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PanelQMEMed-legalGranted

Silva, Anna

ANNA SILVA, Applicant vs. DEPARTMENT OF TRANSPORTATION HEADQUARTERS OPERATIONS, legally uninsured and adjusted by STATE INSURANCE COMPENSATION FUND, Defendant

ADJ number: ADJ13014565
Decision date: Jun 5, 2025
District office: Sacramento
WCJ: —
Claim administrator: State Compensation Insurance Fund (adjusting for legally uninsured Department of Transportation)
Commissioners: ANNE SCHMITZ, DEPUTY COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER

Injury / body parts: psyche, circulatory system

LC §5909LC §5900LC §3208.3LC §5313LC §5903LC §5952

Summary

Anna Silva, a Caltrans staff services manager, alleged a cumulative trauma psyche and circulatory system injury (8/23/2018–8/22/2019). The WCJ found no compensable psyche injury after concluding applicant was not credible as to most of the events the psyche QME (Dr. Allen) had identified as causative, and found no circulatory injury based on QME Levy's opinion of a temporary exacerbation only. The Appeals Board granted reconsideration, holding the FoF failed to clearly state what the actual events of employment were, leaving the QME unable to opine on predominant causation. The Board also held it was legal error to use the QME's individual factor percentages (intended for later Rolda steps) to assess predominant cause, and flagged that the aggravation-versus-exacerbation distinction is a legal question. The FoF was rescinded and the matter returned to the trial level for assignment to a new WCJ.

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.