WCPanelIQ
PanelQMEMed-legalDenied

Jose Argueta Guzman — ADJ13762384

JOSE ARGUETA GUZMAN, Applicant vs. GREEN FARMS, INC.; GREAT AMERICAN INSURANCE, Defendants

ADJ number
ADJ13762384
Decision date
Aug 22, 2022
District office
Van Nuys
WCJ
S. Michael Cole
Claim administrator
Great American Insurance
Commissioners
—

Injury / body parts: face, head, right eye, neck, brain (TBI), psyche

LC §3600LC §3202.5

Summary

Applicant Jose Argueta Guzman sustained serious head, face, and right eye injuries on 9/16/20 when a forklift fork popped out and struck him in the face while he was repairing a scissor lift at Green Farms, Inc. Defendant Great American Insurance denied the claim under the intoxication affirmative defense (Labor Code section 3600(a)(4)), citing post-injury blood/urine testing showing recent drug use. The WCJ found defendant failed to meet its burden of proving that intoxication caused the injury, and that PQME Dr. Gillis's report—which theorized applicant suffered a stroke and fell—was not substantial evidence because it was based on an inaccurate version of events contradicted by workplace video. The WCAB denied reconsideration, adopting the WCJ's Report and agreeing the Gillis report failed the Escobedo substantial evidence standard.

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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