WCPanelIQ
PanelQMEMed-legalGranted in Part

Munoz, Ramon

RAMON MUNOZ, Applicant vs. THE EDWARD THOMAS COMPANY; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, Defendants

ADJ number
ADJ10825156
Decision date
Jul 27, 2025
District office
Los Angeles
WCJ
—
Claim administrator
Travelers Property Casualty Company of America
Commissioners
KATHERINE WILLIAMS DODD, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER

Injury / body parts: right knee, hypertension

LC §5909LC §5900LC §4663LC §4909LC §4906CCR §10600CCR §10555

Summary

Ramon Munoz, a painter/maintenance worker, sustained an admitted industrial injury to his right knee and hypertension on January 13, 2016. After reopening his initially unrepresented claim, the WCJ found 75% PPD after apportioning the knee but no apportionment of the hypertension disability, denied defendant a credit for claimed temporary disability overpayment, and awarded applicant's attorney an 18% fee. Defendant petitioned for reconsideration challenging all three rulings. The Board granted reconsideration only to amend the F&A to add an enforceable finding that attorney's fees be held in trust pending the filing of a fee disclosure statement, but otherwise affirmed the WCJ, finding the internist PQME's apportionment opinion was not substantial evidence and that equitable principles justified denial of the overpayment credit.

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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