WCPanelIQ
PanelQMEMed-legalRemanded

Terrance Martinez — ADJ9191050

TERRANCE MARTINEZ, Applicant vs. MK ROOFING, INC.; STATE COMPENSATION INSURANCE FUND, Defendants

ADJ number
ADJ9191050
Decision date
Sep 20, 2026
District office
Los Angeles
WCJ
—
Claim administrator
State Compensation Insurance Fund
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, JOSEPH V. CAPURRO, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: back, lumbar spine, leg

LC §3600LC §3202.5LC §3208.3LC §4600LC §4650LC §4060LC §4061LC §4062.3LC §5400LC §5401LC §5405LC §5409LC §5411LC §5412LC §5500LC §5701LC §5705LC §5906LC §5952CCR §10450

Summary

Applicant Terrance Martinez claimed an April 13, 2012 back injury while employed by MK Roofing as a salesperson/truck driver. The WCJ found no AOE/COE injury, that the claim was barred by the post-termination defense under section 3600(a)(10), and that it was barred by the section 5405 statute of limitations, ordering applicant take nothing. On reconsideration, the Appeals Board found the QME's causation opinion was not substantial evidence because the QME had not reviewed subpoenaed PIH Health records, Bright Acupuncture Clinic records, or Dr. Reyes's records, and had not addressed the WCJ's credibility determinations. The Board rescinded the F&O and remanded for development of the record, including supplemental QME reporting and resolution of the post-termination and statute of limitations defenses once the record is complete.

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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