WCPanelIQ
PanelQMEMed-legalRemanded

Sergio Garcia — ADJ12546400

SERGIO GARCIA, Applicant vs. BEVERLY COMMUNITY HOSPITAL; SAFETY NATIONAL CASUALTY, administered by KEENAN AND ASSOCIATES, Defendants

ADJ number
ADJ12546400
Decision date
Mar 31, 2021
District office
Los Angeles
WCJ
—
Claim administrator
Keenan and Associates (TPA for Safety National Casualty)
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, DEIDRA E. LOWE, COMMISSIONER

Injury / body parts: skin, face, eyes, left ear, head, headaches, internal system, psychiatric system, neurological system, tinnitus, TMJ, sleep, vertigo

LC §5909LC §4062.1LC §4062.3LC §5903LC §5952LC §5701LC §5906CCR §34CCR §31.5CCR §110CCR §51

Summary

Applicant Sergio Garcia, an ICU nurse, claimed injury to multiple body parts after alleged workplace exposure to a co-worker with a viral infection, leading to cranial nerve palsy and other conditions. The WCJ found injury AOE/COE based on QME Dr. Lawrence Miller's report and applicant's treating physician, and found Dr. Miller's report admissible and substantial evidence. Defendant sought reconsideration challenging both the admissibility and the substantiality of the QME report. The Board affirmed that Dr. Miller's report was admissible, rejecting defendant's arguments based on AD Rule 34 notification violations, examination location, ex parte communication, and service issues. However, the Board found the report was not substantial evidence because the history of exposure relayed to Dr. Miller conflicted with applicant's trial testimony, and because no qualified physician addressed psychiatric causation. The Board rescinded the FA&O and remanded for further development of the record.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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