What the panel treated as outcome-determinative, and which side it favoured.
Applicant sustained injury to left shoulder, neck, and claims injury to chronic regional pain syndrome, back, and bilateral upper extremities.
Favours Applicant prevailed
This establishes the scope of injury relevant to permanent disability and the need for medical evaluation.
From the decision · page 41) Applicant, Javonna the applicant, while employed on February 5, 2018, as a
medication technician, at Alameda, California, by Oakmont Management Group,
LLC, sustained injury arising out of and in the course of employment to her left
shoulder and neck; and claims3 to have sustained injury arising out of and in
the course of employment to chronic regional pain syndrome, back, and bilateral
upper extremities.
2) Applicant's injury caused permanent disability of 100%.
3) Applicant is in need of further medical treatment to cure or relieve from
the effects of the injury.
Dr. Mandell found applicant permanent and stationary with 8% WPI for left shoulder and 14% WPI for cervical spine, and later opined total disability due to orthopedic and CRPS problems.
Favours Applicant prevailed
Supports the finding of permanent disability but requires further clarification on total disability rating.
From the decision · page 4The Agreed Medical Examiner (AME), Dr. Peter Mandell, has provided
numerous reports. He found her to be permanent and stationary in his report
of October 1, 2020 (Exh. 107) and addressed the permanent impairment of 8%
Whole Person Impairment (WPI) for the left shoulder and 14% WPI for the
cervical spine, with no apportionment of permanent disability. In his
December 19, 2020 report (Exh. 105), Dr. Mandell clarified that applicant is totally
disabled "due to a combination of her orthopedic and CRPS problems." He
also recommended that she see a neurologist or specialist in CRPS. In his latest
report of August 17, 2023 (Exh. 101), Dr. Mandell noted at p. 6 that her
reviewed conflicting medical opinions regarding the CRPS diagnosis and
indicated that she "probably" does have CRPS. He then stated at p. 7
that she is 100% unemployable, due to a combination of her musculoskeletal
problems and her CRPS.
Dr. Feinberg found neuropathic pain and probable CRPS component and agreed applicant could not reengage in open labor market, deferring to Dr. Mandell on impairment rating.
Favours Applicant prevailed
Supports the claim of permanent disability and unemployability but leaves rating details unclear.
From the decision · page 5Dr. Feinberg issued his initial report on February 4, 2025 (Exh. 112), wherein
he found that applicant has some type of neuropathic pain in addition to a
cervical radiculopathy and left shoulder structural abnormalities. He further
asserted that it is more probable than not that there is a CRPS like component to
her presentation. He further stated that he agrees with Dr. Mandell that she could
not reengage in the open labor market. With respect to the WPI, Dr. Mandell found
45% WPI on the strict application of the AMA Guides, but he posited that the most
accurate AMA Guides rating is 60% WPI.
The medical record is incomplete and unclear on permanent disability analysis and employability, requiring further development.
Favours neutral
This lack of clarity necessitates reconsideration and further record development to ensure substantial evidence supports the decision.
From the decision · page 10The Appeals Board also has a constitutional mandate to "ensure substantial justice in
all cases." (Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396, 403
[65 Cal.Comp.Cases 264].) The Board may not leave matters undeveloped where it is clear
that additional discovery is needed. (Id. at p. 404.) Here, Dr. Mandell's reports remain unclear
and/or incomplete regarding analysis of applicant's permanent disability analysis. Similarly, Dr.
Feinberg's reporting may need further clarification as to whether the 60% WPI is applied solely to
the CRPS or to all AOE/COE body parts. For these reasons, additional discovery appears necessary
to obtain a complete and substantial medical opinion regarding the applicant's CRPS.As such, it
appears that the existing record may not properly set forth all relevant issues and include all
evidence sufficient to support the decision, findings, award, and legal conclusions of the WCJ,
and thus further development of the record may be necessary with respect to the issues noted above.