WCPanelIQ
PanelQMEMed-legalRemanded

Nancy Burian — ADJ8309831, ADJ1242017, ADJ1419435

NANCY BURIAN, Applicant vs. ZOOLOGICAL SOCIETY OF SAN DIEGO and FEDERAL INSURANCE COMPANY; THE SALVATION ARMY, permissibly self-insured; administered by SEDGWICK CMS, INC.; RECREATIONAL WORLD, INC.; and CIGA, by its servicing facility, SEDGWICK CMS, INC., for RELIANCE INSURANCE COMPANY, in liquidation, Defendants

ADJ number
ADJ8309831, ADJ1242017, ADJ1419435
Decision date
Nov 22, 2021
District office
San Diego
WCJ
—
Claim administrator
Sedgwick CMS, Inc. (for The Salvation Army and for CIGA servicing Reliance Insurance Company, in liquidation); Federal Insurance Company
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, DEIDRA E. LOWE, COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER

Injury / body parts: right knee, left knee, bilateral knees

LC §3202LC §5701LC §5906LC §5952

Summary

Applicant Nancy Burian, an ice skating instructor and later a ticket booth operator, had two accepted specific knee injuries (right knee 9/19/1995 and left knee 1/21/1998) while employed by Recreational World, Inc. CIGA filed an application alleging a cumulative trauma injury to the bilateral knees during applicant's later employment at the Zoological Society of San Diego (Wild Animal Park) and the Salvation Army (Joan Kroc Ice Skating Arena). The WCJ found applicant did not sustain the claimed cumulative injury (ADJ8309831) because CIGA failed to meet its burden of proof, and awarded permanent disability on the two specific injuries. CIGA petitioned for reconsideration arguing the reports of Drs. Bathgate, Greenfield, and Simpkins constituted substantial evidence of a cumulative injury. The Board found the medical reporting contradictory, confusing, based on inadequate information, and possibly the product of speculation, and therefore not substantial evidence. The Board rescinded the F&A and returned the matter to the WCJ to develop the record, including appointing a regular physician to evaluate applicant.

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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