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PanelQMEGranted in Part

Colleen Sass — ADJ11416708

COLLEEN SASS, Applicant vs. ENCOMPASS COMMUNITY SERVICES; LWP CLAIMS; NEW YORK MARINE and GENERAL INSURANCE COMPANY, Defendants

ADJ number: ADJ11416708
Decision date: Feb 1, 2021
District office: Salinas
WCJ: —
Claim administrator: LWP Claims (TPA) for New York Marine and General Insurance Company
Commissioners: KATHERINE A. ZALEWSKI, CHAIR, MARGUERITE SWEENEY, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: back, lumbar spine

LC §4656LC §4600LC §5952CCR §10955CCR §10843

Summary

Applicant Colleen Sass sustained an admitted industrial back injury on June 29, 2018 while working as a case manager. After undergoing lumbar fusion surgery on October 17, 2019, defendant disputed liability for the surgery and resulting temporary disability. The WCJ found the industrial injury hastened the need for surgery based on PQME Dr. Howard's opinions and awarded ongoing temporary disability. The Board granted reconsideration but affirmed the substantive findings, holding that Dr. Howard's opinions constituted substantial evidence that the industrial injury contributed to and hastened the need for surgery. The Board amended the award only to make the temporary disability subject to the 104-week cap of Labor Code section 4656(c)(2) and to provide credit for TD already paid.

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.