ADJ10594852 · April 14, 2025

The Appeals Board substituted findings that the back injury resulted in 15% permanent disability, payable with jurisdiction reserved to the WCJ for disputes.

From the decision · page 1812. For ADJ10594852, applicant sustained injury to the right index finger resulting in permanent disability of 38%, payable in an amount to be adjusted by the parties, with jurisdiction reserved to the WCJ in the event of dispute. 13. For ADJ10882630, applicant sustained injury to the back resulting in permanent disability of 15%, payable in an amount to be adjusted by the parties, with jurisdiction reserved to the WCJ in the event of dispute. 14. Defendant is not entitled to a credit for overpayment of temporary disability benefits in ADJ10882630 to be applicable against permanent disability benefits owed in ADJ10594852. 15. Applicant requires further medical treatment to cure or relieve the effects of these injuries. 16. The issues of the amount of attorney's fees to which applicant is entitled in ADJ10594852 and ADJ10882630 are deferred.

The WCJ found injury by way of hernia over the period from March 23, 2016 to March 23, 2017, which was not disputed on reconsideration.

The Appeals Board substituted findings that the right index finger injury resulted in 38% permanent disability, payable with jurisdiction reserved to the WCJ for disputes.

From the decision · page 1812. For ADJ10594852, applicant sustained injury to the right index finger resulting in permanent disability of 38%, payable in an amount to be adjusted by the parties, with jurisdiction reserved to the WCJ in the event of dispute. 13. For ADJ10882630, applicant sustained injury to the back resulting in permanent disability of 15%, payable in an amount to be adjusted by the parties, with jurisdiction reserved to the WCJ in the event of dispute. 14. Defendant is not entitled to a credit for overpayment of temporary disability benefits in ADJ10882630 to be applicable against permanent disability benefits owed in ADJ10594852. 15. Applicant requires further medical treatment to cure or relieve the effects of these injuries. 16. The issues of the amount of attorney's fees to which applicant is entitled in ADJ10594852 and ADJ10882630 are deferred.

The Appeals Board found defendant is not entitled to credit for overpayment of temporary disability benefits in ADJ10882630 against permanent disability benefits in ADJ10594852 because the periods do not overlap.

From the decision · page 16Accordingly, we will substitute a finding that defendant is not entitled to a credit for overpayment of temporary disability benefits in ADJ10882630 to be applicable against permanent disability benefits in ADJ10594852.

The parties stipulated that applicant sustained injury to the back in ADJ10882630 resulting in 15% permanent disability.

Favours Applicant prevailed

This stipulation formed the basis for the Appeals Board's substituted finding on the back injury permanent disability.

From the decision · page 14Hence, because the record demonstrates that the parties stipulated that applicant sustained injury to the back in ADJ10882630 resulting in permanent disability of 15%, and further stipulated that applicant sustained injury to the right index finger in ADJ1059482, we conclude that the WCJ erroneously failed to issue findings in accordance with these stipulations.

The record shows that the right index finger injury in ADJ10594852 resulted in 38% permanent disability.

Favours Applicant prevailed

This fact led the Appeals Board to substitute findings for the right index finger injury permanent disability rating.

From the decision · page 14Additionally, because the record shows that applicant's injury to the right index finger in ADJ1059482 resulted in permanent disability of 38%, we conclude that the WCJ erroneously failed to find that the right finger injury in ADJ1059482 resulted in disability of 38%. (Report, p. 3.)

The period defendant paid temporary disability in ADJ10882630 does not overlap the period for which defendant owes permanent disability in ADJ10594852.

Favours Defendant prevailed

This fact led the Appeals Board to deny defendant's request for credit for overpayment of temporary disability benefits.

From the decision · page 16Accordingly, we will substitute a finding that defendant is not entitled to a credit for overpayment of temporary disability benefits in ADJ10882630 to be applicable against permanent disability benefits in ADJ10594852.

Found 2% WPI to the MP joint of the middle finger and impairment in the form of grip loss, supporting permanent disability rating.

The WCJ relied on Dr. Harris's September 22, 2016 report as substantial medical evidence for permanent disability rating.

From the decision · page 2Defendant contends that the WCJ erroneously (1) found that QME Dr. Harris's September 22, 2016 reporting that applicant sustained 2% WPI to the MP joint of the middle finger and impairment in the form of grip loss constitutes substantial medical evidence; (2) awarded applicant permanent disability benefits based upon QME Dr. Harris's reporting instead of relying upon PTP Yung's December 7, 2015 reporting that applicant sustained no permanent disability; and (3) combined QME Dr. Harris's rating in ADJ10594852 with QME Fisher's rating in ADJ10882630.

Reported no permanent disability on December 7, 2015.

The WCJ did not rely on Dr. Yung's report that found no permanent disability, instead relying on Dr. Harris's report.

From the decision · page 2Defendant contends that the WCJ erroneously (1) found that QME Dr. Harris's September 22, 2016 reporting that applicant sustained 2% WPI to the MP joint of the middle finger and impairment in the form of grip loss constitutes substantial medical evidence; (2) awarded applicant permanent disability benefits based upon QME Dr. Harris's reporting instead of relying upon PTP Yung's December 7, 2015 reporting that applicant sustained no permanent disability; and (3) combined QME Dr. Harris's rating in ADJ10594852 with QME Fisher's rating in ADJ10882630.

Stipulated permanent disability rating of 15% for back injury in ADJ10882630.

The parties stipulated to Dr. Fisher's 15% permanent disability rating for the back injury, which the Appeals Board adopted.

Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc)

Medical opinion must be framed in terms of reasonable medical probability, based on pertinent facts, adequate examination and history, and set forth reasoning in support of conclusions to constitute substantial evidence.

The WCJ's reliance on Dr. Harris's report was found to meet this standard and constitute substantial evidence.

From the decision · page 12Appeals Bd. (Bolton) (1983) 34 Cal.3d 159 [48 Cal.Comp.Cases 566].) To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) "Medical reports and opinions are not substantial evidence if they are known to be erroneous, or if they are based on facts no longer germane, on inadequate medical histories and examinations, or on incorrect legal theories. Medical opinion also fails to support the Board's findings if it is based on surmise, speculation, conjecture or guess." (Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [93 Cal. Rptr. 15, 480 P.2d 967, 36 Cal.Comp.Cases 93, 97].)

The WCJ found Dr. Harris's medical opinion to be substantial evidence based on his adequate examination, history, and objective findings such as grip strength loss.

From the decision · page 8He documents a scar on the right index finger, a negative Tinel's (sign) and no signs of infection. He documents no localized tenderness over the MP, PIP, and DIP joints.[fn] The joints had full range of motion. There was intact function and sensation in the finger. For the right middle digit, he documents soft tissue thickening over the MP joint with diffuse tenderness to palpation over the MP joint, along with pain with stressing, but no instability. He documents the amount of motion in the MP, PIP, and DIP joints. He states there is intact function and normal sensation. He documents examination of the right wrist and right hand. He documents biceps and forearm measurements and grip strength. This documents an adequate examination. Dr. Harris then lists the nine reports in his medical record review.[fn] This documents an adequate history. Dr. Harris then gives his diagnosis, opinion on causation, apportionment, impairment, and future medical care. These paragraphs document a solid underlying basis for the opinion. (Report, pp. 2-3.)