WCPanelIQ
PanelQMEMed-legalRemanded

De Leon, Edelmira

EDELMIRA DE LEON, Applicant vs. JEFFREY A. KAPLAN; BANKERS’ STANDARD INSURANCE C/O ACE PRIVATE RISK, administered by ESIS, Defendants

ADJ number
ADJ12378634
Decision date
Mar 4, 2026
District office
Los Angeles
WCJ
—
Claim administrator
ESIS (administering Bankers' Standard Insurance c/o ACE Private Risk)
Commissioners
CRAIG L. SNELLINGS, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: back, neck, trunk/waist, legs, right upper extremity, left arm, shoulders, hands, headaches, nervous system, psyche/stress, cervical spine, lumbar spine

LC §3600LC §3202.5LC §3208.3LC §5313LC §5400LC §5411LC §5412LC §5701LC §5705LC §5903LC §5906LC §5952CCR §10787

Summary

Edelmira De Leon, a housekeeper, claimed a cumulative trauma injury to multiple body parts during employment from June 29, 2018 to June 29, 2019. The WCJ found applicant failed to prove AOE/COE injury and that the claim was barred by the post-termination defense under Labor Code section 3600(a)(10) since the injury was not reported until after her termination. On reconsideration, the WCAB found the record contained no evidence confirming the fact or date of applicant's termination, and the section 5412 date of injury for the cumulative trauma was never determined. The Board also found the PQME, Dr. Pratt, had not reviewed relevant treatment records, including those from Dr. Pharm and applicant's physical therapist. The WCAB rescinded the F&O and remanded for further development of the record, including a determination of the date of injury and supplementation of the medical record.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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