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Peter Martinez — ADJ9163216

PETER MARTINEZ, Applicant vs. SOUSA TIRE SERVICE; STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ9163216
Decision date
Mar 13, 2022
District office
Oxnard
WCJ
—
Claim administrator
State Compensation Insurance Fund
Commissioners
—

Injury / body parts: arms, hands, shoulders, neck, psyche, complex regional pain syndrome (CRPS)

LC §4660.1

Summary

Applicant Peter Martinez, a mechanic, sustained a specific industrial injury on May 20, 2013 to his arms, hands, shoulders, neck, psyche, and in the form of CRPS. The WCJ found permanent total disability by adding the psychiatric permanent disability (26%) to the combined orthopedic and CRPS disabilities (91% via Combined Values Chart), relying on a one-page report from treating psychologist Dr. Fowkes-Muto. Defendant sought reconsideration, arguing the psychiatric disability should have been combined, not added, using the Combined Values Chart. The Board granted reconsideration, finding Dr. Fowkes-Muto's report was not substantial medical evidence to rebut the CVC because she opined on impairments outside her own specialty (orthopedic) and failed to explain why adding was more accurate. The Board amended the decision to correct the date of injury and to defer permanent disability and attorney fee issues for re-rating using the Combined Values Chart.

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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