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PanelQMEMed-legalRemanded

Jones, Jr., Billy John

BILLY JOHN JONES, JR., Applicant vs. DRC INTERIORS, allegedly uninsured; SUITSUPPLY, CHUBB; BUILDING CORPORATION (STEP CONSTRUCTION SERVICES), VALLEY FORGE INSURANCE COMPANY, Defendants

ADJ number: ADJ10959526
Decision date: Sep 1, 2025
District office: Marina del Rey
WCJ: —
Claim administrator: Chubb; Valley Forge Insurance Company
Commissioners: JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: foot, toes

LC §3600LC §3202.5LC §4060LC §4061LC §4062.3LC §5903LC §5952LC §5313LC §5701LC §5906CCR §10787

Summary

Applicant Billy John Jones, Jr., a construction worker/superintendent, claimed he sustained an industrial injury to his foot and toes on May 27, 2017 when a screw pierced his shoe, an injury complicated by his pre-existing diabetes. The WCJ found applicant did not sustain injury AOE/COE and ordered take nothing, citing credibility concerns and inconsistencies in the records. On reconsideration, the WCAB held that the WCJ's finding was not supported by any medical evidence, as no medical-legal evaluator or treating physician ever addressed causation of the alleged injury. The Board emphasized that an alleged foot/toe injury in a diabetic individual is a medical question requiring substantial medical opinion, not lay opinion. The Board rescinded the F&O and returned the matter to the trial level to develop the medical record by obtaining a PQME opinion on causation.

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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Similar decisions

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Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.

Full case search with summaries, PDFs, holdings, and filters is included with Member. This block is a decorative placeholder so the page layout is visible without exposing restricted text. Sign in or subscribe to Member to read the complete decision. The panel considered the record, the applicable statutes, and the arguments of the parties. Member is $25/month or $250/year and includes the weekly email digest, full case search, and bookmarks.