WCPanelIQ
PanelQMEMed-legalGranted in Part

Ruben Gilbert — ADJ2804586, ADJ1356968

RUBEN GILBERT, Applicant vs. SOUTHERN CALIFORNIA RECEPTION CENTER, legally uninsured, administered by STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ2804586, ADJ1356968
Decision date
Jul 17, 2022
District office
Long Beach District Office
WCJ
Julie C. Feng
Claim administrator
State Compensation Insurance Fund
Commissioners
—

Injury / body parts: left knee, right knee, right hip, back/lumbar spine, lower extremities

LC §4453LC §4658LC §4660LC §4061LC §4663CCR §10945CCR §10510CCR §9805

Summary

Applicant Ruben Gilbert sought reconsideration of a Joint Findings and Award, arguing his pre-2005 injuries should be rated under the 1997 PDRS rather than the 2005 PDRS and that his multiple impairments should be added rather than combined using the Combined Values Chart (CVC) per Kite. The WCAB affirmed the WCJ's use of the 2005 PDRS, finding no medical-legal or treating physician report indicating permanent disability existed prior to January 1, 2005, and no requirement to provide section 4061 notice. The Board agreed that QME Dr. Schwarz's opinion did not constitute substantial medical evidence to justify adding impairments because he failed to explain how the lumbar spine, lower extremity, and right hip ratings did not overlap (particularly given his use of gait derangement twice). The Board affirmed the F&A but amended it to correct a clerical/legal error in the permanent disability rate from $250.00 to $200.00 per week for the 56% PD finding.

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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