WCPanelIQ
PanelQMEMed-legalDenied

Grimsley II, Ross

ROSS GRIMSLEY II, Applicant vs. SAN FRANCISCO GIANTS; ACE AMERICAN INSURANCE COMPANY, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number
ADJ13704483
Decision date
Date unavailable
District office
Santa Ana
WCJ
Josephine K. Broussard
Claim administrator
Sedgwick Claims Management Services (administering for ACE American Insurance Company)
Commissioners
—

Injury / body parts: left knee, right shoulder, left shoulder, left elbow, bilateral knees, right ankle

LC §5909LC §5900LC §5702LC §4060LC §4062.2LC §5702LC §4600LC §4600.3LC §4605LC §5502LC §5500.5LC §5412LC §5705CCR §10600CCR §9785

Summary

Ross Grimsley II, a professional baseball coach for the San Francisco Giants from 1999-2014, filed a cumulative trauma claim that was denied by defendant in December 2020. After trial, the WCJ found injury AOE/COE, assigned Occupational Group 493 (rather than the stipulated 590 or defendant's proposed 390), relied on the reporting of PTP Dr. Einbund over QME Dr. Tran, and rejected defendant's claimed nonindustrial apportionment as not substantial evidence under Escobedo. Defendant petitioned for reconsideration challenging the occupational group code determination, the admissibility of Dr. Einbund's reports, and the rejection of apportionment. The Appeals Board denied reconsideration, adopting and incorporating the WCJ's well-reasoned report, finding the occupational variant supported by applicant's credible trial testimony, the PTP reporting properly admitted (especially given defendant's denial of liability and failure to object at trial), and the apportionment opinions deficient for failing to explain 'how and why' nonindustrial factors caused current disability.

Issues

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Holding

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