ADJ10902369 · May 15, 2026

The Appeals Board found that the WCJ's conclusion of no industrial right hip injury was not supported by substantial evidence, crediting the uncontroverted medical opinion of PQME Dr. Watkins and the applicant's credible testimony establishing industrial injury to the right hip.

From the decision · page 7Here, applicant's credible testimony and PQME Dr. Watkin's uncontroverted medical reporting vitiate the WCJ's conclusion of no industrial right hip injury. Applicant testified that his work activities caused symptomatology to both hips and that he anticipated having a right hip replacement. Corroborating this, PQME Dr. Watkin found emphatically that it related to the cumulative injury, assessed 10% WPI, and determined it to be a compensable consequence injury.

The Appeals Board found the record deficient regarding the method of calculating permanent disability under Vigil, requiring further development of the record for PQME Dr. Watkins to conduct a complete overlap analysis of applicant's ADLs to determine whether impairments should be added or combined.

From the decision · page 9Here, the record is deficient regarding the method of calculating permanent disability considering Vigil. To rebut the CVC, an employee must present evidence explaining what impact their impairments have had upon their ADLs. Where the medical evidence demonstrates that there is effectively an absence of overlap in the impacted ADLs, or an amplified overall functional impact, the employee has rebutted the CVC. Here, PQME Dr. Watkin opined that adding applicant's impairments was appropriate because he cannot squat to spare his low back due to lower extremity joint injuries, and he cannot bend to spare his lower extremity joints due to his low back condition.

Applicant's credible testimony corroborating symptoms and need for right hip replacement.

Favours Applicant prevailed

Supported the medical opinion and rebutted the WCJ's finding of no industrial injury to the right hip.

From the decision · page 7Here, applicant's credible testimony and PQME Dr. Watkin's uncontroverted medical reporting vitiate the WCJ's conclusion of no industrial right hip injury. Applicant testified that his work activities caused symptomatology to both hips and that he anticipated having a right hip replacement. Corroborating this, PQME Dr. Watkin found emphatically that it related to the cumulative injury, assessed 10% WPI, and determined it to be a compensable consequence injury.

PQME Dr. Watkin's unrebutted expert medical opinion establishing industrial injury to the right hip with 10% WPI assessment.

Favours Applicant prevailed

This opinion constituted definitive proof of industrial injury, leading the Board to amend the FA&O to include the right hip as compensable.

From the decision · page 7Here, applicant's credible testimony and PQME Dr. Watkin's uncontroverted medical reporting vitiate the WCJ's conclusion of no industrial right hip injury. Applicant testified that his work activities caused symptomatology to both hips and that he anticipated having a right hip replacement. Corroborating this, PQME Dr. Watkin found emphatically that it related to the cumulative injury, assessed 10% WPI, and determined it to be a compensable consequence injury.

Applicant's activities of daily living including golfing and desk work noted by WCJ in rejecting adding impairments analysis.

Favours Defendant prevailed

Led to finding that the record was deficient under Vigil and required further development for impairment rating method.

From the decision · page 9The WCJ rejected this analysis as not constituting substantial medical evidence, noting that PQME Dr. Watkin failed to discuss applicant's ability to play golf considering these stated restrictions. The record reflects that applicant engages in several ADLs, including working 40 to 50 hours a week primarily at a desk, driving to properties, taking quarterly flights, and playing golf with the use of a golf cart.

Found cumulative industrial injury to multiple body parts including right hip, assessed 10% WPI to right hip, and opined that impairments to bilateral shoulders should be added but other impairments combined.

Unrebutted expert medical opinion establishing industrial injury to right hip and supporting impairment ratings.

From the decision · page 7Here, applicant's credible testimony and PQME Dr. Watkin's uncontroverted medical reporting vitiate the WCJ's conclusion of no industrial right hip injury. Applicant testified that his work activities caused symptomatology to both hips and that he anticipated having a right hip replacement. Corroborating this, PQME Dr. Watkin found emphatically that it related to the cumulative injury, assessed 10% WPI, and determined it to be a compensable consequence injury.

Recommended adding impairments rather than using Combined Values Chart, but record was deficient under Vigil for ADL impact analysis, requiring further development.

Incomplete analysis of ADLs impact on impairment combination under Vigil standard.

From the decision · page 9Here, the record is deficient regarding the method of calculating permanent disability considering Vigil. To rebut the CVC, an employee must present evidence explaining what impact their impairments have had upon their ADLs. Where the medical evidence demonstrates that there is effectively an absence of overlap in the impacted ADLs, or an amplified overall functional impact, the employee has rebutted the CVC. Here, PQME Dr. Watkin opined that adding applicant's impairments was appropriate because he cannot squat to spare his low back due to lower extremity joint injuries, and he cannot bend to spare his lower extremity joints due to his low back condition.

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

Substantial evidence standard for medical opinions requiring reasonable probability, pertinent facts, adequate examination, and explanation of reasoning.

The Board reweighed evidence and found PQME Dr. Watkin's opinion uncontroverted and credible, overruling the WCJ's contrary finding on right hip injury.

From the decision · page 7The law requires the Appeals Board to base its decisions on substantial evidence. (Lab. Code, § 5903, 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) To constitute substantial evidence, a medical opinion must state its conclusions in terms of reasonable probability, avoid speculation, rely on pertinent facts and an adequate examination and history, and explain the reasoning supporting its conclusions. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) Medical reports do not constitute substantial evidence when they contain known errors or rely on facts that are no longer germane, inadequate medical histories or examinations, or incorrect legal theories. Likewise, a medical opinion cannot support the Board's findings if it rests on surmise, speculation, conjecture, or guesswork. (Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93].) Accordingly, the Board may reweigh the evidence and reach a decision different from the WCJ's determination when other evidence of substantial probative value supports a contrary conclusion. (Lamb, supra, 11 Cal.3d at p. 281; Garza, supra, 3 Cal.2d at pp. 318-319.)

Vigil v. County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc)

Method of calculating permanent disability under Vigil requiring evidence on impact of impairments on activities of daily living to rebut Combined Values Chart.

The Board found the record deficient under Vigil and remanded for further development of evidence on ADL impact to determine impairment combination method.

From the decision · page 8In Vigil v. County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc), the Appeals Board held that an injured employee may rebut the CVC under the PDRS and combine impairments upon establishing the impact of each impairment on ADLs. To do so, the employee must demonstrate either that the rated body parts affect separate and distinct ADLs with no overlap, or that any overlap in the affected ADLs results in an increased or amplified overall functional impact. The Appeals Board explained that medical expertise is required:

Applicant's credible testimony and PQME Dr. Watkin's uncontroverted medical reporting establishing industrial injury to right hip.

From the decision · page 7Here, applicant's credible testimony and PQME Dr. Watkin's uncontroverted medical reporting vitiate the WCJ's conclusion of no industrial right hip injury. Applicant testified that his work activities caused symptomatology to both hips and that he anticipated having a right hip replacement. Corroborating this, PQME Dr. Watkin found emphatically that it related to the cumulative injury, assessed 10% WPI, and determined it to be a compensable consequence injury.

Applicant's activities of daily living including golfing, desk work, and travel, which the WCJ noted in rejecting Dr. Watkin's adding impairments analysis.

From the decision · page 9The WCJ rejected this analysis as not constituting substantial medical evidence, noting that PQME Dr. Watkin failed to discuss applicant's ability to play golf considering these stated restrictions. The record reflects that applicant engages in several ADLs, including working 40 to 50 hours a week primarily at a desk, driving to properties, taking quarterly flights, and playing golf with the use of a golf cart.