ADJ10490434 — California WCAB decision

What the panel ordered

Petition for reconsideration denied, affirming the WCJ's award of 82% permanent partial disability as a single joint and several award without apportionment between injuries.

Defendant sought reconsideration of the WCJ's March 10, 2025 Joint Findings of Fact and Joint Award denying apportionment between multiple industrial injuries.

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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.

ApportionmentApplicant prevailedneck · back · shoulders · knees · circulatory system

The WCJ relied on the expert opinion of Internal Medicine QME Dr. Benjamin Simon, who found the hypertension disability was inextricably intertwined across all injuries and could not be apportioned by date of injury with reasonable medical probability, leading to denial of apportionment and a single joint and several award.

From the decision · page 2Following Trial, post-Trial argument and submission for decision, Joint Findings of Fact and Joint Award issued on March 10, 2025. Among other things, Applicant was found to have sustained 82% permanent partial disability as a result of the combined effect of the five industrial injuries. Apportionment between the injuries was denied in reliance on the expert opinion of Internal Medicine QME Dr. Benjamin Simon. Consistent with the findings, permanent partial disability indemnity and a Life Pension were awarded. Joint Findings of Fact & Joint Award 3/10/2025 p. 4 (Finding of Fact #6), p. 5 (Joint Award), pp. 8-10 (Opinion on Decision).

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.

QMEPartially credited · Orthopedics

Provided multiple reports on orthopedic injuries and impairment, but deferred on apportionment of hypertension disability and did not support apportionment of hypertension.

Deferred apportionment of hypertension to specialists; orthopedic impairment apportionment unchanged.

From the decision · page 4Dr. Fonseca opined that Applicant sustained the February 21, 2015 specific injury and the cumulative injury. He opined that Applicant was permanent and stationary from their effects. Joint Exhibit A: QME report of Allen Fonseca, M.D. 6/03/2016 pp. 2-4, p. 29. He deferred assessment of the extent of impairment and apportionment pending further diagnostic testing. Joint Exhibit A: QME report of Allen Fonseca, M.D. 6/03/2016 pp. 2-4, pp. 31-32.

QMERelied upon · Internal Medicine

Found that the hypertension disability was industrially caused and inextricably intertwined across all injuries, making apportionment by date of injury speculative and not reasonably possible.

Medical records did not provide sufficient information to apportion hypertension disability by date of injury; effects of pain and medications on blood pressure varied and overlapped.

From the decision · page 2Following Trial, post-Trial argument and submission for decision, Joint Findings of Fact and Joint Award issued on March 10, 2025. Among other things, Applicant was found to have sustained 82% permanent partial disability as a result of the combined effect of the five industrial injuries. Apportionment between the injuries was denied in reliance on the expert opinion of Internal Medicine QME Dr. Benjamin Simon. Consistent with the findings, permanent partial disability indemnity and a Life Pension were awarded. Joint Findings of Fact & Joint Award 3/10/2025 p. 4 (Finding of Fact #6), p. 5 (Joint Award), pp. 8-10 (Opinion on Decision).

The rules the panel named

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

Labor Code section 4663(c)

Apportionment must be made by finding the approximate percentage of permanent disability caused by the industrial injury and by other factors, including prior industrial injuries, to a reasonable medical probability.

The WCJ applied this standard to require an apportionment determination by the physician, but accepted that when apportionment cannot be reasonably made, a joint and several award is proper.

From the decision · page 11(c) In order for a physician's report to be considered complete on the issue of permanent disability, the report must include an apportionment determination. A physician shall make an apportionment determination by finding what approximate percentage of the permanent disability was caused by the direct result of injury arising out of and occurring in the course of employment and what approximate percentage of the permanent disability was caused by other factors both before and subsequent to the industrial injury, including prior industrial injuries.

Benson v. Workers' Comp. Appeals Bd. (2009) 170 Cal. App. 4th 1535

Where permanent disability cannot reasonably be parceled out among multiple injuries, a joint and several award of permanent disability must issue.

The WCJ followed this binding precedent to uphold the joint and several award without apportionment.

Brodie v. Workers' Comp. Appeals Bd. (2007) 40 Cal.4th 1313

Employers must compensate injured workers only for the portion of permanent disability attributable to the current industrial injury, not for prior injuries or nonindustrial factors.

The WCJ acknowledged this principle but found apportionment was not reasonably possible in this case.

From the decision · page 10The California worker`s compensation system requires that, "[e]mployers must compensate injured workers only for that portion of their permanent disability attributable to a current industrial injury, not for that portion attributable to previous injuries or to nonindustrial factors. `Apportionment is the process employed by the Board to segregate the residuals of an industrial injury from those attributable to other industrial injuries, or to nonindustrial factors, in order to fairly allocate the legal responsibility.'" (Brodie v. Workers' Comp. Appeals Bd. (2007) 40 Cal.4th 1313, 1321 [57 Cal. Rptr. 3d 644, 156 P.3d 1100, 72 Cal.Comp.Cases 565], quoting Ashley v. Workers' Comp. Appeals Bd. (1995) 37 Cal.App.4th 320, 326 [43 Cal.Rptr. 2d 589, 60 Cal.Comp.Cases 683].)

ADJ10490434 · June 23, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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