WCPanelIQ
PanelQMEMed-legalDenied

Raymond Hernandez — ADJ10431134

RAYMOND HERNANDEZ, Applicant vs. SOUTHWEST AIRLINES, INC.; ACE AMERICAN INSURANCE COMPANY, adjusted by SEDGWICK, Defendants

ADJ number
ADJ10431134
Decision date
Nov 30, 2021
District office
Stockton
WCJ
—
Claim administrator
Sedgwick (adjusting for ACE American Insurance Company)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, DEIDRA E. LOWE, COMMISSIONER

Injury / body parts: right foot, psyche

LC §4660.1LC §3208.3LC §5702

Summary

Raymond Hernandez, a Southwest Airlines flight attendant, sustained an admitted industrial injury to his right foot on December 28, 2014, with a compensable consequence psychiatric injury. The psychiatric QME found his major depressive disorder, alcohol dependence, and pain disorder were 100% caused by his orthopedic injury, warranting 15% WPI. The dispute centered on whether the injury was 'catastrophic' under Labor Code section 4660.1(c)(2)(B), which would allow an increased permanent disability rating for the psychiatric condition. Applying the Wilson en banc factors, the WCJ found the injury was not catastrophic, and applicant sought reconsideration. The Appeals Board denied reconsideration, holding that the right foot injury (despite two surgeries) was not analogous to the statutorily specified catastrophic injuries and that loss of employment alone does not render an injury catastrophic.

Issues

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Holding

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Analysis

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Defense takeaway

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