What the panel ordered
Petition for Reconsideration denied.
Petition for Reconsideration filed by defendant after Findings & Award granting Petition to Reopen for New and Further Disability and finding 100% permanent total disability.
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 applicant was found to be 100% permanently totally disabled based on credible testimony, medical evaluations including psychiatric AME Dr. Nathan, and unrebutted vocational expert opinion that the applicant is not able to sustain gainful employment or compete in the open labor market.
From the decision · page 3This matter came before the undersigned for trial regarding the applicant's Petition to Reopen for New and Further Disability. Ultimately, the undersigned issued Findings & Award dated December 10, 2020. Therein, the applicant's Petition to Reopen for New and Further Disability was granted, and a finding was made that the applicant's injuries caused permanent total disability of 100%.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Agreed Medical Evaluator Dr. Nathan opined the applicant is permanently impaired from returning to the open labor market and supports the addition method for combining impairments.
Favours Applicant prevailed
This medical opinion provided a reasonably articulated basis for the total disability rating and was relied upon by the panel.
From the decision · page 4"In considering the applicant as a whole and her multisystem problemsand her diminished capacity to work in the open labor market, it is my impression the applicant is permanently impaired from returning to the open labor market. The applicant's overall impairment with her multiple body parts because of their synergistic effect upon one another should be added together in order to obtain a more accurate total disability rating. I would recommend that the applicant undergo vocational assessment to determine her level of functionality in the open labor market." (Joint Exhibit EE, page 28, first paragraph)
The applicant was found to be a very credible witness by the WCJ.
Favours Applicant prevailed
Credibility supported the acceptance of the applicant's testimony and medical evidence leading to the finding of total permanent disability.
From the decision · page 6The undersigned found the applicant to be a very credible witness. The psychiatric Agreed Medical Evaluator Dr. Nathan found the applicant to be 100% permanently totally disabled, regardless of the addition method for her disabilities. Notwithstanding, the Agreed Medical Evaluator Dr. Nathan recommended the addition of the ratings, which equates to 100%. In the opinion of the undersigned, Agreed Medical Evaluator Dr. Nathan provided a reasonably articulated medical basis for his opinion that the addition method will result in a more accurate rating of the applicant's level of disability. The undersigned finds no good reason to find the Agreed Medical Evaluator's opinion unpersuasive.
The defendant did not provide sufficient substantial evidence or a rebuttal vocational report to challenge the vocational expert's opinion that the applicant is not able to sustain gainful employment.
Favours Applicant prevailed
Lack of rebuttal evidence favored the applicant's claim of permanent total disability.
From the decision · page 6The Petitioner further asserts that the applicant's vocational expert incorrectly categorized the applicant's job history, and the defendants contend that the orthopedic work restrictions are not so limiting as to preclude the applicant from reasonable vocational rehabilitation. However, the defendant did not obtain a rebuttal vocational report, or provide sufficient substantial evidence to support its assertions.
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.
Applicant is permanently totally disabled and the addition method of combining multiple impairments results in a more accurate total disability rating.
Dr. Nathan provided a reasonably articulated medical basis for the addition method and opined the applicant is permanently impaired from returning to the open labor market.
From the decision · page 4Agreed Medical Evaluator Dr. Nathan stated in his May 12, 2017 report:
From the decision · page 8The undersigned found the applicant to be a credible witness. The factors of permanent disability are based upon applicant's testimony, the medical record herein including agreed medical evaluations from Jeffrey Berman, M.D., Jeffrey Hirsch M.D., the medical evaluations and deposition transcript from AME Myron Nathan M.D., and the Vocational Evaluation Report from Laura Wilson dated November 14, 2018.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Power v. Workers' Comp. Appeals Bd. (1986) 179 Cal. App. 3d. 775
The addition method for combining multiple impairments should be followed if the Agreed Medical Evaluator provides a reasonably articulated medical basis, absent good reason to find that opinion unpersuasive.
The panel followed Dr. Nathan's opinion supporting the addition method for a more accurate total disability rating.
Labor Code Section 4659(c)
Labor Code Section 4659(c) provides for annual cost of living adjustments (COLAs) based on the state average weekly wage (SAWW).
Applicant is entitled to COLAs as per the statute.
What proof carried it
The evidence the panel weighed, by kind.
The WCJ found the applicant to be a very credible witness.
From the decision · page 6The undersigned found the applicant to be a very credible witness. The psychiatric Agreed Medical Evaluator Dr. Nathan found the applicant to be 100% permanently totally disabled, regardless of the addition method for her disabilities. Notwithstanding, the Agreed Medical Evaluator Dr. Nathan recommended the addition of the ratings, which equates to 100%. In the opinion of the undersigned, Agreed Medical Evaluator Dr. Nathan provided a reasonably articulated medical basis for his opinion that the addition method will result in a more accurate rating of the applicant's level of disability. The undersigned finds no good reason to find the Agreed Medical Evaluator's opinion unpersuasive.
The defendant did not provide sufficient substantial evidence or rebuttal vocational report to challenge the vocational expert's opinion.
From the decision · page 6The Petitioner further asserts that the applicant's vocational expert incorrectly categorized the applicant's job history, and the defendants contend that the orthopedic work restrictions are not so limiting as to preclude the applicant from reasonable vocational rehabilitation. However, the defendant did not obtain a rebuttal vocational report, or provide sufficient substantial evidence to support its assertions.
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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