WCPanelIQ
PanelMed-legalDenied

Alicia Ortiz — ADJ13377367

ALICIA ORTIZ, Applicant vs. PEBBLE BEACH COMPANY, PERMISSIBLY SELF-INSURED, ADMINISTERED BY INTERCARE, Defendants

ADJ number
ADJ13377367
Decision date
Jun 19, 2022
District office
Salinas
WCJ
—
Claim administrator
Intercare (administering Pebble Beach Company, permissibly self-insured)
Commissioners
CRAIG SNELLINGS, COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: COVID-19 (systemic infection)

LC §3212.88LC §5904LC §5701LC §5906CCR §10955

Summary

Applicant Alicia Ortiz claimed a COVID-19 injury against Pebble Beach Company (permissibly self-insured, administered by Intercare). At trial, the WCJ raised the issue of injury AOE/COE sua sponte over defendant's objection and initially issued a March 8, 2022 Findings and Order finding no injury. After applicant sought reconsideration, the WCJ rescinded that order via the April 6, 2022 Amended F&O, determining applicant was not entitled to the Labor Code section 3212.88 presumption, that AME Dr. Fishman's reports were insufficient to establish AOE/COE, but that applicant could still meet her burden without the presumption and the record required further development. Defendant petitioned for reconsideration/removal of the order rescinding and providing for record development. The Board applied the removal standard (since defendant challenged only the interlocutory portion) and denied the Petition, finding no significant prejudice or irreparable harm.

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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