WCPanelIQ
PanelDenied

Maria Flores — ADJ10954204

MARIA FLORES, Applicant vs. PINNACLE HEALTH CORP.; SUMMARY OF EVIDENCE INSURANCE COMPANY OF THE WEST; AFFINITY HOME HEALTH CARE SERVICES, insured by FALLS LAKE FIRE & CASUALTY INSURANCE and administered by SEDGWICK CMS; HOME HEALTH CARE SOLUTIONS, INC., insured by FALLS LAKE FIRE & CASUALTY INSURANCE and administered by SEDGWICK CMS, Defendants

ADJ number
ADJ10954204
Decision date
Sep 14, 2022
District office
Pomona
WCJ
Monika Reyes
Claim administrator
Sedgwick CMS (administering Falls Lake Fire & Casualty Insurance); Insurance Company of the West (Pinnacle)
Commissioners
—

Injury / body parts: spine, left thigh, left knee, left ankle, head (deferred)

Summary

Maria Flores, an LVN, provided at-home nursing services for three agencies (Affinity, Solutions, and Pinnacle/Apex) using her own required vehicle to travel between patients' homes. On February 23, 2017, she was injured in a motor vehicle accident while traveling from a Solutions patient to a Pinnacle patient. The WCJ found injury AOE/COE as to Solutions and Pinnacle and held the going and coming rule did not bar the claim, but found no AOE/COE as to Affinity because no transit linked Affinity to the accident. Solutions petitioned for reconsideration arguing it gained no benefit from her travel to a Pinnacle patient. The WCAB denied reconsideration, adopting the WCJ's report, holding the automobile-use requirement and the structure of the employment placed the transit within the employer-employee relationship.

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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