What the panel treated as outcome-determinative, and which side it favoured.
Applicant sustained injury to left hand, neck, right shoulder, right arm, right upper extremity, and psyche on April 29, 2021, while employed as a tree trimmer.
Favours Applicant prevailed
This injury is the basis for the permanent disability and psychiatric impairments found by the medical experts.
From the decision · page 1Defendant seeks reconsideration of the July 16, 2025 Findings and Award (F&A) issued
by the workers' compensation administrative law judge (WCJ). By the F&A, as relevant here, the
WCJ found that while employed by defendant on April 29, 2021, as a tree trimmer, occupational
group number 482, applicant sustained injury arising out of and in the course of his employment
to his left hand, neck, right shoulder, right arm, right upper extremity, and psyche resulting in
permanent and total disability with no apportionment.
QME Dr. George Rakkar diagnosed CRPS to the left upper extremity and rated 45% WPI plus 3% for pain, and right shoulder 4% WPI, finding applicant at MMI and supporting permanent total disability with no apportionment.
Favours Applicant prevailed
Dr. Rakkar's medical opinion was found substantial and supported the permanent total disability rating with no apportionment.
From the decision · page 6On 2/04/2022, applicant was examined by QME George Rakkar, M.D., who issued his
report, dated 2/12/2022. At the time of the evaluation, applicant reported intermittent stabbing pain
in his right shoulder, with pain radiating to his neck and down to his hand. He also reported
intermittent stabbing pain in his left wrist and hand, with pain radiating to his fingers. He had
episodes of numbness and tingling, swelling, cramping, and weakness. Applicant also claimed
development of stress, anxiety, depression, and insomnia, for which he was receiving
psychological counseling. Dr. Rakkar diagnosed applicant with laceration to the dorsum of the left
hand, status post-surgical debridement and closure; left hand pain; left hand and upper extremity
dysfunction; left upper extremity neuropathic pain; and right upper extremity compensatory pain.
He opined that applicant's need for medical care and impairment stemmed from the 4/29/2021
injury and that he had not yet reached maximum medical improvement (MMI). Dr. Rakkar
recommended physical therapy for applicant's left hand and a one-time multidisciplinary
consultation to determine applicant's candidacy for a functional restoration program. He deferred
to a psychiatrist or psychologist for evaluation of applicant's depressed mood and psychological
treatment. (Exhibit 1)
Psychiatric QME Dr. Miguel Alvarellos diagnosed Major Depressive Disorder as a compensable consequence of the injury, rated 30% WPI, and opined psychiatric impairments do not overlap with orthopedic impairments and should be added.
Favours Applicant prevailed
Dr. Alvarellos' psychiatric diagnosis and opinion supported the addition of impairments and permanent total disability finding.
From the decision · page 7On 2/27/2023, applicant was examined by psychiatric QME Miguel Alvarellos, and was
diagnosed with Major Depressive Disorder. Dr. Alvarellos opined that the predominant cause of
applicant's psychiatric impairment was the result of a compensable consequence of the tragic
events that took place on the date of injury, and further opined applicant was permanent and
stationary on a psychiatric basis and assigned a GAF of 50, resulting in 30% WPI, with no
apportionment indicated. (Exhibit 4)
Applicant's credible testimony and medical opinions of Dr. Rakkar and Dr. Alvarellos rebutted the permanent disability schedule (CVC) by showing no overlap in activities of daily living between psychiatric and orthopedic impairments.
Favours Applicant prevailed
This rebuttal allowed the applicant to be found permanently and totally disabled with no apportionment.