ADJ2199336 — California WCAB decision

What the panel ordered

Petition for Reconsideration denied.

Petition for Reconsideration filed by applicant acting in pro per, seeking review of WCJ Findings, Awards & Orders issued October 20, 2020, denied by WCAB panel.

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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 prevailedlumbar spine · psyche · cervical spine

The WCJ found injury AOE/COE to lumbar spine and psyche but not to other body parts claimed by applicant; the WCAB upheld this finding based on substantial evidence from AME Dr. Green and QME Dr. Jacks.

From the decision · page 1Applicant, acting in pro per, seeks reconsideration of the Findings Awards & Orders (F&A) issued by the WCJ on October 20, 2020, wherein the workers' compensation administrative law judge (WCJ) found in pertinent part that while employed by defendant as a driver/furniture mover, applicant: (1) sustained injury arising out of and occurring in the course of employment (AOE/COE) to his lumbar spine and psyche, during the period from October 9, 1999, through September 21, 2004, but did not sustain injury AOE/COE to his upper or lower extremities, and that the injury caused 21% permanent disability (ADJ2199336); (2) sustained injury AOE/COE to his lumbar spine and psyche, on October 8, 1999, but did

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Power v Workers' Comp. Appeals Bd. (1986) 179 Cal.App.3d 775

An agreed medical evaluator's opinion should ordinarily be followed unless there is good reason to find it unpersuasive.

The WCJ and WCAB followed this standard in relying on AME Dr. Green's opinions as substantial evidence.

From the decision · page 5As noted earlier, Dr. Green examined applicant in the capacity of an AME. "[W]orkers' compensation law favors agreed medical examiners in resolving medical disputes fairly and expeditiously." (Green v. Workers' Comp. Appeals Bd. (2005) 127 Cal.App.4th 1426, 1444 [70 Cal.Comp.Cases 294].) The AME was presumably chosen by the parties because of his expertise and neutrality. Therefore, an agreed medical evaluator's opinion should ordinarily be followed unless there is good reason to find that opinion unpersuasive. (Power v Workers' Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].)

Place v. Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372

The relevant and considered opinion of one physician, though inconsistent with other medical opinions, may constitute substantial evidence if based on pertinent facts and adequate examination.

The WCJ and WCAB applied this standard in crediting Dr. Green's detailed medical opinions despite inconsistencies with other opinions.

From the decision · page 5It 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].) To be substantial evidence a medical opinion must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).) Based on our review of the reports from Dr. Green it is clear that he examined applicant on three occasions, that he reviewed the extensive medical record, and he explained in detail the basis for his opinions and conclusions. Thus we see no reason to find his opinions unpersuasive. His reports, and his opinions stated therein, constitute substantial evidence.

ADJ2199336 · March 9, 2021

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