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Luis Garcia / Marlene Garcia — ADJ3482353

LUIS GARCIA (deceased) / MARLENE GARCIA, Applicant vs. LOS ANGELES COUNTY PROBATION DEPARTMENT permissibly self-insured, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES INC., Defendants

ADJ number
ADJ3482353
Decision date
May 19, 2022
District office
Los Angeles
WCJ
—
Claim administrator
Sedgwick Claims Management Services, Inc. (administering for permissibly self-insured Los Angeles County Probation Department)
Commissioners
—

Injury / body parts: psyche, renal system / upper urinary tract, cardiovascular system / hypertension, head, internal organs, stroke

LC §5903LC §3208.3CCR §10605CCR §10421

Summary

Marlene Garcia, surviving spouse of deceased Deputy Probation Officer Luis Garcia, sought reconsideration of the Board's March 2, 2022 Opinion and Decision After Reconsideration, which found Garcia's condition permanent and stationary as of September 10, 2012, and that his injury caused 95% permanent disability. Applicant argued the internal and psychiatric disabilities should have been added rather than combined, and that PD should commence as of October 7, 2010 (the psychiatric P&S date). The Board denied reconsideration, holding that AME Dr. Hirsch's deposition testimony regarding no overlap with the psychiatric condition was not substantial evidence because he gave no explanation, did not discuss psychiatric impairment, and psychiatry was outside his field of practice. The Board also rejected the earlier P&S date argument, reasoning that PD benefits commence only when the entire condition is permanent and stationary, which was September 10, 2012 when the internal conditions stabilized. Defendant's Answer, which improperly sought affirmative relief, was disregarded as it would have been an untimely Petition for Reconsideration.

Issues

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Holding

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Analysis

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Defense takeaway

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Provider takeaway

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