GREGORIO PADILLA, Applicant vs. USA WASTE OF CALIFORNIA, INC.; ACE AMERICAN INSURANCE, Defendants
ADJ number
ADJ11181283
Decision date
Sep 12, 2021
District office
Los Angeles
WCJ
Michael J. Holmes
Claim administrator
Gallagher Bassett Services (administering for ACE American Insurance)
Commissioners
—
Injury / body parts: right shoulder, right elbow, right knee, right hand, eye, neck, hearing, excretory system, gastrointestinal, sleep disorder, high blood pressure, dizziness, tactile feel
LC §5310LC §5900CCR §31.7CCR §10843
Summary
Applicant Gregorio Padilla sustained admitted industrial injuries to his right shoulder, elbow, and knee while working as a driver, and claimed additional injuries to numerous other body parts and systems including internal, psychological, and ENT conditions. After the orthopedic PQME, Dr. Guellich, testified that the non-orthopedic disputed conditions (GI/constipation, sleep, dizziness) fell outside his specialty, the WCJ ordered additional QME panels in Internal Medicine, Psychology, and ENT. Defendant filed a Petition for Removal arguing the order would cause irreparable harm through additional PQME costs and violated the law. The WCAB granted reconsideration to study the issues, then adopted and incorporated the WCJ's report and affirmed the Findings and Order, denying removal. The Board found good cause existed under 8 CCR 31.7 for additional panels in different specialties and that the cost of additional PQMEs did not constitute irreparable harm.
Issues
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Holding
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Analysis
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Applicant takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Defense takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Provider takeaway
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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Similar decisions
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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The panel considered the record, the applicable statutes, and the arguments of the parties.
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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.