WCPanelIQ
PanelQMEMed-legalGranted in Part

Serrano, Alfredo

ALFREDO SERRANO, Applicant vs. BIG IDEA HOLDINGS, LLC; OLD REPUBLIC INSURANCE COMPANY, administered by CANNON COCHRAN MANAGEMENT SERVICES, INC., Defendants

ADJ number
ADJ10986659
Decision date
Sep 29, 2025
District office
Salinas
WCJ
—
Claim administrator
Cannon Cochran Management Services, Inc. (administering Old Republic Insurance Company)
Commissioners
CRAIG SNELLINGS, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: right shoulder

LC §3202LC §3202.5LC §3600LC §4663LC §5701LC §5702LC §5903LC §5906LC §5952CCR §10517CCR §10945

Summary

Applicant Alfredo Serrano sustained an admitted specific injury to his right shoulder on September 15, 2015, while working as a laborer, and also alleged a cumulative trauma injury from April 1, 2006 to October 15, 2015. The WCJ found the specific injury but made no finding on the cumulative trauma, awarding 6% PD based on QME Dr. Huffer's reporting, which apportioned 80% of the need for surgery to preexisting arthritis. Applicant sought reconsideration, arguing the QME applied an incorrect legal standard to causation and apportionment and that the record required development. The Board held that Dr. Huffer's reporting did not constitute substantial medical evidence because it improperly required medical 'certainty' rather than reasonable medical probability, failed to explain why work activities could not be linked to the arthritis, and improperly apportioned the 'need for surgery' rather than the approximate percentages of permanent disability. The Board rescinded the F&A and returned the matter to the WCJ for development of the record under section 5701, suggesting an AME or regular physician rather than further reporting from Dr. Huffer.

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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