WCPanelIQ
PanelQMEMed-legalGranted

Gonzalez, Jose

JOSE GONZALEZ, Applicant vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND, Defendants

ADJ number
ADJ11036278
Decision date
Jun 9, 2025
District office
Santa Barbara
WCJ
—
Claim administrator
—
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, PATRICIA A. GARCIA, DEPUTY COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: bilateral knees, lumbar spine, right wrist, left hip, neurological system (stroke/TIA), hypertension, constipation/gastro-intestinal

LC §4751LC §5909LC §5900LC §5002LC §4660CCR §10600CCR §10700

Summary

Jose Gonzalez sought SIBTF benefits based on a prior orthopedic industrial injury, claiming a 71% standard rating of permanent disability by combining orthopedic impairments found by AME Calderone with hypertension and constipation impairments found by PQME Lensky. The WCJ found applicant failed to meet the 35% threshold under Labor Code section 4751 because the underlying Compromise and Release (C&R) characterized hypertension, neurological, and constipation conditions as disputed/denied body parts, leaving only 16% from the orthopedic components. The WCAB granted reconsideration, holding that a C&R is a compromise, not a stipulation or finding of injury or permanent disability, and that the language disputing certain body parts did not establish those injuries were non-industrial. The Board affirmed the June 10, 2025 decision except to amend it to defer the SIBTF eligibility issue and returned the matter to the trial level for further proceedings.

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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