Daniel Ramos vs. Frito-Lay, Permissibly Self Insured, Sedgwick Management Claims Services

This case is about Daniel Ramos, an employee of Frito-Lay, who sustained an injury to his left knee on July 26, 2005. The Workers’ Compensation Appeals Board granted the defendant’s petition for reconsideration and rescinded the decision of the WCJ, finding that the defendant was not estopped from asserting the 104-week limitation of Labor Code section 4656, subdivision (c)(1). The Board found that the elements of estoppel were not present in this case, and that the record did not provide any justification for awarding temporary disability indemnity beyond the two-year limit provided in section 4656, subdivision (c)(1).

Frito-Lay, Permissibly Self Insured, Sedgwick Management Claims Services Daniel Ramos WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIADANIEL RAMOS, Applicant,vs.    FRITO-LAY, Permissibly Self Insured, SEDGWICK MANAGEMENT CLAIMS SERVICES, DefendantsCase No. OAK 326483OPINION AND ORDER GRANTING RECONSIDERATION AND DECISION AFTER RECONSIDERATION            Defendant seeks reconsideration of the October 13, 2007 Findings and Award wherein the workers’ compensation administrative law judge (WCJ) found that applicant, while employed on July 26, 2005, sustained industrial injury to his left knee, and that applicant was paid temporary disability indemnity (TDI) for 104-weeks from July 27, 2005 through August 7, 2007, The WCJ also found that defendant was estopped from asserting the 104-week cap on TDI from March 13, 2006, when authorization for surgery was requested, to October 13, 2006, the date surgery was performed; from December 11, 2006 through February S, 2007, subject to proof

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