FRANCISCO MARTINEZ, Applicant vs. WEST COAST PRIME MEATS, LLC; OLD REPUBLIC INSURANCE COMPANY, administered by GALLAGHER BASSETT SERVICES, INC., Defendants
ADJ number
ADJ11351201
Decision date
May 6, 2026
District office
Los Angeles
WCJ
—
Claim administrator
Gallagher Bassett Services, Inc. (administering for Old Republic Insurance Company)
Commissioners
CRAIG L. SNELLINGS, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER
Applicant Francisco Martinez, a meat cutter, claimed cumulative trauma injury (September 12, 2015 to September 5, 2017) to multiple body systems, plus an apparent specific injury when meat blood splashed into his left eye around June 15, 2017. The WCJ found no industrial injury and ordered applicant take nothing, relying primarily on PQME Dr. Shokes's orthopedic opinion. On reconsideration, the Board found the extensive PQME record (across ophthalmology, orthopedics, internal medicine, neurology, and psychiatry) to be materially inconsistent, internally conflicted, and dependent on incomplete or erroneous factual assumptions, and thus not substantial evidence. The Board emphasized unresolved issues including a section 5412 date-of-injury question, the distinction between exacerbation and aggravation of myasthenia gravis, derivative causation opinions based on a vacated report, and unaddressed psychiatric compensable-consequence theories. The Board rescinded the F&O and returned the matter to the trial level for further development of the record.
Issues
Member is $25/month or $250/year and includes full case search.
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.
Holding
Member is $25/month or $250/year and includes full case search.
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.
Analysis
Member is $25/month or $250/year and includes full case search.
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.
Applicant takeaway
Member is $25/month or $250/year and includes full case search.
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.
Defense takeaway
Member is $25/month or $250/year and includes full case search.
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.
Provider takeaway
Member is $25/month or $250/year and includes full case search.
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.
Similar decisions
Member is $25/month or $250/year. Subscribe to view similar decisions.
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.
Member is $25/month or $250/year. Subscribe to view similar decisions.
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.
Member is $25/month or $250/year. Subscribe to view similar decisions.
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.
Member is $25/month or $250/year. Subscribe to view similar decisions.
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.
Member is $25/month or $250/year. Subscribe to view similar decisions.
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.
Member is $25/month or $250/year. Subscribe to view similar decisions.
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.
Member is $25/month or $250/year. Subscribe to view similar decisions.
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.
Member is $25/month or $250/year. Subscribe to view similar decisions.
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.