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Everest National Insurance Company seeks reconsideration of an arbitrator's decision awarding CIGA $$95,245.36$ in reimbursement for cumulative trauma benefits. Everest argues the arbitrator erred by finding the cumulative trauma extended over the applicant's entire employment, contrary to the Agreed Medical Examiner's (AME) opinion. The Appeals Board granted reconsideration, finding the AME's opinion legally flawed and lacking substantial evidence for the extended cumulative trauma period. The matter is remanded to the arbitrator for further proceedings to develop the medical record and render a new decision.
REYNA MEZA vs. PACPRO MANAGEMENT, Dba COAST SPORTSWEAR, AMERICAN CLAIMS MANAGEMENT for EVEREST NATIONAL INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, By Its Facilitating Agent, INTERCARE INS. SERVICES, for PAULA INSURANCE COMPANY, In Liquidation is a workers' compensation case decided in . This case addresses legal issues related to compensation claims, benefits, and court rulings.
It is commonly referenced in legal research involving workers' compensation laws in .
Full Decision Text1 Pages
Everest National Insurance Company seeks reconsideration of an arbitrator's decision awarding CIGA $$95,245.36$ in reimbursement for cumulative trauma benefits. Everest argues the arbitrator erred by finding the cumulative trauma extended over the applicant's entire employment, contrary to the Agreed Medical Examiner's (AME) opinion. The Appeals Board granted reconsideration, finding the AME's opinion legally flawed and lacking substantial evidence for the extended cumulative trauma period. The matter is remanded to the arbitrator for further proceedings to develop the medical record and render a new decision.
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