WCPanelIQ
PanelQMEMed-legalDenied

Pilar Valdez — ADJ10540177, ADJ10547062

PILAR VALDEZ, Applicant vs. IN-HOME SUPPORT SERVICES, legally uninsured; adjusted by YORK RISK SERVICES/CMS, Defendants

ADJ number
ADJ10540177, ADJ10547062
Decision date
Apr 24, 2022
District office
Fresno
WCJ
—
Claim administrator
York Risk Services/CMS (administering for In-Home Support Services, legally uninsured)
Commissioners
DEIDRA E. LOWE, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: bilateral knees, back, bilateral hips, neck, sleep (alleged)

LC §4061.5LC §4653LC §4658CCR §9785CCR §10682CCR §10787

Summary

Applicant Pilar Valdez, an IHSS caregiver, claimed bilateral knee injuries (and later additional body parts) from her work duties. The WCJ found that the PQME, Charles Xeller, M.D., did not constitute substantial medical evidence and instead relied on the P&S report of treating chiropractor Lonnie Powell, D.C., finding industrial injury to the knees, back, hips, and neck plus a period of temporary disability from 11/9/2015 through 8/5/2020. Defendant petitioned for reconsideration, arguing Dr. Powell never treated applicant and that his reports were speculative, while contending Dr. Xeller's reports were substantial evidence. The WCAB adopted and incorporated the WCJ's report (correcting only the WCJ's statement about amending issues at trial, noting the MOH/SOE supersede the Pre-Trial Conference Statement under CCR 10787) and denied reconsideration, holding Dr. Powell's opinion was substantial medical evidence and Dr. Xeller's was not.

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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