According to a report from HRD California, a painter has been awarded workers’ compensation benefits after initially being denied by an employer. The ruling demonstrates that injured workers who have had their benefits denied are not out of options. You have the right to appeal a workers’ compensation denial in California. In this blog post, our Fresno workers’ compensation attorneys provide a more detailed analysis of the decision from the WCAB in this case.
Painter Filed a Workers’ Comp Claim for a Cumulative Injury, Initially Denied Benefits
In the case of Menchaca vs. Hedman Manufacturing Company; American Automobile Insurance Company, the employee (Mr. Menchaca) was employed as a painter for Hedman Manufacturing Company between August 2018 and August 2019. During the relevant time period, the worker reports that he sustained cumulative trauma injuries, including to knees, shoulders, ankles, back, neck, hands, and fingers. He filed for workers’ comp benefits. However, his claim was denied. The employer argued that Mr. Menchaca failed to present sufficient evidence that his injuries were work-related.
Medical Evidence: Reasonable to Conclude Work-Related Cumulative Trauma
In appealing the workers’ compensation denial, the injured painter presented both evidence from his personal doctor (treating physician) and from a Qualified Medical Evaluator (QME). In California, a QME is an independent, third-party doctor who may be brought in to help resolve workers’ compensation disputes. Both the workers treating physician and the QME found that it was “reasonable” to conclude that his injuries were primarily caused by work-related trauma. However, the workers’ compensation judge (WCJ) initially ruled against him and in favor of his employer.
WCAB Overturns Decision on Appeal, Awards Workers’ Comp for Cumulative Trauma
On appeal, the WCAB found in favor of the injured worker. It overturned the decision of the judge and ruled in favor of him. The WCAB reached its conclusion on the grounds that the injured worker presented sufficient evidence to establish that his injury was more likely than not caused by his job. The WCAB put significant weight on the opinion of the medical experts.
Indeed, the WCAB accepted the WCJ’s findings that the injured worker was inconsistent in key aspects of his story—including the approximate weight of the heaviest objects that he was required to lift. However, the WCAB also noted that the medical expert testimony, including the report of the QME, was consistent with the worker’s cumulative trauma arising out of the course and scope of his employment.
Speak to a Fresno, CA Work Injury Attorney Today
Joseph C. Yrulegui is a skilled work injury lawyer who is devoted to helping his clients secure the best possible outcome. If you or your loved one was hurt on the job and your employer is challenging your claim on the grounds that your medical impairment is not work-related, we are here to help. Contact our legal team today for immediate assistance. We represent injured workers in Fresno County and throughout the surrounding region.
