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Jessica Lopez — ADJ13428151

JESSICA LOPEZ, Applicant vs. JACK IN THE BOX; ARCH INSURANCE COMPANY, ADMINISTERED BY YORK RISK SERVICES GROUP, A SEDGWICK COMPANY, Defendants

ADJ number
ADJ13428151
Decision date
May 19, 2022
District office
Los Angeles
WCJ
—
Claim administrator
York Risk Services Group, a Sedgwick Company (administering for Arch Insurance Company)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: back, left hip, left leg, right knee

LC §5903LC §5702LC §5506LC §4060LC §4062.2CCR §10600CCR §10605CCR §10617

Summary

Applicant Jessica Lopez, a Jack in the Box cashier, claimed injury to her back, left hip, and left leg on June 28, 2020 when she allegedly slipped on a greasy floor and struck her left hip on a metal corner while trying to avoid falling on her pregnant belly. The WCJ found applicant not credible, credited defense witnesses who denied any reported injury, found the medical record inconsistent, and ordered take-nothing. The Board first resolved timeliness, finding the petition timely under WCAB Rule 10600(b) (25th day fell on a Saturday) and that the timely-filed verification permitted amendment under Rule 10617. On the merits, the Board found that despite the credibility determinations, the record showed consistent, contemporaneous reporting of the injury to two medical providers and the filing of an application all within 30 days of injury, warranting development of the record. The Board rescinded the F&O and remanded for the parties to obtain a section 4060 QME evaluation so the WCJ could decide AOE/COE on substantial evidence in light of the entire record.

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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