WCPanelIQ
PanelQMEMed-legalLienGranted in Part

Felix Aisuan — ADJ9419245, ADJ10435082

FELIX AISUAN, Applicant vs. TRISTAR INSURANCE GROUP; ACE AMERICAN INSURANCE COMPANY, administrated by GALLAGHER BASSETT, Defendants

ADJ number
ADJ9419245, ADJ10435082
Decision date
Date unavailable
District office
Van Nuys
WCJ
M. Victor Bushin
Claim administrator
Gallagher Bassett (administrator for ACE American Insurance Company); TriStar Insurance Group
Commissioners
—

Injury / body parts: cervical spine, thoracic spine, lumbar spine, upper extremities, shoulders, knees, GERD, hypertension, sleep disorder

LC §5313LC §3202.5LC §4659CCR §10492CCR §10517CCR §10775

Summary

Applicant Felix Aisuan, a claims supervisor, claimed industrial injury from a September 10, 2012 specific injury and an alleged 2015-2016 continuous trauma. The WCJ issued an August 5, 2021 Findings, Award and Orders finding injury to various body parts and awarding 74% permanent disability with a life pension, relying on PTP Dr. Sadler over PQME Dr. Mack. Defendants petitioned for reconsideration arguing the award was inconsistent with the opinion on decision and that Dr. Sadler's reports were no more persuasive than Dr. Mack's. The Board granted reconsideration solely to amend the decision to expressly find AOE/COE injury to the lumbar and thoracic spine and in the form of GERD, hypertension, and sleep disorder, relying on Dr. Sadler's and AME Dr. Reynolds's reports as substantial evidence, and otherwise affirmed the WCJ's decision.

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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