Home/Case Law/INOCENCIO PEDROSA vs. KAISER FOUNDATION HEALTH PLAN
Regular DecisionReconsideration

INOCENCIO PEDROSA vs. KAISER FOUNDATION HEALTH PLAN

Filed: Oct 05, 2015
Van Nuys
ADJ9163440

CompFox AI Summary

This case concerns a workers' compensation claim where the applicant alleged injury to his right ankle and cervical spine from operating a pallet jack. The defendant disputed the injury AOE/COE, primarily citing surveillance footage and alleged inconsistencies in applicant's testimony. The WCJ found injury AOE/COE based on Dr. Sadler's report, which interpreted the surveillance video as confirming applicant's head hitting a wall, despite the WCJ finding Dr. Sadler's report not substantial due to his failure to consider prior injuries. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter for further development of the record, finding no substantial evidence to support the injury finding. Additionally, defense counsel was admonished for improperly submitting extraneous documents with the Petition for Reconsideration.

Full Decision Text1 Pages

This case concerns a workers' compensation claim where the applicant alleged injury to his right ankle and cervical spine from operating a pallet jack. The defendant disputed the injury AOE/COE, primarily citing surveillance footage and alleged inconsistencies in applicant's testimony. The WCJ found injury AOE/COE based on Dr. Sadler's report, which interpreted the surveillance video as confirming applicant's head hitting a wall, despite the WCJ finding Dr. Sadler's report not substantial due to his failure to consider prior injuries. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter for further development of the record, finding no substantial evidence to support the injury finding. Additionally, defense counsel was admonished for improperly submitting extraneous documents with the Petition for Reconsideration.

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INOCENCIO PEDROSA vs. KAISER FOUNDATION HEALTH PLAN (2015) – Van Nuys | CompFox