ADJ15807564 — California WCAB decision

What the panel ordered

The WCAB panel denied the defendant's Petition for Reconsideration and upheld the WCJ's Findings and Award of 31% permanent partial disability caused by the applicant's injury.

Defendant filed a timely Petition for Reconsideration of the Findings and Award issued by the WCJ on September 16, 2022, which was denied by the WCAB panel on November 18, 2022.

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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.

Permanent disability ratingApplicant prevailedlumbar spine · low back

The WCAB found the AME Dr. Stark's report substantial evidence supporting a 31% permanent partial disability rating, rejecting defendant's argument for a lower rating based on strict AMA Guides application.

From the decision · page 2BACKGROUND Applicant claimed injury to his low back while employed by defendant as a deputy sheriff on January 16, 2022. AME Dr. Stark evaluated applicant on March 24, 2022. Dr. Stark examined applicant, took a history and reviewed the medical record. He diagnosed applicant as having a lumbar strain that was aggravating multilevel disc bulges, and low back pain. (Joint Exh. 100, Dr. Stark, March 26, 2022, p. 4.) He then stated:

The facts that decided it

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

AMA Guides to the Evaluation of Permanent Impairment (AMA Guides)

Used as a guideline for rating permanent disability, with allowance for rebuttal under Almaraz/Guzman decisions.

From the decision · page 4identify applicant's disability. He then explained that the reason for using the Table 6-9 (Impairment Due to Herniation) was because it addresses the impairment caused by applicant's inability to do heavy lifting. (Joint Exh. 100, pp. 4 - 5.) Dr. Stark referred to the "Almaraz/Guzman decisions" wherein the Appeals Board, and subsequently the Sixth District Court of Appeal, explained that the AMA Guides provide guidelines for the exercise of professional skill and judgment which, in a given case, may result in ratings that depart from those based on the strict application of the AMA Guides. (Almaraz v. Environmental Recovery Services/Guzman v. Milpitas Unified School District (2009) 74 Cal.Comp.Cases 1084 (Appeals Board en banc) (Almaraz/Guzman II) affirmed by Milpitas Unified School Dist. v. Workers' Compensation Appeals Board (2010) 187 Cal.App.4th 808 [75 Cal.Comp.Cases 837] (modified on other grounds on September 1, 2010).) Dr. Stark's explanation of why he rated applicant's lumbar spine impairment by "analogy" to the AMA Guides hernia impairment is consistent with the reporting doctor's responsibility to correctly identify the injured worker's disability as explained in the "Almaraz/Guzman decisions" discussed above.

Almaraz/Guzman decisions

Almaraz v. Environmental Recovery Services/Guzman v. Milpitas Unified School District (2009) 74 Cal.Comp.Cases 1084

Allows rebuttal of strict AMA Guides ratings to reflect accurate disability.

From the decision · page 4identify applicant's disability. He then explained that the reason for using the Table 6-9 (Impairment Due to Herniation) was because it addresses the impairment caused by applicant's inability to do heavy lifting. (Joint Exh. 100, pp. 4 - 5.) Dr. Stark referred to the "Almaraz/Guzman decisions" wherein the Appeals Board, and subsequently the Sixth District Court of Appeal, explained that the AMA Guides provide guidelines for the exercise of professional skill and judgment which, in a given case, may result in ratings that depart from those based on the strict application of the AMA Guides. (Almaraz v. Environmental Recovery Services/Guzman v. Milpitas Unified School District (2009) 74 Cal.Comp.Cases 1084 (Appeals Board en banc) (Almaraz/Guzman II) affirmed by Milpitas Unified School Dist. v. Workers' Compensation Appeals Board (2010) 187 Cal.App.4th 808 [75 Cal.Comp.Cases 837] (modified on other grounds on September 1, 2010).) Dr. Stark's explanation of why he rated applicant's lumbar spine impairment by "analogy" to the AMA Guides hernia impairment is consistent with the reporting doctor's responsibility to correctly identify the injured worker's disability as explained in the "Almaraz/Guzman decisions" discussed above.

ADJ15807564 · November 18, 2022

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