AMERejected · orthopedic surgery
Attributed low back impairment entirely to a specific industrial injury in the mid 1990s and right foot injury to January 18, 2017 event; opined no independent injury to neck or mid back; did not persuasively rebut cumulative trauma presumption for low back injury.
Dr. Previte's opinion lacks detailed reasoning and is based on a legally incorrect theory regarding duty belt injury; therefore, it is not substantial medical evidence to rebut the presumption of cumulative trauma causing lumbar disability.
From the decision · page 19In this case, although the reports and deposition testimony of Dr. Previte attribute
applicant's low back injury to a specific industrial injury that occurred in 1997, these opinions are
unsupported by any detailed or cogent explanation of how or why the presumptive cumulative
effect of wearing a duty belt for more than five years did not contribute in any way whatsoever to
applicant's low back condition. Furthermore, Dr. Previte seems to hold the opinion that wearing a
duty belt cannot constitute a medically probable cause of cumulative lumbar injury. This position
is both unsubstantiated by explanation and based on a legally incorrect theory. As a matter of law,
injury to the lumbar spine is presumed under prescribed circumstances. Any medical-legal
evaluator who presumes the opposite to be true, without a detailed and cogent rebuttal, fails to
meet the standards of substantial medical evidence set forth in Escobedo v. Marshalls (2007) 70
Cal.Comp.Cases 604 (Appeals Board en banc).
AMERelied upon · internal medicine
Found industrial causation of hypertension and other internal conditions due to cumulative trauma; assigned WPI percentages for skin damage, GERD, hypertensive heart disease, and carotid arterial disease; apportionment deferred due to lack of substantial evidence.
Dr. Hyman's opinion on industrial causation of hypertension is followed, but apportionment is deferred due to insufficient substantial medical evidence.
From the decision · page 21With respect to the internal AME, Dr. Hyman, applicant's Petition asserts that the Appeals
Board should follow his finding of injury in the form of hypertension, and permanent disability
related thereto. We agree that Dr. Hyman's opinion regarding industrial causation of injury in the
form of hypertension should be followed, but note that the June 4, 2021 Findings, Award, and
Order did this by finding such injury, based on the parties' stipulation thereto. With respect to
permanent disability, the WCJ's decision deferred that issue, based on a lack of substantial medical
evidence from Dr. Hyman regarding apportionment. We agree with the decision in this respect,
and similarly defer the issue of internal apportionment, but we will rescind the decision in all three
cases because permanent disability of the low back is necessarily apportioned to cumulative trauma
by operation of section 3213.2 and 4663(e) as explained above. (Lab. Code, § 3213.2, 4663(e).)