WCPanelIQ
PanelQMEMed-legalRemanded

Mary Ann Sunshine Medina — ADJ4528679, ADJ4398568

MARY ANN SUNSHINE MEDINA, Applicant vs. SAVERS FUEL MART; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CASUALTY RECIPROCAL EXCHANGE, in liquidation, administered by SEDGWICK CMS, Defendants

ADJ number
ADJ4528679, ADJ4398568
Decision date
May 24, 2022
District office
Fresno
WCJ
—
Claim administrator
Sedgwick CMS (administering CIGA for Casualty Reciprocal Exchange, in liquidation)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, DEIDRA E. LOWE, COMMISSIONER

Injury / body parts: bilateral knees

LC §5909LC §5277LC §5313LC §5903LC §5952CCR §10787CCR §10914CCR §10940CCR §10964CCR §10995

Summary

Applicant Mary Ann Sunshine Medina claimed bilateral knee injury from a specific injury at Savers Fuel Mart (insured by Casualty Reciprocal Exchange, in liquidation, with CIGA assuming obligations) on January 5, 2002, and cumulative trauma during employment with Lowe's from September 7, 2001 to September 7, 2002. After CIGA sought reimbursement/contribution from Lowe's, an arbitrator issued an F&O apportioning causation among preexisting degenerative joint disease/obesity (35%), the Savers injury (30%), the Lowe's CT (20%), and a non-industrial McDonald's fall (15%). Lowe's sought reconsideration, arguing CIGA was not entitled to contribution and that the AME and PQME reports were not substantial medical evidence. The Board rescinded the F&O because the arbitration record was deficient: the summary of evidence lacked a descriptive listing of admitted exhibits, the referenced documents were never formally admitted, and the certified transcript memorializing stipulations and issues did not appear in EAMS. The matter was returned to the trial level for further proceedings consistent with WCAB Rules 10914 and 10995.

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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