What the panel ordered
Findings and Orders issued by WCJ on May 10, 2021, are affirmed by WCAB on January 13, 2022, denying applicant's claims of injury to psyche, nervous system, sexual dysfunction, sleep disorder, low back, left knee, left ankle, and new and further disability.
Petition for Reconsideration filed by applicant to challenge WCJ Findings and Orders denying injury and new and further disability; WCJ recommended denial of Petition; WCAB issued Opinion and Decision After Reconsideration affirming WCJ Findings and Orders.
This docket was decided more than once. Shown here is the latest released decision; we also hold April 12, 2021.
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 WCJ and WCAB found no substantial medical evidence supporting injury to psyche, nervous system, sexual dysfunction, sleep disorder, low back, left knee, or left ankle, and no new and further disability; Dr. Huffer's well-reasoned report was substantial evidence.
From the decision · page 4[T]here was no substantial medical evidence offered to establish applicant sustained injury to his psyche, nervous system (anxiety), sexual dysfunction or sleep disorder arising out of and in the course of his employment with defendant on 05/08/2015. (Report, p. 12.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant's Petition to Reopen did not set forth specific facts or medical evidence supporting new and further disability.
Favours Defendant prevailed
Lack of specific factual and medical evidence led to denial of reopening and new disability claims.
From the decision · page 3Based on our review of the record, including the Electronic Adjudication Management System (EAMS) ADJ file, we see that applicant's Petition to Reopen asserts that applicant "alleges his industrial injuries have worsened" and that he "asserts his right to have the matter re-opened due to his allegation of a new and further disability." However, the Petition to Reopen does not set forth specifically and/or in detail any of the facts relied upon as the basis for his petition. More importantly, the record contains no medical evidence to support applicant's assertion that his condition had worsened or that his disability had increased during the period from October 17, 2019, (the date of the initial Findings and Award) through April 23, 2020 (the date the Petition to Reopen was filed). For example, the medical records provided to Dr. Huffer for his August 24,
Dr. Huffer's October 1, 2020 report was well-reasoned, based on adequate history and examination, and found to be substantial evidence.
Favours Defendant prevailed
This report was relied upon to deny applicant's claims of new injury and further disability.
From the decision · page 4Regarding the issue of whether Dr. Huffer's October 1, 2020 report is substantial evidence, it is well established that the relevant and considered opinion of one physician, though inconsistent with other medical opinions, may constitute substantial evidence. (See Place v. Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372, [35 Cal.Comp.Cases 525].) When a physician's report is well- reasoned, is based on an adequate history and examination, and sets forth the reasoning behind the physician's opinion, not merely his or her conclusions, the report constitutes substantial evidence. (Granado v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 399 [33 Cal.Comp.Cases 647]; McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408 [33 Cal.Comp.Cases 660]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).)
Applicant's testimony about the brief examination by Dr. Huffer was found less credible than Dr. Huffer's report stating a one-hour evaluation with interpreter assistance.
Favours Defendant prevailed
Credibility finding supported reliance on Dr. Huffer's report over applicant's contrary testimony.
From the decision · page 5Applicant is correct that the WCJ did not make a finding that applicant was not credible, but clearly the WCJ found Dr. Huffer's discussion of his examination of applicant to be more credible that applicant's testimony about the length of the examination. Based on our review of the record we see no reason to disturb the WCJ's 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.
Dr. Huffer concluded applicant's only industrial injury was to the right lower extremity in 2015, with no new or further disability; subjective complaints to other areas were not supported by objective findings and showed exaggeration.
Dr. Huffer's October 1, 2020 report was found to be substantial evidence and more credible than applicant's testimony about the examination length.
From the decision · page 2Orthopedic QME Dr. Huffer re-evaluated applicant on August 24, 2020. (Def. Exh. I, Dr. Huffer, August 24, 2020.)1 Dr. Huffer examined applicant and reviewed the records he was provided, including the transcript of applicant's July 15, 2020 deposition. The doctor concluded:
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Place v. Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372
Relevant and considered opinion of one physician may constitute substantial evidence if well-reasoned and based on adequate history and examination.
Dr. Huffer's report was well-reasoned and based on adequate history and examination, thus constituting substantial evidence.
From the decision · page 4Regarding the issue of whether Dr. Huffer's October 1, 2020 report is substantial evidence, it is well established that the relevant and considered opinion of one physician, though inconsistent with other medical opinions, may constitute substantial evidence. (See Place v. Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372, [35 Cal.Comp.Cases 525].) When a physician's report is well- reasoned, is based on an adequate history and examination, and sets forth the reasoning behind the physician's opinion, not merely his or her conclusions, the report constitutes substantial evidence. (Granado v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 399 [33 Cal.Comp.Cases 647]; McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408 [33 Cal.Comp.Cases 660]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).)
Cal. Code Regs., tit. 8, 10534 and 10536
Petitions invoking continuing jurisdiction under Labor Code section 5803 and 5410 must set forth facts establishing good cause or new and further disability.
Applicant's Petition to Reopen did not set forth specific facts or medical evidence supporting new and further disability.
From the decision · page 3Pursuant to Appeals Board rules 10534 and 10536:
What proof carried it
The evidence the panel weighed, by kind.
Applicant's testimony about a brief examination by Dr. Huffer was found less credible than Dr. Huffer's report stating a one-hour evaluation with interpreter assistance.
From the decision · page 5Applicant is correct that the WCJ did not make a finding that applicant was not credible, but clearly the WCJ found Dr. Huffer's discussion of his examination of applicant to be more credible that applicant's testimony about the length of the examination. Based on our review of the record we see no reason to disturb the WCJ's decision.
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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.
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