Home/Case Law/LUIS OCHOA vs. SOHO HOUSE WEST HOLLYWOOD, LLC, FEDERAL INSURANCE COMPANY
Regular DecisionReconsideration

LUIS OCHOA vs. SOHO HOUSE WEST HOLLYWOOD, LLC, FEDERAL INSURANCE COMPANY

Filed: Aug 09, 2019
Van Nuys
ADJ10619121

CompFox AI Summary

The Workers' Compensation Appeals Board granted reconsideration and rescinded the WCJ's decision, finding the original decision lacked substantial evidence. The Board determined that the Qualified Medical Examiner's (QME) report, which was the sole basis for denying the claim, did not adequately explain its reasoning for dismissing the applicant's complaints and the findings from an MRI. Furthermore, the Board recommended admitting applicant's Exhibits 2 and 3 into evidence, as the QME had reviewed these documents, and their exclusion raised due process concerns. The case is remanded to the WCJ for further proceedings to develop the record with adequate, reasoned medical opinions.

Full Decision Text1 Pages

The Workers' Compensation Appeals Board granted reconsideration and rescinded the WCJ's decision, finding the original decision lacked substantial evidence. The Board determined that the Qualified Medical Examiner's (QME) report, which was the sole basis for denying the claim, did not adequately explain its reasoning for dismissing the applicant's complaints and the findings from an MRI. Furthermore, the Board recommended admitting applicant's Exhibits 2 and 3 into evidence, as the QME had reviewed these documents, and their exclusion raised due process concerns. The case is remanded to the WCJ for further proceedings to develop the record with adequate, reasoned medical opinions.

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