What the panel ordered
Petition for Reconsideration denied.
Applicant seeks reconsideration of a WCJ's Findings and Award of January 4, 2022.
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 Board found that the WCJ correctly applied the Combined Values Chart (CVC) for combining disabilities, rejecting the applicant's argument to add orthopedic and internal medicine disabilities based on Dr. Silverman's opinion, which was not substantial medical evidence to rebut the CVC use.
From the decision · page 1Applicant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Award of January 4, 2022 wherein it was found that, while employed as a firefighter during a cumulative period ending March 30, 2018, applicant sustained industrial injury in the form of hypertension, coronary artery disease, hands including thumbs, shoulders, feet including toes, and to the upper digestive tract in the form of a hiatal hernia causing permanent disability of 89%. In finding permanent disability of 89%, applicant's right and left thumb disabilities were added together rather than combined utilizing the Combined Values Chart in the 2005 Schedule for Rating Permanent Disabilities, as were applicant's right and left foot disabilities. The disabilities were otherwise combined utilizing the Combined Values Chart. (2005 Schedule at pp. 8-1 § 8-4.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Silverman opined that orthopedic impairments did not overlap with internal medicine impairments and should be added rather than combined.
Favours Defendant prevailed
Applicant relied on this opinion to argue for adding disabilities, but the Board found it insufficient to rebut the Combined Values Chart use.
From the decision · page 1Applicant argues that the orthopedic disabilities should be added to the internal medicine disabilities based on the June 23, 2021 deposition testimony of orthopedist Mitchel Silverman, M.D. Dr. Silverman opined that applicant's orthopedic impairments did not "overlap" with the internal medicine impairments. (June 23, 2021 deposition at p. 7.) Dr. Silverman opined that the impairments affected different activities of daily living and work restrictions, although the activities of daily living and work restrictions were not specified. (June 23, 2021 deposition at p.
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.
Dr. Silverman opined that the applicant's orthopedic impairments did not overlap with internal medicine impairments and should be added rather than combined using the Combined Values Chart.
Applicant relied on Dr. Silverman's deposition to argue for adding orthopedic and internal medicine disabilities rather than combining them, but the Board found his opinion insufficient to rebut the Combined Values Chart.
From the decision · page 1Applicant argues that the orthopedic disabilities should be added to the internal medicine disabilities based on the June 23, 2021 deposition testimony of orthopedist Mitchel Silverman, M.D. Dr. Silverman opined that applicant's orthopedic impairments did not "overlap" with the internal medicine impairments. (June 23, 2021 deposition at p. 7.) Dr. Silverman opined that the impairments affected different activities of daily living and work restrictions, although the activities of daily living and work restrictions were not specified. (June 23, 2021 deposition at p.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
2005 Schedule for Rating Permanent Disabilities
Use of the Combined Values Chart (CVC) for combining permanent disabilities under the 2005 Schedule for Rating Permanent Disabilities.
The Board applied the CVC to combine disabilities except for thumbs and feet, which were added separately as accepted by the WCJ.
From the decision · page 1Applicant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Award of January 4, 2022 wherein it was found that, while employed as a firefighter during a cumulative period ending March 30, 2018, applicant sustained industrial injury in the form of hypertension, coronary artery disease, hands including thumbs, shoulders, feet including toes, and to the upper digestive tract in the form of a hiatal hernia causing permanent disability of 89%. In finding permanent disability of 89%, applicant's right and left thumb disabilities were added together rather than combined utilizing the Combined Values Chart in the 2005 Schedule for Rating Permanent Disabilities, as were applicant's right and left foot disabilities. The disabilities were otherwise combined utilizing the Combined Values Chart. (2005 Schedule at pp. 8-1 § 8-4.)
Athens Administrators v. Workers' Comp. Appeals Bd. (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.)
Adding impairments rather than combining when substantial medical evidence shows synergistic effect.
The Board distinguished Kite, noting that here the orthopedic and internal medicine impairments were found by different specialists and no compelling reason was given to add rather than combine.
From the decision · page 2In Athens Administrators v. Workers' Comp. Appeals Bd. (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.), we held that adding, rather than combining, two different impairments better reflected a worker's impairment when substantial medical evidence supported the notion that the two impairments had a synergistic effect where, in effect, the resultant impairment was more than the sum of the two impairments. In Kite, the evaluator explained why the disparate impairments were not actually disparate, and the impairments in question were all under the physician's expertise.1 In contrast, here one specialist is suggesting that we add impairments found by him in his own specialty to impairments in completely different body systems found by a different specialist. As an orthopedist, it was Dr. Silverman's role to describe and give a whole person impairment with regard to the orthopedic impairment. Dr. Silverman did not give any compelling reason why the orthopedic and internal medicine impairments should be added, and questions beyond applicant's orthopedic impairment, including applicant's overall impairment or the operation of the CVC, are beyond Dr. Silverman's expertise. (Applied Materials v. Workers' Comp. Appeals Bd. (D.C.) (2021) 64 Cal.App.5th 1042, 1097 [86 Cal.Comp.Cases 331].)
Applied Materials v. Workers' Comp. Appeals Bd. (D.C.) (2021) 64 Cal.App.5th 1042, 1097 [86 Cal.Comp.Cases 331]
Limits of an orthopedist's expertise in opining on overall impairment and Combined Values Chart operation.
The Board noted Dr. Silverman did not provide compelling reasons beyond his orthopedic impairment and that questions beyond his specialty were beyond his expertise.
From the decision · page 2In Athens Administrators v. Workers' Comp. Appeals Bd. (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.), we held that adding, rather than combining, two different impairments better reflected a worker's impairment when substantial medical evidence supported the notion that the two impairments had a synergistic effect where, in effect, the resultant impairment was more than the sum of the two impairments. In Kite, the evaluator explained why the disparate impairments were not actually disparate, and the impairments in question were all under the physician's expertise.1 In contrast, here one specialist is suggesting that we add impairments found by him in his own specialty to impairments in completely different body systems found by a different specialist. As an orthopedist, it was Dr. Silverman's role to describe and give a whole person impairment with regard to the orthopedic impairment. Dr. Silverman did not give any compelling reason why the orthopedic and internal medicine impairments should be added, and questions beyond applicant's orthopedic impairment, including applicant's overall impairment or the operation of the CVC, are beyond Dr. Silverman's expertise. (Applied Materials v. Workers' Comp. Appeals Bd. (D.C.) (2021) 64 Cal.App.5th 1042, 1097 [86 Cal.Comp.Cases 331].)
What proof carried it
The evidence the panel weighed, by kind.
Dr. Silverman's deposition testimony
From the decision · page 1Applicant argues that the orthopedic disabilities should be added to the internal medicine disabilities based on the June 23, 2021 deposition testimony of orthopedist Mitchel Silverman, M.D. Dr. Silverman opined that applicant's orthopedic impairments did not "overlap" with the internal medicine impairments. (June 23, 2021 deposition at p. 7.) Dr. Silverman opined that the impairments affected different activities of daily living and work restrictions, although the activities of daily living and work restrictions were not specified. (June 23, 2021 deposition at p.
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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.
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