ADJ12309738 · October 28, 2022

The WCJ and WCAB found Dr. Shorr's medical opinions substantial and persuasive that applicant's stroke and carotid dissection were industrially caused by work activities, rejecting Dr. Solomon's biomechanical opinions as non-medical and legally insufficient.

From the decision · page 5The Panel QME in the case spent face-to-face time with Applicant, took a detailed history, physically examined, and evaluated him and performed necessary and relevant testing. Dr. Shorr also reviewed medical records and gave well-reasoned, cogent opinions and conclusions. It was undersigned's conclusion that Dr. Shorr's reports, and deposition are substantial evidence... (Report, p. 6, italics and underlining in original.) Based on our review of the trial record, we agree with the WCJ that Dr. Shorr's reports, and deposition testimony are substantial evidence that applicant sustained injury AOE/COE, in the form of a stroke and the resulting conditions. Also, as the WCJ noted, there is no medical evidence in the record controverting or otherwise inconsistent with Dr. Shorr's opinions. Defendant argues that the reports from biomechanics expert Kenneth A.

Dr. Shorr's medical opinions that applicant's stroke and carotid dissection were industrially caused by heavy physical work including use of a pneumatic jack.

Favours Applicant prevailed

These opinions were found substantial evidence and supported injury AOE/COE finding.

From the decision · page 5The Panel QME in the case spent face-to-face time with Applicant, took a detailed history, physically examined, and evaluated him and performed necessary and relevant testing. Dr. Shorr also reviewed medical records and gave well-reasoned, cogent opinions and conclusions. It was undersigned's conclusion that Dr. Shorr's reports, and deposition are substantial evidence... (Report, p. 6, italics and underlining in original.) Based on our review of the trial record, we agree with the WCJ that Dr. Shorr's reports, and deposition testimony are substantial evidence that applicant sustained injury AOE/COE, in the form of a stroke and the resulting conditions. Also, as the WCJ noted, there is no medical evidence in the record controverting or otherwise inconsistent with Dr. Shorr's opinions. Defendant argues that the reports from biomechanics expert Kenneth A.

Dr. Solomon's biomechanical opinions were rejected as non-medical and legally insufficient to refute medical evidence.

Favours Applicant prevailed

Rejection of Dr. Solomon's opinions upheld the medical causation evidence supporting applicant's claim.

From the decision · page 6of the injury, is not evidence regarding the actual jack applicant was using, nor is it evidence pertaining to applicant's physical activity while using the jack prior to his stroke. Also, Dr. Solomon's conclusion that it is unlikely applicant was exerting more than 50 lbs. of force when using the jack, and therefore, "... it is impossible to definitively attribute his carotid artery dissection or stroke solely to his work..." (Def. Exh. A, p. 2) does not constitute substantial evidence. It is well established that for the purpose of meeting the causation requirement in a workers' compensation injury claim, it is sufficient if the work is a contributing cause of the injury. (South Coast Framing, Inc. v. Workers' Comp. Appeals Bd. (2015) 61 Cal.4th 291 [80 Cal.Comp.Cases 489].) Clearly, Dr. Solomon's conclusion is based on an incorrect legal theory. Also, it appears that since Dr.

Testimony of applicant's co-workers about applicant's physical struggle and slurred speech immediately after using the jack.

Favours Applicant prevailed

Supported the timing and occurrence of injury at work, corroborating medical opinions.

From the decision · page 2Applicant and his co-workers had been assigned to remove large milk storage tanks from a dairy barn on May 6, 2019. ... Applicant took a jack to the rear of the tank and, when his co-workers had elevated the front of the tank, he positioned his pneumatic jack while working on his hands and knees. According to the testimony, Applicant pressurized the jack while in a kneeling position. When he stood up, his co-workers observed that he was struggling physically and heard him speak in a slurred manner. (Report, p.2.)

Tested a pneumatic jack different from the one used by applicant; opined applicant unlikely exerted over 50 lbs. force and that stroke could not be definitively attributed solely to work; opinions rejected as non-medical and legally insufficient.

Dr. Solomon's opinions were rejected as outside medical expertise and based on incorrect legal theory that work must be sole cause.

From the decision · page 5Solomon, Ph.D., are evidence that applicant was not performing work activity that would be considered heavy lifting prior to his stroke. Dr. Solomon's initial report states in part that: 2. Based on our preliminary analysis, it is unlikely that Plaintiff the applicant would have been exerting over 50 lbs. of force in order to operate the subject jack prior to his stroke. 3. Considering that Plaintiff the applicant was not exerting himself significantly during the operation of the subject jack, it is impossible to definitively attribute his carotid artery dissection or stroke solely to his work the day of the subject incident. (Def. Exh. A, Dr. Solomon, March 1, 2022, p. 2.)

Applicant suffered a right carotid artery dissection causing a right middle cerebral artery ischemic stroke industrially caused by heavy physical work activities including use of a pneumatic jack, supported by medical records, depositions, and examination.

The WCJ and WCAB found Dr. Shorr's reports and deposition substantial evidence supporting injury AOE/COE.

From the decision · page 2Neurology qualified medical examiner (QME) Robert J. Shorr, M.D., evaluated applicant on September 24, 2019. Dr. Shorr examined applicant and took a history, but he noted that he had only received one medical report to review, and he explained that:

South Coast Framing, Inc. v. Workers' Comp. Appeals Bd. (2015) 61 Cal.4th 291

For causation in workers' compensation, work need only be a contributing cause, not the sole cause.

Dr. Solomon's opinion was rejected for incorrectly requiring sole causation.

From the decision · page 6of the injury, is not evidence regarding the actual jack applicant was using, nor is it evidence pertaining to applicant's physical activity while using the jack prior to his stroke. Also, Dr. Solomon's conclusion that it is unlikely applicant was exerting more than 50 lbs. of force when using the jack, and therefore, "... it is impossible to definitively attribute his carotid artery dissection or stroke solely to his work..." (Def. Exh. A, p. 2) does not constitute substantial evidence. It is well established that for the purpose of meeting the causation requirement in a workers' compensation injury claim, it is sufficient if the work is a contributing cause of the injury. (South Coast Framing, Inc. v. Workers' Comp. Appeals Bd. (2015) 61 Cal.4th 291 [80 Cal.Comp.Cases 489].) Clearly, Dr. Solomon's conclusion is based on an incorrect legal theory. Also, it appears that since Dr.

Applicant's co-workers' testimony about applicant's physical struggle and slurred speech immediately after using the jack

From the decision · page 2Applicant and his co-workers had been assigned to remove large milk storage tanks from a dairy barn on May 6, 2019. ... Applicant took a jack to the rear of the tank and, when his co-workers had elevated the front of the tank, he positioned his pneumatic jack while working on his hands and knees. According to the testimony, Applicant pressurized the jack while in a kneeling position. When he stood up, his co-workers observed that he was struggling physically and heard him speak in a slurred manner. (Report, p.2.)