WCPanelIQ
PanelQMEMed-legalGranted in Part

Deborah Johnson — ADJ10123051

DEBORAH JOHNSON, Applicant vs. ALVARADO HOSPITAL and SAFETY NATIONAL INSURANCE COMPANY, administered by AMERICAN CLAIMS MANAGEMENT, Defendants

ADJ number
ADJ10123051
Decision date
May 19, 2022
District office
San Diego
WCJ
—
Claim administrator
American Claims Management (administering for Safety National Insurance Company)
Commissioners
DEIDRA E. LOWE, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: lumbar spine, right knee, headaches

LC §4616.2LC §4600LC §4062LC §5952LC §5701LC §5906CCR §9767.9CCR §9767.10

Summary

Applicant Deborah Johnson, a phlebotomist/lab technician, claimed a June 20, 2015 industrial injury to her lumbar spine, right knee, and in the form of headaches. The WCJ found 33% permanent disability after apportionment based on QME Dr. Wieseltier's reports, found a need for future medical treatment (but failed to include it in the Award), and required treatment within defendant's MPN. On reconsideration, the WCAB found Dr. Wieseltier's apportionment opinion was not substantial evidence because he speculated that the pre-existing knee condition 'would have manifested' without explaining how and why those factors caused current permanent disability, and because he apportioned disability before actually determining the level of disability. The Board also found the MPN/transfer-of-care record contained inconsistencies and that defendant did not comply with notice requirements, but applicant had agreed to and received treatment from in-network providers. The Board affirmed in part, amended to find the QME reports not substantial evidence, deferred the permanent disability and MPN issues, added an award of future medical care, and remanded for further development of the record.

Issues

Member is $25/month or $250/year and includes full case search.

Holding

Member is $25/month or $250/year and includes full case search.

Analysis

Member is $25/month or $250/year and includes full case search.

Applicant takeaway

Member is $25/month or $250/year and includes full case search.

Defense takeaway

Member is $25/month or $250/year and includes full case search.

Provider takeaway

Member is $25/month or $250/year and includes full case search.

Similar decisions

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.

Member is $25/month or $250/year. Subscribe to view similar decisions.