What the panel ordered
Findings and Award issued February 17, 2022, affirmed by WCAB Decision After Reconsideration dated November 29, 2023.
Petition for Reconsideration filed by defendant and granted to further study factual and legal issues; WCJ recommended denial of Petition; WCAB considered and affirmed WCJ Findings and Award after reconsideration.
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 WCAB found Dr. Nacouzi's medical opinions to be substantial evidence supporting the 56% permanent disability rating and found no good cause to appoint a regular physician or replace the QME.
From the decision · page 1Defendant seeks reconsideration of the Findings and Award (F&A) issued by the workers' compensation administrative law judge (WCJ) on February 17, 2022, wherein the WCJ found in pertinent part that applicant's October 31, 2017 injury caused 56% permanent disability and that, "There is no good cause for a replacement QME or an appointment of a regular physician." (F&A, p. 1.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Nacouzi examined applicant, took history, and reviewed extensive medical records, providing a detailed medical opinion.
Favours Applicant prevailed
This opinion was found substantial evidence supporting the permanent disability rating and no need for QME replacement or regular physician appointment.
From the decision · page 4Cal.Comp.Cases 604 (Appeals Board en banc).) Here, Dr. Nacouzi examined applicant, took a
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 29% whole person impairment due to left main coronary artery aneurysm; safe level of maximal physical exercise is 7 METs; agreed with treating cardiologist Dr. Dhond that injury is industrial in origin and caused exercise-induced myocardial ischemia; applicant unable to resume usual work duties.
Dr. Nacouzi examined applicant, took history, reviewed medical records, and his opinions were found substantial evidence by WCAB; no good cause to replace QME or appoint regular physician.
From the decision · page 2QME Dr. Nacouzi evaluated applicant on April 6, 2018. Dr. Nacouzi examined applicant,
Agreed with Dr. Nacouzi that left main coronary artery aneurysm is industrial in origin and caused exercise-induced myocardial ischemia.
Dr. Nacouzi agreed with Dr. Dhond's opinion on industrial causation and injury mechanism, supporting the permanent disability rating.
From the decision · page 4treating cardiologist Milind Dhond, M.D. However, after reviewing an October 13, 2017 stress
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc)
A medical opinion must be based on pertinent facts, an adequate examination, accurate history, and must set forth the basis and reasoning in support of conclusions to be substantial evidence.
The WCAB found Dr. Nacouzi's opinion met these criteria and was substantial evidence supporting the permanent disability rating.
From the decision · page 4and the reasoning in support of the conclusions. (Escobedo v. Marshalls (2005) 70
What proof carried it
The evidence the panel weighed, by kind.
Dr. Nacouzi's medical opinion based on examination, history, and medical record review
From the decision · page 4Cal.Comp.Cases 604 (Appeals Board en banc).) Here, Dr. Nacouzi examined applicant, took a
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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.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
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