WCPanelIQ
PanelQMEMed-legalDenied

Mejia, Jose

JOSE MEJIA, Applicant vs. JB CRITCHLEY, INC.; AMERICAN CLAIMS MANAGEMENT, Defendants

ADJ number
ADJ8558358
Decision date
Nov 8, 2023
District office
Fresno
WCJ
—
Claim administrator
American Claims Management (administering for permissibly self-insured J. B. Critchley, Incorporated)
Commissioners
JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER

Injury / body parts: cervical spine, thoracic spine, lumbar spine, headaches, hearing loss, psyche, hypertension, high blood pressure, heart-left ventricular hypertrophy, chest pain, medication effects, sleep, dysphagia, failed spine surgery, adjacent segment disease

LC §4660LC §139.2LC §4061LC §4062.3LC §4064LC §4628LC §4663CCR §10964CCR §10166CCR §9785CCR §10133.36CCR §10682CCR §10683

Summary

Applicant Jose Mejia, a semi-truck driver/laborer, sustained an admitted industrial injury on August 4, 2010 to multiple body parts including the cervical, thoracic, and lumbar spine, psyche, internal medicine, neurologic, and otolaryngologic systems. The WCJ found applicant permanently and totally disabled without apportionment, relying on the aggregate medical-legal record (AME and multiple QMEs), the primary treating physician's opinions, applicant's vocational expert, and credible trial testimony from applicant's son. Defendant sought reconsideration, arguing that the vocational expert's report was not substantial evidence and that the award should reflect orthopedic apportionment found by AME Dr. Lundeen. The Board affirmed, holding that the WCJ properly based the PTD determination on the entire record (not primarily the vocational expert), and that because the only nonindustrial apportionment came from the orthopedic AME, the WCJ correctly relied on applicant's psychiatric, internal medicine, and neurologic disabilities—combined with the apportioned orthopedic impairment—to find unapportioned total disability arising solely from industrial factors.

Issues

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Holding

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Analysis

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