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Filemon Moreno — ADJ11986060

FILEMON MORENO, Applicant vs. IRVINE VIEJO PAINTING COMPANY and INSURANCE COMPANY OF THE WEST, Defendants

ADJ number
ADJ11986060
Decision date
Nov 15, 2021
District office
Santa Ana
WCJ
—
Claim administrator
Insurance Company of the West
Commissioners
DEIDRA E. LOWE, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: back, neck, shoulders, arms, wrists, hands, fingers, knees, internal system (hernia)

LC §3208.1LC §3600LC §5952LC §5701LC §5906

Summary

Applicant Filemon Moreno, a painter, claimed a cumulative trauma injury to multiple orthopedic body parts and an internal (hernia) injury over a roughly 24-year employment period. The WCJ found no AOE/COE injury to the orthopedic body parts, relying in part on QME Dr. Danzig's report, which presented two alternative scenarios and deferred the causation question to the trier of fact. The WCAB granted reconsideration and held that Dr. Danzig's report was not substantial evidence because he never opined whether the physical demands of applicant's work were a contributing cause of the orthopedic condition. The Board emphasized that the absence of prior treatment records is a factor but not, by itself, a basis to deny a cumulative injury. The Board rescinded the F&O, deferred all AOE/COE issues, ordered an internal medicine QME evaluation, and remanded for further development of the record.

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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