ADJ11139524 · July 27, 2026

From the decision · page 1Defendant seeks reconsideration of the April 20, 2026 Findings of Fact and Award (F&A), wherein the workers’ compensation administrative law judge (WCJ) found, in pertinent part, that while employed by defendant from August 1, 2016 through August 1, 2017 as an inmate laborer, applicant sustained injury arising out of and in the course of employment (AOE/COE) to his lower back, neck, knees, hips, ankles, wrists, upper gastrointestinal system, hypertension, coronary heart disease, and right elbow; that good cause has been shown to prove applicant has incurred new and further disability; that applicant’s impairments to his lower extremities and low back should be added under Vigil v. County of Kern (2024) 89 Cal. Comp.

Additive impairments to lumbar spine and lower extremities produce a combined permanent disability rating exceeding 100%, supporting total permanent disability award.

Favours Applicant prevailed

This fact supports the conclusion that applicant is permanently and totally disabled, justifying the 100% permanent disability award.

From the decision · page 5However, as noted by the WCJ, when the impairments assessed by Dr. Garfinkel for the lumbar spine and lower extremities are adjusted for occupation, age, and apportionment as required by sections 4660.1 and 4663, the resulting permanent disability is 29% for the right hip, 29% for the left hip, 32% for the low back, 23% for the right knee, and 13% for the left knee, which, if added, produces a total of 126%. Accordingly, while the combination of these impairments when combined with the remaining impairments would theoretically be well in excess of 126%, impairment to the other industrially injured body parts has no effect on the level of permanent disability, because a permanent disability award cannot exceed 100 percent for a single injury. (Lab. Code, § 4664(c)(2).) Because the percentages of permanent disability of the low back, hips, and knees equal 126 percent when added without consideration of applicant’s other permanent impairments, the other rating arguments raised in defendant’s Petition are of no consequence. No vocational expert is required to support the conclusion that applicant is entitled to an award of 100 percent permanent disability. Any technical rating argument with respect to the low back or lower extremities would

Dr. Garfinkel's expert opinions are credible, reasonable, and supported by applicant's testimony and medical evidence.

Favours Applicant prevailed

The credibility and probative value of Dr. Garfinkel's opinions underpin the substantial evidence supporting the permanent disability rating.

From the decision · page 4expert opinions of Dr. Garfinkel that formed the basis for the finding of 100 percent permanent disability have probative value, are more than a mere scintilla, and are reasonable in nature, credible, and of solid value. The remainder of the evidentiary record herein, including applicant’s unrebutted testimony at trial, affords no reason to disbelieve Dr. Garfinkel’s conclusions, which apply correct legal standards to the issue of whether applicant’s low back and lower extremity disabilities should be added or combined. We previously noted in Vigil, cited supra, that the CVC in the Permanent Disability Ratings Schedule (PDRS) may be rebutted and impairments may be added where an applicant establishes the impact of each impairment on the activities of daily living (ADLs) and that either (a) there is no overlap between the effects on ADLs as between the body parts rated; or (b) there is overlap, but the overlap increases or amplifies the impact on the overlapping ADLs. (Vigil, supra, 89 Cal. Comp. Cases at p. 689.) In this case, Dr. Garfinkel’s testimony establishes that applicant’s lumbar spine and lower extremity impairments do not operate in isolation but instead interact in a manner that amplifies his overall functional loss. Although Dr.

Defendant's arguments on rating methodology, apportionment, and due process were rejected as they do not alter the mathematical result or legal standards applied.

Favours Applicant prevailed

Rejection of these arguments affirms the validity of the 100% permanent disability rating and the denial of the petition for reconsideration.

From the decision · page 6have to reduce their collective permanent disability by at least 26 percent in order to negate applicant’s entitlement to a finding of 100 percent permanent disability. Accordingly, reduction of low back impairment by three percent 3 for pain and reduction of low back disability by six percent to reflect 20 percent apportionment as suggested in the Petition would not change the mathematical result of addition as indicated by Dr. Garfinkel. Any arguments regarding impairments of the gastrointestinal system and heart are likewise inconsequential to the conclusion that applicant is permanently and totally disabled. Defendant argues it was deprived of due process because the WCJ rated the permanent disability of applicant without sending the matter to the Disability Evaluation Unit (DEU) with rating instructions for a formal rating. It is well established that a WCJ has special expertise in rating and may rate an employee's permanent disability without a formal rating. (Blackledge v. Bank of America (2010) 75 Cal.Comp.Cases 613, 625 (Appeals Board en banc), citing Hegglin v. Workmen’s Comp. Appeals Bd. (1971) 4 Cal.3d 162, 172 [36 Cal.Comp.Cases 93] (“the Board may not be required in all cases to obtain a recommended rating from the rating bureau”), and, sub nota, Cruz v. Workers' Comp. Appeals Bd.

Dr. Garfinkel opined that the lumbar spine and lower extremity impairments should be added rather than combined on the Combined Values Chart (CVC) because they amplify the impact on activities of daily living (ADLs), supporting a 100% permanent disability rating.

From the decision · page 4expert opinions of Dr. Garfinkel that formed the basis for the finding of 100 percent permanent disability have probative value, are more than a mere scintilla, and are reasonable in nature, credible, and of solid value. The remainder of the evidentiary record herein, including applicant’s unrebutted testimony at trial, affords no reason to disbelieve Dr. Garfinkel’s conclusions, which apply correct legal standards to the issue of whether applicant’s low back and lower extremity disabilities should be added or combined. We previously noted in Vigil, cited supra, that the CVC in the Permanent Disability Ratings Schedule (PDRS) may be rebutted and impairments may be added where an applicant establishes the impact of each impairment on the activities of daily living (ADLs) and that either (a) there is no overlap between the effects on ADLs as between the body parts rated; or (b) there is overlap, but the overlap increases or amplifies the impact on the overlapping ADLs. (Vigil, supra, 89 Cal. Comp. Cases at p. 689.) In this case, Dr. Garfinkel’s testimony establishes that applicant’s lumbar spine and lower extremity impairments do not operate in isolation but instead interact in a manner that amplifies his overall functional loss. Although Dr.

Dr. Grodan provided medical evaluation supporting the finding of new and further disability and total permanent disability.

Dr. Grodan's evaluation supported the finding of new and further disability and total permanent disability.

From the decision · page 3We also will not disturb the WCJ’s findings that applicant’s low back and lower extremity impairments should be added together in determining permanent disability, and that applicant is now permanently and totally disabled. All decisions by the Appeals Board must be supported by 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].) “The term ‘substantial evidence’ means evidence which, if true, has probative force on the issues. It is more than a mere scintilla, and means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion…It must be reasonable in nature, credible, and of solid value.” (Braewood Convalescent Hospital v. Workers’ Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, 164 [48 Cal.Comp.Cases 566], emphasis removed and citations omitted.) We agree with the WCJ that the expert opinions of Dr. Garfinkel in orthopedics and QME Paul Grodan, M.D., in internal medicine constitute substantial medical evidence. The medical

Braewood Convalescent Hospital v. WCAB (Bolton) (1983) 34 Cal.3d 159

Substantial evidence standard for workers' compensation decisions

The WCJ and WCAB applied the substantial evidence standard to evaluate medical opinions and testimony supporting the permanent disability rating.

From the decision · page 3We also will not disturb the WCJ’s findings that applicant’s low back and lower extremity impairments should be added together in determining permanent disability, and that applicant is now permanently and totally disabled. All decisions by the Appeals Board must be supported by 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].) “The term ‘substantial evidence’ means evidence which, if true, has probative force on the issues. It is more than a mere scintilla, and means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion…It must be reasonable in nature, credible, and of solid value.” (Braewood Convalescent Hospital v. Workers’ Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, 164 [48 Cal.Comp.Cases 566], emphasis removed and citations omitted.) We agree with the WCJ that the expert opinions of Dr. Garfinkel in orthopedics and QME Paul Grodan, M.D., in internal medicine constitute substantial medical evidence. The medical

Cal. Lab. Code §§ 4660, 4662

Labor Code section 4660 and 4662(b) regarding permanent disability rating and total disability determination

The decision applied Labor Code sections 4660 and 4662(b) to support the additive approach to impairments and total disability award.

From the decision · page 10Hence an award for 100% is warranted under Cal. Lab. Code sec. 4660. Cal. Lab. Code sec. 4662(b) Under Cal. Lab. Code sec. 4662(b) total disability is determined “in accordance with the fact.” In essence the medical evidence can rebut the ratings under sec. 4660.

Applicant's unrebutted testimony describing significant functional limitations consistent with Dr. Garfinkel's opinion on additive impairments and amplified effect on activities of daily living.

From the decision · page 5a left hip replacement, a right hip replacement, a revision of the right hip, and a left ankle fusion with screws. (Minutes of Hearing and Summary of Evidence of March 18, 2026, p. 3, lines 20– 22.) He further testified that his low back requires 45 minutes to an hour in the morning before he can stand up straight, and that prolonged sitting requires almost 15 minutes before he can stand up and straighten. (Id. at p. 3, lines 23–25.) Although he can function to some degree with significant discomfort in his back, he avoids many activities, including bending. (Id. at p. 4, line 24 to p. 5, line 1.) He is also unable to bend because of his knees, and he will “plop down” when sitting. (Id. at p. 4, lines 12-13.) He cannot pick up his keys if he were to drop them, because both of his knees will lock up. (Id. at p. 5, lines 6-7.) He walks with a significant limp. (Ibid.) This testimony is consistent with Dr.