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PanelMed-legalGranted in Part

Luiz Gomez — ADJ9752268

LUIZ GOMEZ, Applicant vs. SLAKEY BROTHERS, INC.; CYPRESS INSURANCE COMPANY, adjusted by BERKSHIRE HATHAWAY HOME STATE COMPANIES, Defendants

ADJ number: ADJ9752268
Decision date: Oct 6, 2021
District office: Oakland
WCJ: —
Claim administrator: Berkshire Hathaway Homestate Companies (adjusting for Cypress Insurance Company)
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: left knee, tibial plateau, psyche, left hip, low back, Complex Regional Pain Syndrome (lower left extremity)

LC §5900LC §5903LC §4660.1CCR §10848CCR §10964CCR §10507CCR §10605CCR §10845CCR §10940CCR §10392CCR §10615CCR §10840

Summary

Applicant Luiz Gomez, a truck driver/loader-unloader, sustained an admitted industrial injury to his left knee (including tibial plateau) and psyche on May 12, 2014. The WCJ found 52% permanent disability and rejected claimed injuries to the low back and left hip, as well as CRPS. On reconsideration, the Appeals Board affirmed the denial of back injury but found that further development of the record was required on the left hip injury, the claimed CRPS diagnosis, and the extent of permanent impairment, because the AME (Dr. Fernandez) overlooked the treating pain specialist's documentation of hip and chronic pain complaints. The Board concluded the AME's medical record review was unreliable, rescinded and deferred the permanent disability award, and returned the matter to the trial level for further proceedings and a new decision.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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.