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PanelQMEGranted in Part

Ernesto Mora — ADJ12841551

ERNESTO MORA, Applicant vs. BENIHANA NATIONAL CORPORATION; ZURICH AMERICAN INSURANCE COMPANY; administered by BROADSPIRE, a CRAWFORD COMPANY, Defendants

ADJ number: ADJ12841551
Decision date: Jan 17, 2022
District office: Marina del Rey
WCJ: —
Claim administrator: Broadspire, a Crawford Company (administering for Zurich American Insurance Company)
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: bilateral wrists, left knee

LC §4656LC §4061.5LC §4657CCR §10964CCR §10625

Summary

Applicant Ernesto Mora, a cook/chef for Benihana, sustained an admitted industrial injury to his bilateral wrists (ganglion cysts) and claimed a left knee injury. The WCJ awarded temporary total disability (TTD) from January 15, 2020 'and continuing,' which defendant challenged on grounds that applicant was terminated for cause, lacked wage loss, and that the treating physician's reporting was not substantial evidence. The Board granted reconsideration, rejecting defendant's termination-for-cause argument, reasoning that applicant's wage loss stemmed from his total disability that removed him from the labor market, not from the termination. However, the Board amended the award to limit TTD to a closed period (January 15, 2020 to September 14, 2021) because the last medical report found applicant temporarily totally disabled for only seven weeks beyond July 27, 2021, with jurisdiction reserved for future TTD.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.