCE COMPANY, Defendants

ADJ number
ADJ10729444
Decision date
Date unavailable
District office
Marina del Rey
WCJ
—
Claim administrator
Chubb Group of Insurance Company
Commissioners
JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: bilateral shoulders, psyche, IBS/lower GI, sleep, dental, head, cervical spine

LC §5952LC §5701LC §5906CCR §10945

Summary

Applicant Sandra Rodarte sought reconsideration of a Joint F&O finding she failed to prove industrial dental injury in two claims (ADJ10729444 and ADJ10729802). The PQME dentist, Dr. Jeffrey Miller, opined that applicant's bruxism, TMJ disorder, jaw pain, and xerostomia were industrially caused as secondary to primary orthopedic trauma and stress, but deferred to the Trier-of-Fact on whether the underlying specific injuries and work stress were industrial, and had not reviewed records from Dr. Schames or Noble Dental Care. The WCJ found Dr. Miller's opinions did not constitute substantial medical evidence. The Board determined that because the WCJ found industrial injury to head, cervical spine, and psyche, the record required further development to determine whether those injuries caused the dental conditions. The Board affirmed the F&O but amended it to defer the dental injury issues and returned the matter for supplemental reporting from Dr. Miller.

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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