WCPanelIQ
PanelQMEMed-legalLienGranted in Part

Ortiz, Sergio Alejandro

SERGIO ALEJANDRO ORTIZ, Applicant vs. PINDLER & PINDLER, INC.; AMTRUST; BERKSHIRE HATHAWAY HOMESTATE COMPANIES, Defendants

ADJ number
ADJ11665067
Decision date
Sep 28, 2025
District office
Anaheim
WCJ
—
Claim administrator
AmTrust; Berkshire Hathaway Homestate Companies
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: lumbar spine, bilateral shoulders, right hand and wrist, neck, arm, upper extremities, lower extremities, neurological system, sleep, psyche

LC §3600LC §3208.3LC §5400LC §5411LC §5412LC §5705LC §3202.5LC §5902LC §4600CCR §10940CCR §10964

Summary

Lien claimant Bell Community Medical Group sought reconsideration of a June 18, 2021 F&O in which the WCJ found that applicant fabric cutter did not sustain industrial injury AOE/COE, primarily because lien claimants failed to call applicant to testify. The WCAB held that uncontradicted medical reporting from QME Dr. Mikhael and treating physician Dr. Bazel established cumulative trauma injury to the lumbar spine, bilateral shoulders, and right hand and wrist, and that applicant's testimony was not a prerequisite to establishing a prima facie case. The Board also found that defendants failed to meet their affirmative burden under section 3600(a)(10) because they offered no evidence of a notice of termination or layoff. The Board rescinded the F&O, substituted findings of industrial injury not barred by section 3600(a)(10), deferred remaining body parts and issues, and returned the matter to the trial level. Although the Petition was unverified, the Board exercised its discretion to review on the merits while warning lien claimant to comply with verification rules.

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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