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PanelQMEMed-legalDenied

Julian Sosa — ADJ11024874

JULIAN SOSA, Applicant vs. RACE ENGINEERING, INC.; INSURANCE COMPANY OF THE WEST, Defendants

ADJ number
ADJ11024874
Decision date
May 22, 2022
District office
Los Angeles
WCJ
—
Claim administrator
Insurance Company of the West
Commissioners
MARGUERITE SWEENEY, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: right hand, psyche, sleep, internal system, skin, gastrointestinal system

LC §4660.1LC §3208.3

Summary

Applicant Julian Sosa sustained an accepted right hand injury on June 1, 2017, when an ice machine tilted and fell toward him. The WCJ found AOE/COE injury to the right hand, psyche, and sleep, awarding 10% permanent disability for the right hand only, and held the psyche and sleep conditions were compensable consequences not eligible to be combined into PD. Applicant sought reconsideration arguing the 2019 amendment to Labor Code section 4660.1 allowed impairment for sleep/psyche, that his psychiatric disorder was directly caused by the injury, and that he qualified for the violent act exception. The Board denied reconsideration, holding the 2019 amendment was a nonsubstantive 'maintenance of the codes' change, that the QME found the psychiatric condition to be a compensable consequence rather than directly caused, and that an ice machine tilting and falling did not constitute a violent act under section 4660.1(c)(2)(A).

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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