ADJ11262036 — California WCAB decision

What the panel ordered

Petition for Reconsideration denied.

Applicant sought reconsideration of the Findings and Award issued by the WCJ on October 13, 2023, which found injury and permanent disability; the WCJ recommended denial of reconsideration, and the Board panel adopted the WCJ's Report and Recommendation.

Read the official decision →

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.

Medical treatment / UR / IMRDefendant prevailedneck

The Board found no evidence warranting further development of the record or additional medical treatment based on the applicant's worsening symptoms without supporting medical evidence.

From the decision · page 4Applicant's testimony, taken into context with the medical record did not warrant development of the record as there is no evidence that applicant's alleged worsening symptoms are due to the current cumulative trauma. (Report, p. 2.)

Permanent disability ratingDefendant prevailed

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Dr. Dericks opined that 100% of the cervical spine permanent disability was caused by a 2009 injury with only temporary exacerbation from the 2017 injury.

Favours Defendant prevailed

This medical opinion supported denial of further medical treatment and record development for the neck condition.

From the decision · page 3It is my opinion, based on a reasonable degree of medical probability, that 100 percent of the cervical spine permanent disability was caused by the 2009 injury and progression thereof, with a temporary exacerbation on 12.27.17. ... The primary treating physician should monitor the progression/regression of the cervical spine condition with the ability to make justifiable treatment plan modifications including, but not limited to updated diagnostic testing and corresponding specialty referral. This [sic] should be considered on the basis of the prior 2009 injury. (Joint Exh. 2, p. 15.)

Applicant testified to worsening symptoms but did not submit new medical evidence or request supplemental AME report.

Favours Defendant prevailed

Lack of new evidence or request for supplemental report meant no basis to develop the record further.

From the decision · page 4Further, it appears that the argument for further development of the record is based on applicant's testimony that he "underwent an MRI and electrodiagnostic study for his neck... approximately two to three months ago." (MOH/SOE, p. 4.) There is no evidence in the record indicating that applicant submitted the MRI or the electrodiagnostic study to Dr. Dericks and thereon requested a supplemental report. If, based on newly obtained medical records a request for a supplemental report from the AME had been made, and additionally if those records had been offered into the record as newly discovered evidence, the WCJ may have determined that there was good cause for continuing the trial or ordering it taken off calendar. However, absent the newly obtained medical records and a request for a supplemental report, there is no factual and/or legal basis for the WCJ to make that ruling.

ADJ11262036 · January 5, 2024

What the panel ordered

What was disputed, and how it came out

Your case already resembles someone else’s. Find whose.

The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

About this page