WCPanelIQ
PanelQMEMed-legalGranted

Brenda Chavez — ADJ11187899

BRENDA CHAVEZ, Applicant vs. NOR-CAL CHICKEN, INC., dba EL POLLO LOCO and CALIFORNIA RESTAURANT MUTUAL BENEFIT CORPORATION, administered by AMERICAN CLAIMS MANAGEMENT, Defendants

ADJ number
ADJ11187899
Decision date
May 20, 2021
District office
Stockton
WCJ
—
Claim administrator
American Claims Management (administering California Restaurant Mutual Benefit Corporation)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: upper extremities, left arm, right shoulder, right elbow

LC §3208.1LC §5401LC §5701LC §5906LC §5909

Summary

Applicant Brenda Chavez, a prep cook, claimed a February 28, 2017 industrial injury to her upper extremities, right shoulder, and right elbow after a freezer door struck her elbow. The WCJ found injury AOE/COE, and defendant sought reconsideration arguing that QME Dr. Ciepiela's reports and deposition testimony established no industrial injury. The Board found that Dr. Ciepiela's opinions were not substantial evidence because he failed to address whether the incident aggravated applicant's pre-existing degenerative shoulder condition, whether the incident caused the 'loose bodies,' and whether it was a minor industrial injury requiring only first aid. The Board also noted inconsistencies between applicant's trial testimony and the Doctor's First Report of Injury, and that lay testimony cannot establish AOE/COE. The Board granted reconsideration, rescinded the F&O, and remanded for development of the record, directing evaluation by an AME or a court-appointed regular physician since Dr. Ciepiela declined to re-examine applicant.

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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