Martinez v. Pacific Coast Construction
Case Overview
Open Issues
5 of 6 active
Issue
Status
Evidence
Permanent Disability (PD Rating)
Awaiting QME addendum — final PD % not established
QME Report
MMI Determination
Post-surgery; MMI expected Q3 2024
FCE Report
Apportionment Analysis
Carrier claims 30% pre-existing condition
2 docs
Vocational Rehabilitation
Eligibility assessment pending MMI
—
Temporary Total Disability (TTD)
Paid Apr 10 – Oct 14, 2023 @ $1,842.31/wk
Pay records
Surgery Authorization — L3-L4 Discectomy
IMR reversal 03/01/2024; surgery completed 04/22/2024
IMR Decision
Activity
Post-Surgical FCE Report uploaded
Dr. Patricia Kim, MD — Functional Capacity Evaluation post L3-L4 microdiscectomy. Preliminary WPI: 35%.
Medical
View document
Conflict detected: PD rating discrepancy
QME (Dr. Singh) reports 22% WPI vs. PTP (Dr. Ramirez) reports 45% WPI. Requires attorney review.
Conflict
QME Addendum requested
Request sent to Dr. Anil Singh for post-surgical impairment addendum. Expected: 3–4 weeks.
Admin
Carrier demand letter received
Zurich American — demand re: apportionment, claims 30% pre-existing. Response due May 31, 2024.
Correspondence
Due May 31
MSC Hearing — continued to June 10
WCAB Long Beach. Continued from May 10 — post-surgical recovery ongoing, QME addendum pending.
Hearing
L3-L4 Microdiscectomy completed
Good Samaritan Hospital, Los Angeles. Dr. Manuel Ramirez — operative report uploaded.
Medical
Case Facts
Upcoming Deadlines
3 pending
May 31
Carrier Demand Response
Reply to Zurich apportionment demand
Jun 10
MSC Hearing
WCAB Long Beach — Dept. 4
Jun 30
PD Rating Deadline
Final rating due post-QME addendum
Case Contacts
SC
Sarah Chen, Esq.
Attorney of Record
AS
Dr. Anil Singh, MD
AME Orthopedics
LT
Lisa Torres
Zurich — Claim Adjuster