What the panel ordered
Petition for Reconsideration denied.
Petition for Reconsideration filed by applicant and denied by WCAB panel after review of WCJ report.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The petition failed to cite specific evidence and was contrary to the substantial evidence in the record, including medical opinions from QME Dr. Anderson and Dr. Nguyen, which did not support fibromyalgia or industrial aggravation of diabetes and hypertension.
From the decision · page 1We have considered the allegations of the Petition for Reconsideration and the contents of the report of the workers' compensation administrative law judge (WCJ) with respect thereto. Based on our review of the record, and for the reasons stated in the WCJ's report, which we adopt and incorporate, we will deny reconsideration.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Petition failed to cite specific evidence with any specificity as required by WCAB Rule 10945(a).
Favours Defendant prevailed
This failure was an additional basis for denial of the petition.
From the decision · page 1We admonish applicant's attorney for failing to cite to the record with any specificity, which is an additional basis for denial. WCAB Rule 10945(a) provides, in relevant part:
Dr. Nguyen's deposition did not support fibromyalgia diagnosis or industrial aggravation of diabetes and hypertension.
Favours Defendant prevailed
This testimony undermined the applicant's claim and supported denial of the petition.
From the decision · page 4Exhibit B is the transcript of the cross examination of Dr. Tuan Nguyen, a family practice doctor, who treated the applicant commencing 2015 and continuing through 2019. This deposition does not support diagnoses or treatment for fibromyalgia, nor a work-related onset of overall pain except related to a single episode of the flu. Over the years, he prescribed for the applicant's diabetes and hypertension, both longstanding pre-existing conditions with no indication of any industrial aggravation.
Dr. Fisher's opinion on fibromyalgia was not substantial evidence and lacked persuasive causation explanation.
Favours Defendant prevailed
This weakened the applicant's claim for fibromyalgia causation.
From the decision · page 5Dr. Fisher then utilizes Almaraz Guzman, Chapter 13 on arousal disorders stating that although he did not find a significant number of tender points, he states he does not believe it is necessary. This explanation of causation is not persuasive and not substantial evidence on causation regarding fibromyalgia.
Dr. Anderson's medical opinion found no industrial causation for hypertension and diabetes, attributing some conditions to nonindustrial causes.
Favours Defendant prevailed
This medical opinion was relied upon to deny the petition.
From the decision · page 6He does not find a basis for any aggravation of her diabetes or hypertension in the medical records.6
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Found fibromyalgia supported by applicant's self-report but lacked persuasive causation evidence and was not substantial evidence on causation regarding fibromyalgia.
Dr. Fisher's opinion on fibromyalgia was not persuasive or substantial evidence on causation, relying on non-peer-reviewed sources and lacking explanation.
From the decision · page 5Exhibit 7 the internal reporting of QME Dr. Fisher the blood chemistry is described as within normal limits in his report 07/31/20181 wherein he finds fibromyalgia supported by applicant's self-report. He lists reference material as support for his position as an herbal treatment approach 2015 by Katya Adachi MD that gives a summation that no one really knows the causation bridge for fibromyalgia.
Found no basis for aggravation of diabetes or hypertension; attributed some hand osteoarthritis and gastroesophageal reflux disease to industrial causes but found hypertension, diabetes, and other conditions nonindustrial.
Dr. Anderson's opinion was relied upon as substantial evidence contradicting industrial causation for diabetes and hypertension and limiting industrial causation to hand conditions and reflux disease.
From the decision · page 6He does not find a basis for any aggravation of her diabetes or hypertension in the medical records.6
Did not support diagnoses or treatment for fibromyalgia or work-related onset of overall pain except related to a single episode of flu; prescribed for longstanding diabetes and hypertension with no industrial aggravation.
Dr. Nguyen's deposition did not support fibromyalgia diagnosis or industrial aggravation of diabetes and hypertension, supporting denial of petition.
From the decision · page 4Exhibit B is the transcript of the cross examination of Dr. Tuan Nguyen, a family practice doctor, who treated the applicant commencing 2015 and continuing through 2019. This deposition does not support diagnoses or treatment for fibromyalgia, nor a work-related onset of overall pain except related to a single episode of the flu. Over the years, he prescribed for the applicant's diabetes and hypertension, both longstanding pre-existing conditions with no indication of any industrial aggravation.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Cal. Code Regs., tit. 8, 10945(a)-(b)
WCAB Rule 10945(a)-(b) regarding specificity and evidentiary support in petitions for reconsideration.
Petition denied for failure to cite specific evidence and comply with evidentiary requirements.
From the decision · page 1We admonish applicant's attorney for failing to cite to the record with any specificity, which is an additional basis for denial. WCAB Rule 10945(a) provides, in relevant part:
What proof carried it
The evidence the panel weighed, by kind.
Dr. Nguyen's deposition testimony did not support fibromyalgia diagnosis or industrial aggravation of diabetes and hypertension.
From the decision · page 4Exhibit B is the transcript of the cross examination of Dr. Tuan Nguyen, a family practice doctor, who treated the applicant commencing 2015 and continuing through 2019. This deposition does not support diagnoses or treatment for fibromyalgia, nor a work-related onset of overall pain except related to a single episode of the flu. Over the years, he prescribed for the applicant's diabetes and hypertension, both longstanding pre-existing conditions with no indication of any industrial aggravation.
Dr. Fisher's reports lacked persuasive causation evidence and were not substantial evidence on fibromyalgia causation.
From the decision · page 5Dr. Fisher then utilizes Almaraz Guzman, Chapter 13 on arousal disorders stating that although he did not find a significant number of tender points, he states he does not believe it is necessary. This explanation of causation is not persuasive and not substantial evidence on causation regarding fibromyalgia.
Dr. Anderson's medical opinion found no industrial causation for hypertension and diabetes, attributing some conditions to nonindustrial causes.
From the decision · page 6He does not find a basis for any aggravation of her diabetes or hypertension in the medical records.6
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
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