WCPanelIQ
PanelMed-legalDismissed

Jaime Lugo Pena — ADJ8761355

JAIME LUGO PENA, Applicant vs. SUTTER MEMORIAL HOSPITAL, permissibly self-insured, SUTTER HEALTH, Defendants

ADJ number
ADJ8761355
Decision date
May 22, 2022
District office
Sacramento
WCJ
—
Claim administrator
Sutter Health (permissibly self-insured)
Commissioners
JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: lower back, ankle, rib

LC §5502LC §5900LC §5902LC §5903LC §5952CCR §10955

Summary

Applicant Jaime Lugo Pena sustained an industrial low back injury in 2012 and sought to reopen for new and further disability. While the reopening was pending, he suffered a serious fall in August 2021 at a relative's home in Mexico when his leg 'gave out,' fracturing his ankle and back and breaking a rib. At trial, applicant sought to admit post-fall treatment records, which defendant objected to as untimely disclosed under Labor Code section 5502(d)(3) and the PTCS. The WCJ admitted the records and ordered the record developed to have AME Bathgate determine whether the fall was a compensable consequence of the prior industrial injury. Defendant petitioned for reconsideration/removal; the Board majority dismissed the reconsideration petition (the order was interlocutory, not final) and denied removal, holding the WCJ was obligated to develop the record based on applicant's credible testimony of further injury regardless of the records' admissibility. Commissioner Razo dissented, arguing the WCJ failed to analyze admissibility under section 5502(d)(3) and San Bernardino given applicant's counsel's lack of diligence.

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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