What the panel ordered
Findings of Fact and Order issued April 30, 2024, rescinded; matter returned to trial level for further proceedings.
Petition for Reconsideration granted; prior Findings of Fact and Order rescinded; matter returned to trial level for further proceedings.
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 erroneously applied the Combined Values Chart and apportionment in calculating the permanent disability threshold, requiring further medical evidence to determine the accurate method of combining impairments and application of the adjustment factor.
From the decision · page 1Defendant seeks reconsideration of the Findings of Fact and Order (F&O) issued on April 30, 2024, wherein the workers' compensation administrative law judge (WCJ) found that (1) while employed as an investigator by the County of Los Angeles during the period of May 21, 1991 through November 5, 2021, applicant sustained injury to the cervical spine, lumbar spine, and left knee, with Whole Person Impairment (WPI) before application of the Labor Code Section 4660.1(b)1 1.4 adjustment factor, adjustment for occupation and age of 7 percent for the cervical spine, 7 percent for the lumbar spine, and 12 percent for the left knee, and WPI after application of the adjustment factor of 10 percent for the cervical spine, 10 percent for the lumbar spine, and 17 percent for the left knee, and with apportionment of the neck disability of 10 percent and the left knee disability of 75 percent; (2) applicant's subsequent permanent disability excluding apportionment amounts to 10 percent for the cervical spine, 10 percent for the lumbar spine, and 17 percent for the left knee; and (3) the subsequent permanent disability of the cervical spine, lumbar spine, and left knee are added and amount to 37 percent, establishing the 35 percent threshold for entitlement to SIBTF benefits under section 4751(b).
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The WCJ found that impairments should be added rather than combined using the Combined Values Chart for the permanent disability rating.
Favours Applicant prevailed
This finding was not supported by medical evidence and led to an erroneous conclusion that the 35 percent threshold was met.
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.
Provided medical reports used in stipulations for permanent disability ratings of cervical spine, lumbar spine, and left knee.
From the decision · page 2FACTUAL BACKGROUND On December 7, 2022, applicant and the County of Los Angeles entered Stipulations with Request for Award regarding applicant's cumulative injury for the period of May 21, 1991 through November 05, 202l. (Signed Stipulations with Request for Award, December 7, 2022, p. 1.) The Stipulations include an addendum, which provides: The settlement is based on the AME reports of Dr. James Sherman dated 3/11/22, and 5/6/21, as well as the AME reports of Dr. Steven Silbart dated 10/17 /22, 9/6/22, 3/7 /22, and 12/13/21. The rating is as follows: Left Knee: 25% (17.05.06.0.- 12%[1.4]- 17- 4901- 23- 27) 7% Cervical: 90% (15.01.01.00- 7%[1.4]- 10- 4901- 15- 18) 16% Lumbar: 15.03.01.00- 7% [1.4]- 10- 4901- 15- 18% Right Knee: No ratable impairment GERD: 100% - (06.01.00.00 - 15 - [1.4] 21 - 490F- 21 - 25%) 25% CVC: 53%PD (Id., pp. 7, 9.)
Provided medical reports and impairment ratings used in stipulations; did not opine on whether impairments should be combined or added for accurate rating.
The WCJ found that impairments should be added rather than combined, but this was not supported by medical evidence from Dr. Silbart.
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
Medical opinion must be based on reasonable medical probability, pertinent facts, adequate examination, and set forth reasoning to constitute substantial evidence.
The Board found the WCJ's finding unsupported by substantial medical evidence as required by Escobedo.
From the decision · page 11To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) "Medical reports and opinions are not substantial evidence if they are known to be erroneous, or if they are based on facts no longer germane, on inadequate medical histories and examinations, or on incorrect legal theories. Medical opinion also fails to support the Board's findings if it is based on surmise, speculation, conjecture or guess." (Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93, 97].)
Bookout v. City of Los Angeles, 62 Cal.App.3d 214 (1985)
Permanent disability for SIBTF benefits under Labor Code section 4751(b) must be calculated excluding apportionment and not combined using the Combined Values Chart.
The Board applied Bookout to hold that apportionment is excluded and the Combined Values Chart cannot be used to combine impairments for the 35 percent threshold determination.
What proof carried it
The evidence the panel weighed, by kind.
Applicant's impairments must be added rather than combined using the Combined Values Chart for accurate permanent disability rating, but medical evidence is lacking to support this method.
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
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.
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