WCPanelIQ
PanelQMEMed-legalDenied

Lomeli, Luis

LUIS LOMELI, Applicant vs. COUNTY OF LOS ANGELES, PERMISSIBLY SELF-INSURED, Defendants

ADJ number
ADJ10280441
Decision date
May 15, 2025
District office
Marina Del Rey District Office
WCJ
Ivy W. Mi
Claim administrator
County of Los Angeles, Permissibly Self-Insured (administered by Sedgwick COLA Orange; previously Tristar)
Commissioners
—

Injury / body parts: psyche, head, neck, shoulders, back, nervous system

LC §4600LC §3208.3LC §5705LC §4060LC §5502CCR §10955CCR §10625

Summary

Applicant Luis Lomeli, a medical case worker for the County of Los Angeles (permissibly self-insured), claimed a cumulative psychiatric injury from December 1, 2014 to December 1, 2015. The WCJ found a compensable industrial psyche injury, relying on the reporting of treating/evaluating physician Dr. Nelson Flores, and rejecting the contrary apportionment opinions of PQME Dr. Dorsey as not substantial medical evidence. Defendant sought reconsideration arguing that Dr. Flores' reports were improperly admitted, that its Labor Code section 4600 designation letter should have been admitted, and that Dr. Flores failed to address good faith personnel action causation under section 3208.3(h). The WCAB affirmed, adopting the WCJ's Report, holding that defendant failed to timely object or seek removal of prior orders, that the section 4600 letter was waived under section 5502(d), and that the section 3208.3(h) defense was an affirmative defense never raised and thus waived—leaving defendant unable to meet its burden of proof.

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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