On 01/29/16, Applicant suffered burns to his feet while handling caustic materials at work. The injury was accepted, and benefits were provided. Ultimately, Applicant was evaluated by a PQME in podiatry.
On 12/27/17, Applicant sustained injuries to his left hand, fingers, and chest while using a table saw at home. He claimed that this was a compensable consequence on the theory that the burns to his feet caused him to lose balance and suffer further injury. On 6/07/18, Applicant fell in the street while walking home and sustained a back injury, a head injury, a broken orbital bone, and loss of consciousness. He later claimed that this fall was another compensable consequence, alleging that the burns to his feet caused him to lose his balance and fall.
Applicant’s counsel amended the claim to add the left hand, left fingers, chest, head, left eye, left orbital bone, and back. Jason Buscaino, an experienced California workers’ compensation defense attorney, believed the newly alleged compensable consequence injuries were questionable, particularly Applicant’s fall in the street, as Applicant had originally reported to his PTP that he experienced non-industrial dizziness, which caused him to fall. Interestingly, the PTP’s next report changed the narrative, indicating that Applicant lost his balance, causing him to fall and then feel dizzy.
As part of a diligent California workers’ compensation defense investigation of the newly alleged compensable consequence injuries, Jason secured records from Applicant’s private medical providers. These medical records, particularly those from the emergency room visits, did not mention anything about the industrial burns to his feet but did detail different factual scenarios:
As to the table saw incident, the records documented that the table saw propelled a wooden plank backwards toward the Applicant at a high rate of speed, causing injury; and as to the fall, the records documented that Applicant suffered a syncope episode, causing his collapse in the middle of the street, resulting in injuries.
Jason filed a DOR for an MSC to either settle the case or set it for trial. At the MSC, Applicant’s counsel sought an order allowing additional QME panels in orthopedic surgery, neurology, and ophthalmology. Jason successfully argued that before allowing the three additional QME panels, the WCAB needed to first make the factual determination as to whether the subsequent incidents were related to the original injury. The MSC judge agreed and allowed the case to be set for trial.
At trial, Applicant and his wife maintained that the industrial burns to his feet caused him to lose his footing and slip, resulting in both the table saw incident and the fall. When Jason cross-examined them, he used the emergency room records in a successful attack on the credibility of their testimonies.
The WCJ found permanent disability from the admitted injury to Applicant’s feet based on the podiatry PQME. The WCJ also found that Applicant did not sustain injury to his left eye, left orbital bone, left hand, left middle fingers, left ribcage, and back as a compensable consequence.
Applicant filed a petition for reconsideration. In this instance, given their high level of confidence in the position taken at trial and the strength of the WCJ’s decision, no answer was filed. The WCAB denied Applicant’s Petition for Reconsideration. With the trial results upheld on appeal, Jason successfully shut down this claim and avoided at least three additional PQMEs, which would have prolonged the litigation, and potential additional exposure for benefits.
You can read redacted versions of the Report and Recommendation on Petition for Reconsideration, Opinion and Order Denying Petition for Reconsideration and Findings and Award and Opinion on Decision below.
Company Name: Dietz, Gilmor & Chazen, APC
Industry: California workers’ compensation defense
Full Name: David Jankosky, DGC Client Services (818-654-9911, Ex. 1231)
Email Address: firstname.lastname@example.org