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Isaias Vazquez — ADJ12900094

ISAIAS VAZQUEZ, Applicant vs. LEPRINO FOODS, permissibly self-insured, administered by TRISTAR, Defendants

ADJ number
ADJ12900094
Decision date
Mar 3, 2022
District office
Fresno
WCJ
Javier A. Albart
Claim administrator
TRISTAR (administrator for permissibly self-insured Leprino Foods)
Commissioners
—

Injury / body parts: Low Back

LC §4657

Summary

Applicant Isaias Vazquez, a forklift driver, sustained an accepted low back injury on 3/21/2019 while working for permissibly self-insured Leprino Foods. TD benefits were terminated based on an 11/5/2019 full-duty release authored by a PA-C, Jaime Salvatierra, that was never countersigned by a treating physician. Applicant sought treatment from non-MPN physician Dr. Leon, who certified disability during the disputed period, and PQME Dr. Klassen retrospectively found temporary partial disability from 11/27/2019 to 4/5/2020, disagreeing with the PA-C's release. The WCJ awarded total temporary disability for that period (including EDD reimbursement and the differential to applicant), reasoning the PA-C report was not substantial evidence, applicant received no notice of his rights, and the employer failed to investigate accommodation. The WCAB denied defendant's Petition for Reconsideration, adopting the WCJ's report and noting that under Labor Code section 4657, temporary partial disability that effectively prevents the worker from performing any duty—absent a showing that work was available and offered—is deemed total.

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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