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Sebastiano Bonfiglio — ADJ13056523

SEBASTIANO BONFIGLIO, Applicant vs. KAISER FOUNDATION HEALTH PLAN, permissibly self-insured; administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number
ADJ13056523
Decision date
Aug 26, 2021
District office
Oakland
WCJ
—
Claim administrator
Sedgwick Claims Management Services (administering for permissibly self-insured Kaiser Foundation Health Plan)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, MARGUERITE SWEENEY, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: back, low back, hips, lower extremities, chest, upper extremities, nervous system, psyche

LC §3600LC §5952LC §5701LC §5906

Summary

Applicant Sebastiano Bonfiglio, an area superintendent for self-insured Kaiser Foundation Health Plan, claimed a cumulative injury to his back, psyche, and other body parts during December 2018 through December 2019. The WCJ found applicant did not sustain a cumulative injury AOE/COE and that the claim was barred by the Labor Code section 3600 post-termination defense, ordering applicant take nothing. On reconsideration, the WCAB found the QME reports of Dr. Feinberg were internally inconsistent and therefore not substantial evidence, and noted the post-termination defense had actually been deferred and would not apply to a voluntary resignation in any event. The Board granted reconsideration, rescinded the F&A, and remanded for further development of the record, including a supplemental report from Dr. Feinberg and a psychiatric/psychological medical-legal evaluation.

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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