WCPanelIQ
PanelQMEMed-legalRemanded

Art Gomez — ADJ8420296, ADJ10940866, ADJ10985261

ART GOMEZ, Applicant vs. CITY OF LOS ANGELES POLICE DEPARTMENT; permissibly self-insured, administered by TRISTAR RISK MANAGEMENT, Defendants

ADJ number
ADJ8420296, ADJ10940866, ADJ10985261
Decision date
May 22, 2022
District office
Van Nuys
WCJ
—
Claim administrator
Tristar Risk Management
Commissioners
DEIDRA E. LOWE, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: right shoulder, lumbar spine, bilateral knees, bilateral upper extremities, bilateral lower extremities (gait derangement), bilateral hips, cervical spine, varicose veins/venous disease, GERD, sleep disorder, hypertension, stroke, hearing loss, blood clots, heart, bladder, headaches, double vision (diplopia), dysphasia/speech disorder, vertigo, bilateral elbows

LC §4850LC §4662LC §5313LC §3212

Summary

Art Gomez, a motorcycle sergeant police officer for the City of Los Angeles, pursued three injury claims: a cumulative trauma settled at 48% PD with a petition to reopen (ADJ8420296), a cumulative trauma claim (ADJ10940866), and a June 8, 2017 specific injury claim (ADJ10985261). The WCJ found 55% PD in ADJ8420296, 100% permanent total disability in ADJ10940866, and stated in the Opinion on Decision that ADJ10985261 would be dismissed as duplicative. Defendant sought reconsideration challenging the substantial evidence value of QME Dr. Hyman and AME Dr. Richman, arguing disability factors should be combined not added, and asserting entitlement to Labor Code section 4850 credit. The Board rescinded the F&A and remanded, finding multiple procedural and substantive deficiencies, including no finding of good cause to reopen, no actual order dismissing ADJ10985261, failure to address all issues, and inadequate treatment of apportionment and the section 3212 stroke presumptions.

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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