WCPanelIQ
PanelQMERemanded

Jaime Ramirez — ADJ9962889, ADJ10250841

JAIME RAMIREZ, Applicant vs. CITY OF FULLERTON, permissibly self-insured, administered by ADMINSURE, Defendants

ADJ number
ADJ9962889, ADJ10250841
Decision date
Apr 12, 2022
District office
Anaheim
WCJ
—
Claim administrator
AdminSure (administering for City of Fullerton, permissibly self-insured)
Commissioners
ANNE SCHMITZ, DEPUTY COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: cervical spine, right shoulder, right wrist

LC §132aLC §5705LC §5903LC §5952LC §5313

Summary

Applicant Jaime Ramirez, an equipment operator for the City of Fullerton, sustained industrial injuries to his cervical spine, right shoulder, and right wrist. After he had returned to full duty for approximately a year and a half based on his treating physician's release, defendant's attorney requested a supplemental report from the panel QME, Dr. Wieseltier, who then imposed work restrictions, causing applicant to be taken off work and forced to use 350-400 hours of vacation and sick time. The WCJ found no violation of Labor Code section 132a and ordered applicant take nothing. On reconsideration, the WCAB rescinded the F&O, finding the evidence established a prima facie section 132a claim because defendant deviated from its usual procedures by (1) seeking a non-treating physician's restriction report and (2) imposing restrictions without resolving a conflict between physicians' reports. The Board deferred the issues of legitimate business necessity and pretext and remanded for further development of the record.

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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