WCPanelIQ
PanelMed-legalDenied

Roxanne Heisinger — ADJ10356941

ROXANNE HEISINGER, Applicant vs. WATSONVILLE COMMUNITY HOSPITAL; ACE AMERICAN INSURANCE COMPANY, administered by GALLAGHER BASSETT, Defendants

ADJ number
ADJ10356941
Decision date
Oct 17, 2021
District office
Salinas
WCJ
Michael H. Young
Claim administrator
Gallagher Bassett (administering for ACE American Insurance Company)
Commissioners
—

Injury / body parts: thoracic spine, lumbar spine, bilateral shoulders, bilateral hands (carpal tunnel syndrome), bilateral lower extremities (plantar fasciitis)

LC §5909CCR §10945CCR §10842CCR §10606

Summary

Applicant Roxanne Heisinger, a nurse, sustained cumulative trauma injury during 2001-2016 to multiple body parts. The WCJ found permanent total disability based on the AME (Dr. Anderson), applicant's vocational expert (Scott Simon), and credible testimony from applicant and her husband. Defendant petitioned for reconsideration arguing the PTD finding was not based on substantial evidence and that the AME relied on a flawed history. The Board first addressed the Labor Code section 5909 timing issue, finding its time to act was tolled under Shipley because it failed to act within 60 days through no fault of defendant. On the merits, the Board adopted the WCJ's report, deferred to the AME's neutral expertise and the WCJ's credibility determinations, faulted defendant for failing to cite the record with specificity under Rule 10945, and denied reconsideration.

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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