WCPanelIQ
PanelQMEDenied

Alvarado, Jorge

JORGE ALVARADO, Applicant vs. BMW OF MURIETTA, HENDRICK AUTOMOTIVE GROUP, THE HARTFORD ACCIDENT AND INDEMNITY administered by SEDGWICK CMS, Defendants

ADJ number
ADJ9081819
Decision date
Jul 20, 2025
District office
Los Angeles District Office
WCJ
Jerilyn Cohen
Claim administrator
Sedgwick CMS (administering The Hartford Accident and Indemnity)
Commissioners
—

Injury / body parts: lumbar spine, thoracic spine, right hip

LC §5909LC §5900LC §5902LC §5903CCR §10600

Summary

Applicant Jorge Alvarado, a 49-year-old auto detailer, sustained an industrial injury on July 3, 2013 to the lumbar spine, thoracic spine, and right hip while working for BMW of Murietta/Hendrick Automotive Group. The WCJ found 38% permanent disability with no apportionment, based on the credible opinion of PQME Dr. Steiger, who attributed the DRE Category IV impairment entirely to a defendant-authorized L5-S1 interbody cage fusion surgery. Although Dr. Steiger had opined that the surgery was medically unnecessary and rendered an apportionment opinion (10% degenerative, 45% current injury, 45% to a 2011 injury), the WCJ found the disability arose solely from the consequences of medical treatment and was thus not subject to apportionment under Hikida. Defendant petitioned for reconsideration arguing substantial evidence supported apportionment to non-industrial factors. The Appeals Board adopted the WCJ's Report and denied reconsideration, also addressing timeliness under amended Labor Code section 5909.

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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