WCPanelIQ
PanelQMEMed-legalGranted

Samuel Enrique Tejada Cruz — ADJ11548913, ADJ11548920, ADJ11548921

SAMUEL ENRIQUE TEJADA CRUZ, Applicant vs. COMMERCIAL CLEANING SYSTEMS; STARR INDEMNITY & LIABILITY COMPANY, GALLAGHER BASSETT, Defendants

ADJ number
ADJ11548913, ADJ11548920, ADJ11548921
Decision date
May 24, 2021
District office
Los Angeles
WCJ
—
Claim administrator
Gallagher Bassett (TPA); Starr Indemnity & Liability Company (insurer)
Commissioners
DEIDRA E. LOWE, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: fingers, head, bilateral hips, bilateral ankles, hands, back, shoulders, arms, knees, legs, respiratory system, headaches, insomnia, sleep apnea

LC §5803LC §5804LC §5810LC §5900LC §5813CCR §10421CCR §10561

Summary

Applicant's three claims were dismissed without prejudice on September 6, 2019 after he failed to appear for a July 29, 2019 AOE/COE trial. Applicant timely filed a petition to reopen and objection, and the WCJ ultimately found good cause to reopen all three claims, admitting QME Dr. Miller's report into evidence over defendant's objection. Defendant petitioned for removal, arguing applicant willfully failed to appear, that Dr. Miller's report was improperly admitted, and that the WCJ lacked jurisdiction because applicant did not seek reconsideration of the dismissal order. The Board treated the petition as one for reconsideration (because reopening is a threshold issue), granted it, and affirmed the F&O as amended to formally find Dr. Miller's report constitutes evidence of good cause to reopen and to admit the report into evidence. The Board found no merit to defendant's arguments, holding that dismissal without prejudice did not bar reopening and that no statutory authority allowed forfeiture of claims for failure to appear.

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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