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JoseManuel Ramirez Santos — ADJ12990177

JOSE MANUEL RAMIREZ SANTOS, Applicant vs. SUNNY DISTRIBUTORS, INC. / SUNNY HEALTH & FITNESS, and PREFERRED EMPLOYERS INSURANCE COMPANY, Defendants

ADJ number: ADJ12990177
Decision date: May 4, 2021
District office: Santa Ana
WCJ: —
Claim administrator: Preferred Employers Insurance Company
Commissioners: DEIDRA E. LOWE, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: neck, bilateral shoulders, back, left knee

LC §5952LC §3600LC §4060LC §4062.2LC §5701LC §5906CCR §10300CCR §10803CCR §10807

Summary

Applicant Jose Manuel Ramirez Santos, a forklift driver, claimed cumulative trauma injury to his neck, bilateral shoulders, back, and left knee during employment from August 5, 2019 through January 29, 2020. The WCJ found applicant did not sustain injury AOE/COE and deemed the post-termination defense moot. The WCAB granted reconsideration, finding that the reports of the PTP (Dr. Green) and secondary treater (Dr. Komberg) did not constitute substantial evidence under Escobedo, and that applicant's testimony alone cannot establish a cumulative injury requiring expert medical opinion. Because the record lacked sufficient medical evidence and no medical-legal evaluation had occurred, the Board rescinded the F&O and returned the matter to the WCJ to develop the record by having applicant undergo a medical-legal evaluation. The Board emphasized it was not deciding the merits of AOE/COE or the post-termination defense.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. 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.