ADJ16909714 · April 25, 2025

The record lacks evidence that applicant was employed by the entity in ADJ20101471 or injured after January 13, 2018, so no grounds for consolidation exist.

From the decision · page 8II. Defendant first contends that the WCJ erroneously failed to consolidate case number ADJ16909714 with case number ADJ20101471, which was filed by defendant. As stated in the Report, the record lacks evidence that applicant has been employed by the entity against which defendant asserted the claim in ADJ20101471 or was injured at any time after January 13, 2018. It follows that the record is without grounds for consolidation of the cases. Defendant next contends that the WCJ erroneously found that applicant sustained injury to the cervical spine resulting in permanent disability of 18%. As stated in the Report, PQME Dr. Ryan adequately explained the grounds on which she found that applicant sustained a fracture of the C-6 vertebrae injury and rated the resulting disability. It follows that the argument that the record lacked substantial medical evidence to support the finding that applicant sustained injury to the cervical spine is without merit. Defendant next contends that the WCJ erroneously declined to admit exhibits in evidence. As stated in the Report, defendant failed to timely file exhibits for trial and failed to establish grounds for applicant's deposition transcript to be admitted in evidence notwithstanding that he appeared as a witness at trial.

Defendant failed to timely file exhibits and did not establish grounds for admission, so the WCJ did not err in declining to admit them.

From the decision · page 8II. Defendant first contends that the WCJ erroneously failed to consolidate case number ADJ16909714 with case number ADJ20101471, which was filed by defendant. As stated in the Report, the record lacks evidence that applicant has been employed by the entity against which defendant asserted the claim in ADJ20101471 or was injured at any time after January 13, 2018. It follows that the record is without grounds for consolidation of the cases. Defendant next contends that the WCJ erroneously found that applicant sustained injury to the cervical spine resulting in permanent disability of 18%. As stated in the Report, PQME Dr. Ryan adequately explained the grounds on which she found that applicant sustained a fracture of the C-6 vertebrae injury and rated the resulting disability. It follows that the argument that the record lacked substantial medical evidence to support the finding that applicant sustained injury to the cervical spine is without merit. Defendant next contends that the WCJ erroneously declined to admit exhibits in evidence. As stated in the Report, defendant failed to timely file exhibits for trial and failed to establish grounds for applicant's deposition transcript to be admitted in evidence notwithstanding that he appeared as a witness at trial.

PQME Dr. Ryan's medical opinion was substantial evidence supporting the finding of injury and 18% permanent disability.

From the decision · page 3Dr. Ryan gave her expert medical opinion that Applicant's C6 fracture results in 8% Whole Person Impairment based on an AMA Guides Table 15-5 cervical DRE with an additional 3% for cervicogenic headaches. AMA Guides Table 18-1 and section 18.3d provide for a 3% WPI increase for the headaches. The result is 11% WPI as a result of Applicant's industrial injury.

Defendant waived the statute of limitations defense and failed to prove the claim was untimely; the claim was filed within five years of injury and medical treatment was provided, tolling the limitation period.

From the decision · page 6In this case the facts are that Applicant's date of injury was January 13, 2018 and the Application for Adjudication of Claim was filed on November 4, 2022. By Defendant's argument, Applicant would have until January 13, 2023 to request additional benefits. Applicant's Attorney filed the first Declaration of readiness to Proceed to Expedited Hearing on November 28, 2022 and a second declaration of Readiness to Proceed to Expedited Hearing on January 6, 2023. Defendant did not assert Applicant's claim was barred based on an untimely filing of the Application for Adjudication of Claim. Defendant is still currently providing treatment with Dr. Shin as the Primary Treating Physician.... Labor Code 5410 does not bar the Application for benefits as it was filed within five years of the date of injury.... Defendant's claim that there is nonstatutory Statute of Limitation on permanent disability is not supported by any law or facts of this case.... CONCLUSION

Applicant suffered an industrial injury to his neck including cervical spine on January 13, 2018

Favours Applicant prevailed

Established the basis for the claim and injury

From the decision · page 3the applicant (Applicant) was thirty-five (35) years old and employed as an Industrial Maintenance Mechanic, Occupational Group Number 4 70, by Truck Accessories Group LLC (Employer) on January 13, 2018, when he suffered an industrial injury to his neck including his cervical spine. Employer was immediately aware of Applicant's industrial and provided medical treatment.

PQME Dr. Manijeh Ryan's medical opinion provided substantial evidence of injury and 18% permanent disability

Favours Applicant prevailed

Supported the finding of injury and disability

From the decision · page 3Dr. Ryan gave her expert medical opinion that Applicant's C6 fracture results in 8% Whole Person Impairment based on an AMA Guides Table 15-5 cervical DRE with an additional 3% for cervicogenic headaches. AMA Guides Table 18-1 and section 18.3d provide for a 3% WPI increase for the headaches. The result is 11% WPI as a result of Applicant's industrial injury.

Defendant failed to timely file exhibits and did not establish grounds for admission

Favours Applicant prevailed

Justified declining defendant's exhibits and supported applicant's position

From the decision · page 5Procedurally, two Mandatory Settlement Conferences were held because the parties were unable to complete the Pre-Trial Conference Statement at the first MSC. The PTCS was completed and served on November 25, 2024 with an Order that exhibits be properly filed 20 days or more before the first day of trial. Defendant filed its exhibits on January 22, 2025, which was the day before the trial. Defendant failed to file some of the exhibits it listed, and these were identified in the Minutes of Hearing-Summary of Evidence issued February 5, 2025. Defendant did not file any request to resubmit the exhibits it failed to properly file.

Defendant provided medical treatment and did not timely assert statute of limitations defense

Favours Applicant prevailed

Defeated defendant's untimeliness claim and supported claim validity

From the decision · page 6In this case the facts are that Applicant's date of injury was January 13, 2018 and the Application for Adjudication of Claim was filed on November 4, 2022. By Defendant's argument, Applicant would have until January 13, 2023 to request additional benefits. Applicant's Attorney filed the first Declaration of readiness to Proceed to Expedited Hearing on November 28, 2022 and a second declaration of Readiness to Proceed to Expedited Hearing on January 6, 2023. Defendant did not assert Applicant's claim was barred based on an untimely filing of the Application for Adjudication of Claim. Defendant is still currently providing treatment with Dr. Shin as the Primary Treating Physician.... Labor Code 5410 does not bar the Application for benefits as it was filed within five years of the date of injury.... Defendant's claim that there is nonstatutory Statute of Limitation on permanent disability is not supported by any law or facts of this case.... CONCLUSION

Applicant's C6 fracture results in 8% Whole Person Impairment with an additional 3% for cervicogenic headaches, totaling 11% WPI, caused by the industrial injury on January 13, 2018, with all disability apportioned to the industrial injury.

Dr. Ryan explained how she reached her expert medical opinion with reasoning and pertinent facts, providing substantial medical evidence for injury and permanent disability.

From the decision · page 3Dr. Ryan gave her expert medical opinion that Applicant's C6 fracture results in 8% Whole Person Impairment based on an AMA Guides Table 15-5 cervical DRE with an additional 3% for cervicogenic headaches. AMA Guides Table 18-1 and section 18.3d provide for a 3% WPI increase for the headaches. The result is 11% WPI as a result of Applicant's industrial injury.

Labor Code section 5705; Lantz v. Workers' Comp. Appeals Bd. (2014) 226 Cal.App.4th 298; Hand Rehabilitation Center v. Workers' Comp. Appeals Bd. (1995) 34 Cal.App.4th 1204

Preponderance of the evidence

The burden of proof rests upon the party holding the affirmative of the issue, and all parties must meet the evidentiary burden by a preponderance of the evidence.

From the decision · page 8The record thus lacks grounds to conclude that defendant was denied notice and an opportunity to be heard. It follows that the argument that the WCJ failed to admit defendant's exhibits is without support. Lastly, defendant argues that the WCJ erroneously failed to find that applicant's claim is untimely under Labor Code section 5410. We observe that the burden of proof rests upon the party holding the affirmative of the issue, and all parties shall meet the evidentiary burden of proof on all issues by a preponderance of the evidence. (§ 5705; Lantz v. Workers' Comp. Appeals Bd. (2014) 226 Cal.App.4th 298, 313 [79 Cal.Comp.Cases 488]; Hand Rehabilitation Center v. Workers' Comp. Appeals Bd. (Obernier) (1995) 34 Cal.App.4th 1204 [60 Cal.Comp.Cases 289].) "Preponderance of the evidence" is defined by section 3202.5 as the "evidence that, when weighed with that opposed to it, has more convincing force and the greater probability of

Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604

Medical opinion must be framed in terms of reasonable medical probability, based on pertinent facts and adequate examination, with reasoning in support

Dr. Ryan's reporting clearly explains how she reached her expert medical opinion on injury and disability, providing substantial evidence.

From the decision · page 4"[A] a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc). Dr. Ryan's reporting clearly explains how she reached her expert medical opinion that Applicant's C6 fracture results in 8% Whole Person Impairment based on an AMA Guides Table 15-5 cervical DRE with an additional 3% for cervicogenic headaches. AMA Guides Table 18-1 and section 18.3d provide for a 3% WPI increase for the headaches. (OOD Pg. 3 - 4) Applicant was struck in his head, neck and shoulder area by a large industrial mixing blade that knocked him off a ladder, into the wall of the mixing tank and then down to the floor where he was struck by the lower mixing blade. There is no evidence of any other event that could have caused the facture in Applicant's C-6 vertebrae. Applicant credibly testified at trial that he started working with Dignity Health Medical Foundation in 2020 and his symptoms have remained the same at his new employment other than improving with treatment with Dr. Shin. (MOH-SOE Pg. 7 - 10)

Labor Code section 5410

Labor Code section 5410 tolls the one-year limitation and extends the period to five years for new and further disability when medical treatment is provided

Defendant accepted claim and provided medical treatment, tolling the limitation period and allowing filing within five years.

From the decision · page 9Further, section 5410 provides: Nothing in this chapter shall bar the right of any injured worker to institute proceedings for the collection of compensation within five years after the date of the injury upon the ground that the original injury has caused new and further disability. The jurisdiction of the appeals board in these cases shall be a continuing jurisdiction within this period. This section does not extend the limitation provided in Section 5407. (§ 5410.)

Applicant's credible testimony and medical records establish accepted industrial injury causing cervical fracture at C-6 level

From the decision · page 6Applicant's credible testimony and the medical records on file clearly establish Applicant was involved in an accepted industrial injury that resulted in a cervical fracture at his C-6 level. The cervical fracture is being treated by Dr. Carl Shin as the Primary Treating Physician and has been evaluated by Dr. Ryan as the Qualified Medical Evaluator. There is no evidence of any other event or injury that could cause a fracture of Applicant's cervical spine. Dr. Ryan gave her expert medical opinion that Applicant's cervical fracture resulted in 11% WPI that adjusts to 18% permanent partial disability. (OOD Pg. 3- 5) Neither Defendant's failure to properly file exhibits nor Defendant's filing of an Application against the wrong entity justify further delaying the Permanent Disability Indemnity payments to Applicant.

Defendant failed to timely file exhibits and did not establish grounds for admission

From the decision · page 5Procedurally, two Mandatory Settlement Conferences were held because the parties were unable to complete the Pre-Trial Conference Statement at the first MSC. The PTCS was completed and served on November 25, 2024 with an Order that exhibits be properly filed 20 days or more before the first day of trial. Defendant filed its exhibits on January 22, 2025, which was the day before the trial. Defendant failed to file some of the exhibits it listed, and these were identified in the Minutes of Hearing-Summary of Evidence issued February 5, 2025. Defendant did not file any request to resubmit the exhibits it failed to properly file.

Defendant provided medical treatment and did not timely assert statute of limitations defense

From the decision · page 6In this case the facts are that Applicant's date of injury was January 13, 2018 and the Application for Adjudication of Claim was filed on November 4, 2022. By Defendant's argument, Applicant would have until January 13, 2023 to request additional benefits. Applicant's Attorney filed the first Declaration of readiness to Proceed to Expedited Hearing on November 28, 2022 and a second declaration of Readiness to Proceed to Expedited Hearing on January 6, 2023. Defendant did not assert Applicant's claim was barred based on an untimely filing of the Application for Adjudication of Claim. Defendant is still currently providing treatment with Dr. Shin as the Primary Treating Physician.... Labor Code 5410 does not bar the Application for benefits as it was filed within five years of the date of injury.... Defendant's claim that there is nonstatutory Statute of Limitation on permanent disability is not supported by any law or facts of this case.... CONCLUSION