ADJ10896001 · June 18, 2026

Defendant failed to make a bona fide offer of modified work as the January 3, 2017 letter was an order without specific duties, thus temporary disability indemnity was owed from November 2, 2016 to September 19, 2017.

The apportionment opinions by PQME Dr. Brooks and Dr. Tirmizi lacked sufficient medical explanation and were speculative, so no apportionment was found. The permanent disability was found to be 27%.

From the decision · page 14Here, a careful review of the medical reporting in this matter reveals that the apportionment opinions provided by both PQME Dr. Brooks and PQME Dr. Tirmizi fail to meet this rigorous evidentiary standard. The apportionment analysis proffered by PQME Dr. Brooks regarding applicant's thoracic and lumbar spine relies upon generalized factors rather than a precise medical explanation of causation. PQME Dr. Brooks assigned 75% nonindustrial apportionment to both spinal regions, attributing this allocation to applicant's mild degenerative MRI findings, his 16 years of previous employment in the construction industry, his participation in sports activities, and his limited 60-day tenure with defendant. PQME Dr. Brooks justified this determination by concluding that a single specific injury likely did not cause the total impairment and positing that applicant likely would have developed 75% of the impairment even absent the October 28, 2016 injury. This rationale is fundamentally speculative. The mere fact that a medical report assigns approximate percentages of industrial and nonindustrial causation does not make the report reliable medical evidence by itself. By relying on applicant's prior work history and sports activities

The January 3, 2017 letter was an order to return to work without specifying modified duties, and no detailed response was given to applicant's concerns about medication effects on driving.

Favours Applicant prevailed

This meant the defendant did not make a bona fide offer of modified work, so temporary disability indemnity was owed.

PQME Dr. Brooks' apportionment opinion was speculative and lacked precise medical explanation, relying on generalized factors such as prior work history and sports activities.

Favours Applicant prevailed

This led to rejection of apportionment and a finding of 27% permanent disability without apportionment.

From the decision · page 14Here, a careful review of the medical reporting in this matter reveals that the apportionment opinions provided by both PQME Dr. Brooks and PQME Dr. Tirmizi fail to meet this rigorous evidentiary standard. The apportionment analysis proffered by PQME Dr. Brooks regarding applicant's thoracic and lumbar spine relies upon generalized factors rather than a precise medical explanation of causation. PQME Dr. Brooks assigned 75% nonindustrial apportionment to both spinal regions, attributing this allocation to applicant's mild degenerative MRI findings, his 16 years of previous employment in the construction industry, his participation in sports activities, and his limited 60-day tenure with defendant. PQME Dr. Brooks justified this determination by concluding that a single specific injury likely did not cause the total impairment and positing that applicant likely would have developed 75% of the impairment even absent the October 28, 2016 injury. This rationale is fundamentally speculative. The mere fact that a medical report assigns approximate percentages of industrial and nonindustrial causation does not make the report reliable medical evidence by itself. By relying on applicant's prior work history and sports activities

PQME Dr. Tirmizi's apportionment opinion for the umbilical hernia lacked analytical foundation and failed to explain how the preexisting condition contributed to disability.

Favours Applicant prevailed

This was legally insufficient to support apportionment, supporting the finding of no apportionment.

From the decision · page 15Similarly, the apportionment determination issued by PQME Dr. Tirmizi concerning applicant's umbilical hernia lacks the requisite explanatory rigor to serve as substantial evidence. PQME Dr. Tirmizi assessed a 1% WPI for the hernia, apportioning 50% of the resulting impairment to a preexisting condition and 50% to the industrial aggravation caused by applicant's physical therapy exercises. However, PQME Dr. Tirmizi explicitly reported that applicant possessed a preexisting umbilical hernia that remained stable until he participated in physical therapy for his admitted industrial back injury, at which point the hernia iatrogenically enlarged and worsened causing disability and the need for medical treatment on an industrial basis. Apportionment must directly account for the factors that caused the permanent disability and PQME Dr.

Evaluated applicant on September 20, 2017 and October 12, 2017, found maximum medical improvement, and provided a methodical permanent disability rating with 75% nonindustrial apportionment which was rejected for lack of medical explanation.

His apportionment opinion was speculative and lacked precise medical explanation, thus not substantial evidence.

From the decision · page 14Here, a careful review of the medical reporting in this matter reveals that the apportionment opinions provided by both PQME Dr. Brooks and PQME Dr. Tirmizi fail to meet this rigorous evidentiary standard. The apportionment analysis proffered by PQME Dr. Brooks regarding applicant's thoracic and lumbar spine relies upon generalized factors rather than a precise medical explanation of causation. PQME Dr. Brooks assigned 75% nonindustrial apportionment to both spinal regions, attributing this allocation to applicant's mild degenerative MRI findings, his 16 years of previous employment in the construction industry, his participation in sports activities, and his limited 60-day tenure with defendant. PQME Dr. Brooks justified this determination by concluding that a single specific injury likely did not cause the total impairment and positing that applicant likely would have developed 75% of the impairment even absent the October 28, 2016 injury. This rationale is fundamentally speculative. The mere fact that a medical report assigns approximate percentages of industrial and nonindustrial causation does not make the report reliable medical evidence by itself. By relying on applicant's prior work history and sports activities

Concluded maximum medical improvement on February 5, 2020, but relied heavily on generalized assessments and lacked critical evaluation of objective findings, less persuasive than Dr. Brooks.

Less analytically supported and generalized reporting compared to Dr. Brooks.

From the decision · page 11Turning to the appropriate permanent and stationary date, the opinion articulated by PQME Dr. Brooks is demonstrably more persuasive and firmly grounded in substantial evidence than the conclusion posited by Dr. Scheinberg. While Dr. Scheinberg concluded that applicant reached maximum medical improvement on February 5, 2020, the overall analysis relied heavily upon generalized assessments of his ADLs and lacked a critical evaluation of objective diagnostic findings. Conversely, PQME Dr. Brooks evaluated applicant on September 20, 2017 and determined in a subsequent October 12, 2017 supplemental report that he had achieved maximum medical improvement. The evidentiary record supports this timeline, demonstrating that he remained incapable of returning to work precisely up until that September 20, 2017 evaluation. By deliberately reconciling the subjective complaints with objective medical evidence, PQME Dr. Brooks exercised a significantly higher degree of forensic reliability in stark contrast to Dr. Scheinberg's comparatively generalized reporting.

Assessed 1% WPI for umbilical hernia with 50% apportionment to preexisting condition, but failed to explain how the preexisting condition contributed to disability, so apportionment was rejected.

Lacked necessary analytical foundation and was legally insufficient to support apportionment.

From the decision · page 14Here, a careful review of the medical reporting in this matter reveals that the apportionment opinions provided by both PQME Dr. Brooks and PQME Dr. Tirmizi fail to meet this rigorous evidentiary standard. The apportionment analysis proffered by PQME Dr. Brooks regarding applicant's thoracic and lumbar spine relies upon generalized factors rather than a precise medical explanation of causation. PQME Dr. Brooks assigned 75% nonindustrial apportionment to both spinal regions, attributing this allocation to applicant's mild degenerative MRI findings, his 16 years of previous employment in the construction industry, his participation in sports activities, and his limited 60-day tenure with defendant. PQME Dr. Brooks justified this determination by concluding that a single specific injury likely did not cause the total impairment and positing that applicant likely would have developed 75% of the impairment even absent the October 28, 2016 injury. This rationale is fundamentally speculative. The mere fact that a medical report assigns approximate percentages of industrial and nonindustrial causation does not make the report reliable medical evidence by itself. By relying on applicant's prior work history and sports activities

Navarrete Medrano v. Santa Rosa City Sch. Dist. (2025)

Defendant has the burden to identify and offer physically appropriate modified or alternative work to be relieved of liability for temporary disability indemnity.

Defendant failed to meet this burden as the January 3, 2017 letter was an order without specific duties, not a bona fide offer.

Escobedo v. Marshalls (2005)

Apportionment must be based on causation of permanent disability and supported by substantial evidence explaining the 'how and why' of apportionment.

Apportionment opinions by PQME Dr. Brooks and Dr. Tirmizi were speculative and lacked sufficient medical explanation, thus rejected.

From the decision · page 13Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 927-928 [71Cal.Comp.Cases 1687].) Instead, apportionment of permanent disability is "based on causation" and the "employer shall only be liable for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of employment." (Lab.Code, § 4663(a) and 4664(a).) "The plain reading of `causation' in this context is causation of the permanent disability." (Escobedo, supra, 70 Cal.Comp.Cases at p. 611.) Apportionment now includes pathology, asymptomatic prior conditions, and retroactive prophylactic work preclusions, provided there is substantial evidence establishing that these other factors have caused permanent disability. Pursuant to Escobedo, a physician's opinion must rely on reasonable medical probability, cannot be speculative, must rely on pertinent facts and/or an adequate examination and history, and must set forth the reasoning in support of its conclusions. (Id. at p.621.) That is, a physician must explain the "howand why" of their apportionment opinion (Ibid.) and consider all potential causes of disability, whether from a current, prior or subsequent industrial or nonindustrial injury or condition. (Benson v. Permanente Med. Group (2007) 72Cal.Comp.Cases 1620, 1622 (Appeals Board en banc).)

Applicant's testimony that the January 3, 2017 letter did not specify modified duties and no response was given to his concerns about medication effects on driving, supporting no bona fide offer of work.