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PanelMed-legalGranted

Lafleur, Marc

MARC LAFLEUR, Applicant vs. MILHOUSE CHILDREN’S SERVICES, through NON-PROFITS UNITED, as a self-insured group, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INCORPORATED, Defendants

ADJ number: ADJ10423250
Decision date: Apr 17, 2025
District office: Redding
WCJ: —
Claim administrator: Sedgwick Claims Management Services, Incorporated (administering Non-Profits United, a self-insured group)
Commissioners: JOSE H. RAZO, COMMISSIONER, CRAIG SNELLINGS, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: left ankle, back

LC §5909LC §5900LC §5950LC §5903LC §5952LC §5907LC §5908LC §5908.5LC §5803LC §5901LC §5814LC §5410CCR §10600CCR §10152

Summary

Applicant Marc Lafleur sustained an admitted industrial injury to his left ankle and back on June 11, 2015, resolved by a Stipulated Award at 38% permanent disability. He filed a timely Petition to Reopen on June 9, 2020, alleging new and further disability, and underwent extensive subsequent treatment including total ankle arthroplasty and multiple later surgeries. The WCJ denied the Petition to Reopen, finding no actual evidence of new and further disability within five years of the original date of injury. Applicant sought reconsideration, arguing the WCJ should have relied on AME Dr. Thomas Pattison's opinion and erred in characterizing his occupation as merely 'driver.' The Appeals Board granted reconsideration, finding the WCJ's decision was not supported by substantial evidence without further development of the record, and deferred a final decision pending further review.

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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Similar decisions

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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.

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.

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.

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.

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.

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.

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.