WCPanelIQ
PanelQMEMed-legalGranted in Part

Juan Gonzalez — ADJ12129817

JUAN GONZALEZ, Applicant vs. CROWN BUILDING MAINTENANCE, Permissibly Self-Insured, Defendants

ADJ number
ADJ12129817
Decision date
Sep 21, 2021
District office
San Francisco
WCJ
—
Claim administrator
Crown Building Maintenance (Permissibly Self-Insured)
Commissioners
ANNE SCHMITZ, DEPUTY COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER, MARGUERITE SWEENEY, COMMISSIONER

Injury / body parts: right inguinal hernia, left inguinal region

LC §3202.5LC §4600LC §4604LC §4610LC §4610.5LC §5904CCR §38

Summary

Applicant Juan Gonzalez, a janitor, sustained an industrial right inguinal hernia on January 9, 2019. The WCJ found applicant was not entitled to further medical treatment and that PQME Dr. Aubrey Swartz was not subject to replacement. On reconsideration, the Appeals Board concluded that the preponderance of evidence—applicant's trial testimony of continuing painful symptoms combined with Dr. Swartz's report recommending a reevaluation by surgeon Dr. Lesher—justified a finding of entitlement to further medical treatment. The Board rejected applicant's jurisdictional argument because the issue before the WCJ was the general right to future medical care under sections 4600 and 4604, not the propriety of a specific treatment request subject to UR/IMR. The Board amended the Sixth Finding of Fact to award further medical treatment and returned the matter to the trial level for further proceedings.

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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