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PanelQMEDenied

Jose Luis Valencia — ADJ13633820

JOSE LUIS VALENCIA, Applicant vs. ENTERPRISE RENT-A-CAR COMPANY OF LOS ANGELES, LLC; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., Defendants

ADJ number
ADJ13633820
Decision date
Sep 10, 2026
District office
Van Nuys
WCJ
—
Claim administrator
Sedgwick Claims Management Services, Inc. (administering for Travelers Property Casualty Company of America)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, LISA A. SUSSMAN, DEPUTY COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER

Injury / body parts: bilateral shoulders, right knee, left knee, right foot, cervical spine, thoracic spine, lumbar spine, bilateral elbows, bilateral wrists/hands

LC §5909LC §4660LC §4662LC §5903LC §5952

Summary

Applicant Jose Luis Valencia sustained a cumulative trauma injury (2019-2020) as a driver affecting multiple body parts. After the WCJ found 100% permanent total disability based on the vocational reporting of applicant's expert Enrique Vega, defendant sought reconsideration, arguing Vega's report was not substantial evidence because it relied on functional limitations not found in the PQME reports and rendered improper medical opinions, and that the record needed development because the PQME did not review the vocational reports. The WCAB denied reconsideration, holding Vega's report constituted substantial evidence because his real-time observations during vocational testing fell within the scope of vocational assessment, while defendant's expert Nick Corso improperly evaluated a hypothetical worker by inflating applicant's aptitude and language baselines to average levels. The Board also rejected the request to develop the record and declined to reopen apportionment, finding defendant failed to meet its burden of proving apportionment.

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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