ADJ10795207 — California WCAB decision

What the panel ordered

Petition for Reconsideration denied.

Petition for Reconsideration of the Findings of Fact and Award issued by the WCJ on December 7, 2020, denied by the Appeals Board panel on March 1, 2021.

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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.

AOE/COEDefendant prevailedhead · left ear · psyche · right knee · left ankle · stomach · dental system

The Appeals Board found no substantial evidence to support injury AOE/COE to the other listed body parts based on the medical opinions and record.

From the decision · page 1Applicant seeks reconsideration of the Findings of Fact and Award (F&A), issued by the workers' compensation administrative law judge (WCJ) on December 7, 2020, wherein the WCJ found in pertinent part that applicant sustained injury arising out of and occurring in the course of employment (AOE/COE) to her right ankle and left knee, and that she did not sustain injury AOE/COE to her head, left ear, psyche, right knee, left ankle, stomach, and dental system.

AOE/COE

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

The AME Dr. Silbart's opinion based on examination and extensive medical records that applicant sustained injury to right ankle and left knee only.

Favours Applicant prevailed

This opinion was relied upon by the Appeals Board as substantial evidence supporting injury AOE/COE to these body parts.

From the decision · page 2On June 4, 2019, applicant was evaluated by orthopedic agreed medical examiner (AME) Steven B. Silbart, M.D. (Def. Exh. B, Dr. Silbart, June 4, 2019.) Dr. Silbart examined applicant and took a lengthy history (see Def. Exh. B, pp. 2 § 10). He diagnosed:

The ENT Dr. Berman's opinion that applicant's auditory conditions were not caused by the February 17, 2015 injury.

Favours Defendant prevailed

This opinion was relied upon by the Appeals Board to deny injury AOE/COE to head, left ear, psyche, and other listed body parts.

From the decision · page 2On February 27, 2020, applicant was seen by otorhinolaryngology (ear, nose, and throat; ENT) specialist Andrew G. Berman, M.D., for a primary treating physician initial evaluation. (App. Exh. 6, Dr. Berman, March 24, 2020.) Dr. Berman noted that, "The purpose of this visit was to evaluate this woman's hearing loss, tinnitus and dizziness secondary [to] head trauma she sustained on the date of injury." (App. Exh. 6, p. 2.) He reviewed the reports from Dr. Silbart and conducted audio tests. Dr. Berman diagnosed applicant as having bilateral hearing nerve loss, mild

The cumulative injury claim filed on October 19, 2020, does not affect the substantial evidence supporting the specific injury claim adjudicated here.

Favours Defendant prevailed

The Appeals Board found no reason to disturb the Findings of Fact and Award despite the pending cumulative injury claim.

From the decision · page 3Applicant argues that the WCJ's Finding that applicant injured her right ankle and left knee and no other body parts as a result of the February 17, 2015 injury, "... is premature at this point in time" because her cumulative injury claim is pending. (Petition, p. 3.) As noted above, Dr.

ADJ10795207 · March 1, 2021

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

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