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Applicant, a 58 year-old, claimed they suffered a right knee injury while working at a landfill as an employee of a placement agency. The claim was denied following an employer-level investigation.

Applicant received significant conservative medical treatment and underwent a right knee MRI revealing significant damage. Applicant’s treating physician issued multiple reports indicating that applicant’s condition remained temporarily totally disabling. He also referred applicant to a specialist and thought applicant would ultimately require surgery on their knee. The parties also went to a PQME who opined that applicant’s injury was consistent with the described mechanism of injury.

Prior to trial, the parties had agreed to settle this matter for a $20,000.00 Compromise and Release. Applicant, however, then fired his attorney and retained new counsel. Applicant’s new attorney informed defendants that the case value was closer to $100,000.00, given the nearly 15 months of TTD potentially owed as well as expected permanent disability and future medical care.

After further settlement negotiations stalled, the parties conducted the AOE/COE trial. Applicant testified on his behalf and claimed that he had stepped into a sinkhole while working at the landfill causing the right knee injury. Applicant further testified that, immediately after injuring himself, they informed a co-worker, the landfill supervisor and their supervisor. Defendants presented two witnesses: applicant’s co-worker and their supervisor. Both denied that applicant had reported the injury on that day. Applicant’s supervisor further testified applicant had later come to his office and was paid for the week.

After hearing testimony, the trial Judge, ruled in defendants’ favor and issued a Take Nothing. The Judge found a number of inconsistencies in applicant’s testimony and found that defendants’ witnesses testified credibly.

Order Obtained for Imposing Sanctions on Lien Claimant, Pursuant to their Petition

Lien claimant filed a DOR for a lien conference. We appeared in Los Angeles, where were able to review their bill and discover that they had filed their lien more than 10 years after their last date of service. We made a good faith offer to resolve their lien, as they had passed the statute of limitations. This was rejected, and they indicated they were requesting discovery. We stated that if they continued the lien conference for additional information, we would be filing a petition for costs and sanctions as they were aware they were now past the statute to collect on their decade-old lien.

Nevertheless, we then appeared at the continued lien conference in Oxnard, petition for costs and sanctions in hand. At the Oxnard Board, lo and behold lien claimant does not appear. The Judge then indicated that lien claimant had in fact been dismissed and was served the dismissal, stating that lien claimant’s behavior were sanctionable and so we amended our Petition for Costs and Sanctions even further.

He eventually issued a Notice of Intent to Issue Sanctions against lien claimant and their representative, both of whom were served with the original and amended petitions, as well as the NOIs, with no objections.

The case involved two specific injuries one on 2/1/2012 and the other on 11/1/2012. Applicant’s medical reporting was all over the place. The QME on this matter stated that there was no injury and that the applicant was not reliable. Our defense attorney cross examined the applicant at trial who kept going back and forth and stated that he could not remember. DA also introduced sub-rosa at the time of trial. The Judge, found applicant not to be reliable and issued the Take Nothing on both claims!

Applicant, a 60 year old farm laborer, claimed to have suffered a cumulative trauma injury to his neck, abdomen, back and foot in the course & scope of employment with the farm labor contractor (06/01/2012 – 10/19/2012). Applicant had worked in the fields for approximately 10 years. His job duties did include frequent repetitive work of removing leaves and gathering grapes and walking on wet surfaces. Applicant alleged being exposed to pesticides and working in the fields over the years had caused his symptoms. This claim was timely denied based on a lack of medical evidence to support a claim of injury and a lack of timely reporting to the employer.

The Applicant’s only evidence in support of an industrial injury were reports from non-MPN PTP, Dr. Toutoundjian. According to the medical reports, over time, the applicant developed neck pain, groin, mid back and low back pain radiating to his left foot from working his daily job duties. Dr. Toutoundjian found the applicant on TTD for Applicant had also been recently diagnosed with autoimmune disorder, Myasthenia Gravis (MG).

Applicant was seen by an internal QME who found all of the applicant’s symptoms were related to the MG. The QME found the applicant’s history of working around pesticides in the fields would not cause the MG or current symptoms. The QME also noted that the autoimmune MG would have been present absent any industrial exposure and did not find an industrial injury.

At Trial, Applicant’s attorney did not provide evidence to rebut the QME report. The Applicant refused to testify on his own behalf. Applicant’s attorney did not support his burden of proving the claim was AOE/COE.

Since the applicant could not prove his injury was industrially related, the ALJ ordered the applicant to take nothing on his claim. The Applicant is not entitled to compensation in the form of temporary disability, permanent disability, need for further medical care, or coverage of attorney’s fees.

The Applicant, a 44-year-old male, was working as a baker at a large grocery chain on the date of the alleged injury. The Applicant claimed to have suffered a cumulative trauma injury to his eye, back, psyche, respiratory system, sleep disorder, & skin in the course & scope of employment with the grocery chain (December 30, 2011 – November 14, 2012). This claim was timely denied based on a lack of medical evidence to support a claim of injury and a lack of timely reporting to the employer.

The Applicant’s only evidence in support of the injury AOE/COE was the medical reporting of his primary physician, Chiropractor Caligiuri. Caligiuri’s reliance on the Applicant’s inadequate & inaccurate medical history, as well as his failure to review the Applicant’s prior medical history represented two big flaws in his evaluation of the Applicant. The Applicant had failed to disclose to Chiropractor Caligiuri his prior industrial back injury & his prior motor vehicle accidents. Three separate & independent Panel Qualified Medical Examiners (PQMEs) conducted exhaustive reviews of the Applicant’s prior medical history & found the Applicant’s alleged injuries non-industrial in nature & unrelated to his employment at the grocery chain, based on several, irrefutable factors.

At trial, the Applicant outright misstated that he did not have a prior back injury. He stated that his previous workers’ compensation claim with another firm was for an injury to his right shoulder, despite medical & legal evidence disproving his statements. None of this information was mentioned to any of the PQMEs that met previously with the Applicant. The Applicant admitted he did not tell anyone that he worked with that his injuries were work related.

Further, it is found that Chiropractor Caligiuri’s reports were inadmissible for failure to rise to the level of substantial medical evidence. Due to absent medical evidence to support his claim of industrial injury, the applicant is incapable of meeting the burden of proving the injury AOE/ COE.

The Applicant was found to be less than credible. His testimony at times was inconsistent with the information contained in the medical record & his deposition testimony. He denied knowing any of his injuries were work related before he stopped working.

As injury was found to be not industrially related, the Applicant is not entitled to compensation on the basis of temporary disability, permanent disability, apportionment, need for further medical care, or coverage of attorney’s fees.

The Applicant was ordered by the ALJ to take nothing on his claim.