ADJ4162830 · August 14, 2026

The WCJ found that the applicant sustained injury arising out of and in the course of employment to multiple body parts and conditions, supported by substantial medical evidence including reports from Dr. Flores on psyche injury and other medical experts on orthopedic and cardiac injuries.

From the decision · page 1Defendant seeks reconsideration of the Joint Findings, Award, and Order (JFA&O) issued on May 7, 2026 wherein the workers’ compensation administrative law judge (WCJ) found, in relevant part, that while employed by defendant as a plant manager and associate warden, applicant sustained injury arising out of and occurring in the course of employment (AOE/COE) on August 31, 2007 (ADJ2411991) to the lumbar spine, cervical spine, left elbow, bilateral arms, and bilateral legs, and during the period from November 1, 1981 to June 27, 2005 (ADJ4162830), to the cervical spine, lumbar spine, bilateral shoulders, bilateral wrists, left hip, bilateral knees, GERD, hypertension, coronary artery disease and psyche.

The WCJ found the applicant’s testimony credible regarding his work as an associate warden and assigned occupational group number 490, which was not rebutted by defendant and upheld on reconsideration.

From the decision · page 17Lastly, defendant argues that applicant’ occupational group number should be 212 based upon applicant’s deposition testimony and statements made by applicant to doctors regarding job duties. (Petition, p. 2.) An employee’s occupation is one of the component parts for rating permanent disability. The reason for this is that it serves to “aid in determining the relative effects of disability to various parts of the body taking into account the physical requirements of various occupations.” (Holt v. Workers’ Comp. Appeals Bd. (1986) 187 Cal.App.3d 1257, 1261 [51 Cal.Comp.Cases 576].) For

The WCJ assigned the applicant to occupational group 490 and found 100% permanent and total disability based on credible testimony and medical evidence, which was upheld on reconsideration.

From the decision · page 1The WCJ assigned applicant to occupational group number 490 based upon his testimony that he worked as both a plant manager and associate warden and found that applicant sustained a one hundred percent (100%) permanent and total disability. Defendant contends that applicant’s psyche claim is not based upon substantial medical evidence; applicant’s occupational group number should be 212 based upon applicant’s deposition testimony and statements made by applicant to doctors regarding job duties; the Almaraz Guzman ratings of Richard Fedder, M.D. and Richard Hyman, M.D. are not substantial medical evidence; and reports of Laura Wilson on the issue of “non feasibility” of applicant’s ability to return to work

The WCJ found the vocational expert’s reports to be substantial evidence supporting the applicant’s inability to return to work and rebuttal of the PDRS, considering all medical records and apportionment.

From the decision · page 10749.) Among the methods described for challenging a rating obtained under the PDRS is establishing that “the injury to the employee impairs his or her rehabilitation, and for that reason, the employee’s diminished future earning capacity is greater than reflected in the employee’s scheduled rating.” (Ogilvie v. Workers’ Comp. Appeals Bd. (2011) 197 Cal.App.4th 1262, 1274 [76 Cal.Comp.Cases 624].) Our opinion in Nunes I made clear that “[t]he same considerations used to evaluate whether a medical expert’s opinion constitutes substantial evidence are equally applicable to vocational reporting … [i]n order to constitute substantial evidence, a vocational expert’s opinion must detail the history and evidence in support of its conclusions, as well as ‘how and why’ any specific condition or factor is causing permanent disability.” (Nunes I, supra, at p. 751.) Based upon our review of the evidentiary record, including the vocational reports in this matter, we believe that VE Wilson’s opinions are substantial evidence and that applicant has successfully rebutted the PDRS. Wilson completed a full assessment, took a detailed history, and provided evidence and reasoning in support of her conclusions.

Applicant sustained injury arising out of and in the course of employment to multiple body parts and psyche.

Favours Applicant prevailed

Supported by substantial medical evidence including Dr. Flores' report on psyche injury.

From the decision · page 1Defendant seeks reconsideration of the Joint Findings, Award, and Order (JFA&O) issued on May 7, 2026 wherein the workers’ compensation administrative law judge (WCJ) found, in relevant part, that while employed by defendant as a plant manager and associate warden, applicant sustained injury arising out of and occurring in the course of employment (AOE/COE) on August 31, 2007 (ADJ2411991) to the lumbar spine, cervical spine, left elbow, bilateral arms, and bilateral legs, and during the period from November 1, 1981 to June 27, 2005 (ADJ4162830), to the cervical spine, lumbar spine, bilateral shoulders, bilateral wrists, left hip, bilateral knees, GERD, hypertension, coronary artery disease and psyche.

Applicant assigned occupational group number 490 based on credible testimony of work duties including associate warden role.

Favours Applicant prevailed

Credibility upheld by WCJ and Appeals Board, affecting permanent disability rating.

From the decision · page 189.) As an associate warden, he was required to “maintain his peace officer standards” including firearms training, which was initially a one-time two-week training, but ultimately became a 40-hour per year training. (Ibid.) Given that applicant’s work as an associate warden was an integral part of his occupation and was not rebutted by defendant, he is entitled to a higher occupational group number of 490. We further note that the WCJ found applicant’s testimony regarding his work as an associate warden to be credible. (Report, p. 2.) Credibility determinations of the WCJ, as the trier of fact, are entitled to great weight based upon the WCJ’s opportunity to observe the demeanor of the witnesses and weigh their statements in connection with their manner on the stand. (Garza v. Workmen’s Comp. Appeals Bd. (1970) 3 Cal.3d 312, 318-319 [35 Cal.Comp.Cases 500].) A WCJ’s credibility determination may be disturbed only where there is contrary evidence of considerable substantiality. (Ibid.) No such evidence was provided here. As such, there is no reason to disturb the WCJ’s assignment of applicant to occupational group 490. Accordingly, defendant’s Petition is denied.

Vocational expert reports found substantial evidence supporting applicant's inability to return to work and rebuttal of PDRS.

Favours Applicant prevailed

Detailed assessments and review of medical records including apportionment supported permanent disability finding.

From the decision · page 10749.) Among the methods described for challenging a rating obtained under the PDRS is establishing that “the injury to the employee impairs his or her rehabilitation, and for that reason, the employee’s diminished future earning capacity is greater than reflected in the employee’s scheduled rating.” (Ogilvie v. Workers’ Comp. Appeals Bd. (2011) 197 Cal.App.4th 1262, 1274 [76 Cal.Comp.Cases 624].) Our opinion in Nunes I made clear that “[t]he same considerations used to evaluate whether a medical expert’s opinion constitutes substantial evidence are equally applicable to vocational reporting … [i]n order to constitute substantial evidence, a vocational expert’s opinion must detail the history and evidence in support of its conclusions, as well as ‘how and why’ any specific condition or factor is causing permanent disability.” (Nunes I, supra, at p. 751.) Based upon our review of the evidentiary record, including the vocational reports in this matter, we believe that VE Wilson’s opinions are substantial evidence and that applicant has successfully rebutted the PDRS. Wilson completed a full assessment, took a detailed history, and provided evidence and reasoning in support of her conclusions.

Took accurate history, thoroughly examined applicant, and explained how industrial work exposure caused applicant’s psyche complaints, constituting substantial medical evidence.

Report satisfied requirements under Labor Code section 3208.3(b)(1) for psychiatric injury causation.

From the decision · page 9(citation.)” “A medical report which lacks a relevant factual basis cannot rise to a higher level than its own inadequate premises. Such reports do not constitute substantial evidence to support a denial of benefits. (citation.)” (Kyle v. Workers’ Comp. Appeals Bd (City and County of San Francisco) (1987) 195 Cal.App.3d 614, 621.) Based upon our review of the reports of Dr. Flores, we believe he took an accurate and adequate history of the injury, thoroughly examined the applicant, and explained how and why industrial work exposure caused applicant’s psyche complaints. As such, we believe that the reporting of Dr. Flores constitutes substantial medical evidence. Defendant contends that the reports of Dr. Flores are unrelated to the cumulative injury through June 27, 2005, and do not “demonstrate by a preponderance of the evidence that actual events of employment were predominant as to all causes combined of the psychiatric injury” as outlined under section 3208.3(b)(1). We disagree. In his report dated July 23, 2007, Dr.

Found multiple orthopedic injuries with specific whole person impairment percentages and opined 100% apportionment to continuous trauma from 1981 to 2005.

Report provided detailed impairment ratings and causation linking injuries to continuous trauma.

From the decision · page 3Fedder opined that applicant sustained injury AOE/COE to the cervical spine, shoulders, wrists, lumbar spine, left hip, and knees with a resulting in five percent (5%) WPI to the cervical spine based upon DRE category II and effects upon activities of daily living, twenty-eight percent (28%) WPI to the lumbar spine based upon loss of range of motion, neuro deficits, and development of a specific spinal disorder, 7% WPI to each upper extremity (seven percent (7%) upper extremity impairment (UEI) due to loss of range of motion in the left shoulder, six percent (6%) UEI for loss of range of motion in the right shoulder, and a five percent (5%) UEI to each wrist for carpal tunnel), twenty percent (20%) WPI to the left hip due to a replacement surgery, three percent (3%) WPI to the left knee for surgery, one percent (1%) WPI to the right knee for surgery, and a 2% add-on for pain. (Exhibit EE, pp. 32-37.) Dr. Fedder indicated that all the orthopedic injuries were “inextricably intertwined and [impairment] should be apportioned 100% to the continuous trauma from November 1981 through June 27, 2005.” (Id. at p. 33.) One year post lumbar fusion, in an updated report dated May 30, 2014, Dr.

Provided multiple reports on cumulative injury, including impairment ratings and apportionment percentages for GERD, hypertension, and coronary artery disease.

Reports supported cumulative injury through June 27, 2005 and impairment ratings with apportionment.

From the decision · page 13Subsequent to Kite, the Appeals Board issued its en banc decision in Vigil v. County of Kern (2024) 89 Cal.Comp.Cases 686, 688-689 (Appeals Bd. en banc) wherein it was determined that if an applicant seeks to rebut the CVC and add rather than combine impairments, the applicant must establish 1) The activities of daily living (ADLs) impacted by each impairment, and 2) That the ADLs either do not overlap, or overlap in such a way that it increases or amplifies the impact of the overlapping ADLs. Here, in a report dated January 7, 2026, Dr. Hyman reiterated that due to “narcotic induced constipation” applicant sustained an 8% WPI for GERD with 40% apportionment to work, and with respect to applicant’s deconditioning, hypertension, and coronary artery disease, applicant sustained 15%, 30%, and 35% WPI, respectively, with apportionment divided 100%, seventy percent (70%) and forty-five percent (45%) to the cumulative injury. (Exhibit BBB, p. 1.) In an earlier report dated November 12, 2025, Dr. Hyman opined as follows with respect to use of the addition versus CVC method for rating impairment: Relating to the issue of Vigil, his internal medicine problems should be additive rather than combined with any orthopedic or psychological issues as they impact his impairment in different ways.

Provided substantial evidence on non-feasibility of return to work, rebutting PDRS, based on detailed assessments and review of medical records including apportionment.

Reports detailed history, evidence, and reasoning supporting permanent disability and inability to compete in open labor market.

From the decision · page 10749.) Among the methods described for challenging a rating obtained under the PDRS is establishing that “the injury to the employee impairs his or her rehabilitation, and for that reason, the employee’s diminished future earning capacity is greater than reflected in the employee’s scheduled rating.” (Ogilvie v. Workers’ Comp. Appeals Bd. (2011) 197 Cal.App.4th 1262, 1274 [76 Cal.Comp.Cases 624].) Our opinion in Nunes I made clear that “[t]he same considerations used to evaluate whether a medical expert’s opinion constitutes substantial evidence are equally applicable to vocational reporting … [i]n order to constitute substantial evidence, a vocational expert’s opinion must detail the history and evidence in support of its conclusions, as well as ‘how and why’ any specific condition or factor is causing permanent disability.” (Nunes I, supra, at p. 751.) Based upon our review of the evidentiary record, including the vocational reports in this matter, we believe that VE Wilson’s opinions are substantial evidence and that applicant has successfully rebutted the PDRS. Wilson completed a full assessment, took a detailed history, and provided evidence and reasoning in support of her conclusions.

Lab. Code, § 5705

Burden of proof rests on party holding affirmative; preponderance of evidence standard for industrial causation.

Applied to require applicant to show employment was a contributing cause of injury.

From the decision · page 8Turning now to the merits of the Petition, it is well established that the burden of proof rests upon the party holding the affirmative of the issue. (Lab. Code, § 5705.) As such, when an employee claims injury AOE/COE, it is the employee, or the lien claimant who steps in the shoes of the employee, who carries the burden of proof in establishing industrial causation and they must show that the employment was a contributing cause. (South Coast Framing v. Workers’ Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297- 298, 302; §§ 5705; 3600.) Pursuant to section 3202.5, the evidentiary burden of proof is to be met by a preponderance of the evidence. However, “[t]hat burden manifestly does not require the applicant to prove causation by scientific certainty.” (Rosas v. Worker’s Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692, 1701 [58 Cal.Comp.Cases 313].) Further, substantial medical evidence is used to establish industrial causation. “The term ‘substantial evidence’ means evidence which, if true, has probative force on the issues.

Holt v. Workers’ Comp. Appeals Bd. (1986) 187 Cal.App.3d 1257

Occupational group number aids in determining relative effects of disability considering physical job requirements.

Applied to uphold assignment of occupational group number 490 based on credible testimony.

From the decision · page 17Lastly, defendant argues that applicant’ occupational group number should be 212 based upon applicant’s deposition testimony and statements made by applicant to doctors regarding job duties. (Petition, p. 2.) An employee’s occupation is one of the component parts for rating permanent disability. The reason for this is that it serves to “aid in determining the relative effects of disability to various parts of the body taking into account the physical requirements of various occupations.” (Holt v. Workers’ Comp. Appeals Bd. (1986) 187 Cal.App.3d 1257, 1261 [51 Cal.Comp.Cases 576].) For

Braewood Convalescent Hospital v. Workers’ Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159

Substantial medical evidence means evidence credible and of solid value, not mere speculation.

Applied to evaluate medical opinions for industrial causation.

From the decision · page 8Turning now to the merits of the Petition, it is well established that the burden of proof rests upon the party holding the affirmative of the issue. (Lab. Code, § 5705.) As such, when an employee claims injury AOE/COE, it is the employee, or the lien claimant who steps in the shoes of the employee, who carries the burden of proof in establishing industrial causation and they must show that the employment was a contributing cause. (South Coast Framing v. Workers’ Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297- 298, 302; §§ 5705; 3600.) Pursuant to section 3202.5, the evidentiary burden of proof is to be met by a preponderance of the evidence. However, “[t]hat burden manifestly does not require the applicant to prove causation by scientific certainty.” (Rosas v. Worker’s Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692, 1701 [58 Cal.Comp.Cases 313].) Further, substantial medical evidence is used to establish industrial causation. “The term ‘substantial evidence’ means evidence which, if true, has probative force on the issues.

Nunes v. State of California, Dept. of Motor Vehicles (2023) 88 Cal.Comp.Cases 741

Vocational expert opinions must detail history and evidence supporting conclusions to be substantial evidence.

Applied to evaluate vocational expert reports on non-feasibility of return to work.

From the decision · page 10749.) Among the methods described for challenging a rating obtained under the PDRS is establishing that “the injury to the employee impairs his or her rehabilitation, and for that reason, the employee’s diminished future earning capacity is greater than reflected in the employee’s scheduled rating.” (Ogilvie v. Workers’ Comp. Appeals Bd. (2011) 197 Cal.App.4th 1262, 1274 [76 Cal.Comp.Cases 624].) Our opinion in Nunes I made clear that “[t]he same considerations used to evaluate whether a medical expert’s opinion constitutes substantial evidence are equally applicable to vocational reporting … [i]n order to constitute substantial evidence, a vocational expert’s opinion must detail the history and evidence in support of its conclusions, as well as ‘how and why’ any specific condition or factor is causing permanent disability.” (Nunes I, supra, at p. 751.) Based upon our review of the evidentiary record, including the vocational reports in this matter, we believe that VE Wilson’s opinions are substantial evidence and that applicant has successfully rebutted the PDRS. Wilson completed a full assessment, took a detailed history, and provided evidence and reasoning in support of her conclusions.

Credibility of applicant's testimony regarding work as associate warden was upheld by WCJ and Appeals Board.

From the decision · page 189.) As an associate warden, he was required to “maintain his peace officer standards” including firearms training, which was initially a one-time two-week training, but ultimately became a 40-hour per year training. (Ibid.) Given that applicant’s work as an associate warden was an integral part of his occupation and was not rebutted by defendant, he is entitled to a higher occupational group number of 490. We further note that the WCJ found applicant’s testimony regarding his work as an associate warden to be credible. (Report, p. 2.) Credibility determinations of the WCJ, as the trier of fact, are entitled to great weight based upon the WCJ’s opportunity to observe the demeanor of the witnesses and weigh their statements in connection with their manner on the stand. (Garza v. Workmen’s Comp. Appeals Bd. (1970) 3 Cal.3d 312, 318-319 [35 Cal.Comp.Cases 500].) A WCJ’s credibility determination may be disturbed only where there is contrary evidence of considerable substantiality. (Ibid.) No such evidence was provided here. As such, there is no reason to disturb the WCJ’s assignment of applicant to occupational group 490. Accordingly, defendant’s Petition is denied.

Reports of Dr. Flores on psyche injury were found substantial medical evidence supporting industrial causation.

From the decision · page 9(citation.)” “A medical report which lacks a relevant factual basis cannot rise to a higher level than its own inadequate premises. Such reports do not constitute substantial evidence to support a denial of benefits. (citation.)” (Kyle v. Workers’ Comp. Appeals Bd (City and County of San Francisco) (1987) 195 Cal.App.3d 614, 621.) Based upon our review of the reports of Dr. Flores, we believe he took an accurate and adequate history of the injury, thoroughly examined the applicant, and explained how and why industrial work exposure caused applicant’s psyche complaints. As such, we believe that the reporting of Dr. Flores constitutes substantial medical evidence. Defendant contends that the reports of Dr. Flores are unrelated to the cumulative injury through June 27, 2005, and do not “demonstrate by a preponderance of the evidence that actual events of employment were predominant as to all causes combined of the psychiatric injury” as outlined under section 3208.3(b)(1). We disagree. In his report dated July 23, 2007, Dr.

Vocational expert Laura Wilson's reports were found substantial evidence supporting permanent disability and rebuttal of PDRS.

From the decision · page 10749.) Among the methods described for challenging a rating obtained under the PDRS is establishing that “the injury to the employee impairs his or her rehabilitation, and for that reason, the employee’s diminished future earning capacity is greater than reflected in the employee’s scheduled rating.” (Ogilvie v. Workers’ Comp. Appeals Bd. (2011) 197 Cal.App.4th 1262, 1274 [76 Cal.Comp.Cases 624].) Our opinion in Nunes I made clear that “[t]he same considerations used to evaluate whether a medical expert’s opinion constitutes substantial evidence are equally applicable to vocational reporting … [i]n order to constitute substantial evidence, a vocational expert’s opinion must detail the history and evidence in support of its conclusions, as well as ‘how and why’ any specific condition or factor is causing permanent disability.” (Nunes I, supra, at p. 751.) Based upon our review of the evidentiary record, including the vocational reports in this matter, we believe that VE Wilson’s opinions are substantial evidence and that applicant has successfully rebutted the PDRS. Wilson completed a full assessment, took a detailed history, and provided evidence and reasoning in support of her conclusions.