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.
secondary_treaterRejected
Opined the incident caused the shoulder pain necessitating operation but provided no explanation or reasoning for causation of the high-grade tear.
Report lacked explanation and reasoning for causation, focusing only on conclusion.
From the decision · page 4In support of causation, the applicant submitted reports from Dr. Nguyen and Dr. Wang.
In Dr. Nguyen's report dated July 24, 2023, the doctor opined "The incident rather than the
length of work at U-Haul caused the pain in the shoulder that necessitated an operation."
(Exhibit 1 pg. 1-2). However, the report contained no explanation as to what the "incident"
was as relayed to that doctor, nor did Dr. Nguyen's report provide an explanation for on
how a high-grade tear could be caused by applicant's alleged specific injury. Dr. Nguyen's
report did not offer the reasoning behind the opinions; instead focusing entirely on the
conclusion.
secondary_treaterRejected
Believed injury was possibly due to job but failed to provide analysis or explanation for causation of chronic tear; opinion was surmise without substantial evidence.
Report failed to provide analysis or explanation for causation and was surmise.
From the decision · page 4Dr. Wang's progress report's causation analysis is "Like Dr. Nguyen, I do believe it's
possible that his injury was due to his job, and so will give him a note stating thus." (Exhibit
3). The report fails to provide any analysis or explanation how the job duties could create
a type of tear that Dr. McGahan opines is chronic. Dr. Wang does not explain the reasoning
behind the physician's opinion instead surmising that it is industrial. Dr. Wang's report is
not substantial medical evidence to support a finding of industrial causation to a specific
injury.
QMERelied upon
Concluded rotator cuff tear was non-industrial based on pre-existing pathology, limited activity time, and tear consistent with chronic injury; provided reasoning and reviewed medical records.
Report explained non-industrial causation with three reasons and reviewed appropriate medical records, making it substantial evidence.
From the decision · page 3Applicant started working for U-Haul on July 25, 2022 as a yard worker. His main job was
washing and cleaning the trucks. On July 26, 2022, applicant washed the windows of a
large truck and felt pain in his right shoulder. Initially, he thought he had just sprained his
shoulder. Applicant kept working for U-Haul until August 20, 2022. On September 1, 2022,
Applicant filed an Application for Adjudication while represented by Alex Bonilla for a
specific injury of July 26, 2022. Applicant was evaluated by QME Dr. Patrick McGahan.
Dr. McGahan issued two reports; and concluded the rotator cuff tear was non-industrial.
Dr. McGahan's reports are dated February 22, 2023 and February 3, 2023. Applicant was
represented by counsel up until May 16, 2023, when he dismissed his attorney. A
Declaration of Readiness to Proceed was filed on June 29, 2023. The June. 27, 2023 hearing
was continued over defendant's objection to give applicant an opportunity to find new
counsel. On September 21, 2023 the matter was set for trial with discovery closed. At the
time discovery was closed and the pre-trial conference was uploaded, applicant's ptp
reports were uploaded into FileNet. Applicant is being treated on a non-industrial basis by
Dr. Nguyen and Dr. Wang. Both doctors issued opinions regarding causation.