WCPanelIQ
PanelQMEMed-legalGranted

Garcia, Roy

ROY GARCIA, Applicant vs. RICHARD J. DONOVAN CORRECTIONAL FACILITY; legally uninsured, administered by STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ9599561
Decision date
Oct 26, 2025
District office
San Diego
WCJ
—
Claim administrator
State Compensation Insurance Fund (administering legally uninsured Richard J. Donovan Correctional Facility)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, ANNE SCHMITZ, DEPUTY COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: neck, lumbar spine, right knee, psyche, urinary incontinence

LC §5909LC §5900LC §5950LC §5410LC §5705LC §5803LC §5903LC §5952LC §4660.1LC §5907LC §5908LC §5908.5LC §5901

Summary

Roy Garcia, a registered dental assistant, sustained an industrial injury on July 8, 2013 to his neck, lumbar spine, right knee, psyche, and urinary incontinence, which was resolved in 2018 via Stipulation and Award at 41% PD with future medical care. Applicant timely petitioned to reopen, arguing new and further disability rendering him permanently and totally disabled. The WCJ found applicant is permanently and totally disabled but concluded the medical record failed to establish that the total disability was due solely to the 2013 industrial injury, given non-industrial physical conditions (including prior Navy injuries) and non-compensable psychiatric disability, and thus awarded no additional benefits. The Appeals Board granted reconsideration, finding it lacked substantial evidence to determine whether the increase in disability was industrial or non-industrial, and deferred a final decision to allow further study of the record.

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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