WCPanelIQ
PanelQMEMed-legalDenied

Tole, Darrell

DARRELL TOLE, Applicant vs. ZURICH AMERICAN INSURANCE COMPANY, administered by COTTINGHAM AND BUTLER CLAIMS SERVICES, for its insured BIAGI BROTHERS INCORPORATED, Defendants

ADJ number
ADJ16120106
Decision date
Sep 28, 2025
District office
Santa Rosa
WCJ
—
Claim administrator
Cottingham and Butler Claims Services (administering for Zurich American Insurance Company, insuring Biagi Brothers Incorporated)
Commissioners
CRAIG SNELLINGS, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: bilateral knees

LC §5909LC §5900LC §4062.3LC §4060LC §4062.2CCR §10600CCR §9785

Summary

Applicant Darrell Tole, a truck driver, sustained an industrial injury to his bilateral knees on February 18, 2022. The WCJ found a closed period of temporary disability extending beyond the initially-asserted August 3, 2023 MMI date through July 31, 2024. Defendant petitioned for reconsideration, arguing that an award of temporary disability requires contemporaneous medical reporting and that no such evidence supported the extended TD period. The Board rejected this argument, distinguishing the cited panel decisions (Howland and Moore) as cases about insufficient substantial evidence rather than the absence of contemporaneous reporting. The Board found that PQME chiropractor Michaels' reporting—including documentation of deterioration of the applicant's condition and a revised P&S date of August 1, 2024—constituted substantial evidence supporting the TD period. Reconsideration was denied.

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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