Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 4660; Ogilvie v. Workers' Comp. Appeals Bd. (2011) 197 Cal.App.4th 1262
Permanent Disability Rating Schedule (PDRS) is prima facie evidence of permanent disability; combination of disabilities generally uses Combined Values Chart (CVC) but can be rebutted by reasoned medical opinion within AMA Guides.
Applied to assess combination vs. addition of disabilities.
From the decision · page 4We first address defendant's contentions that the WCJ erred in adding rather than
combining applicant's disabilities herein. The Permanent Disability Rating Schedule (PDRS) is
prima facie evidence of an injured employee's permanent disability. (Lab. Code, § 4660; cf.
Ogilvie v. Workers' Comp. Appeals Bd. (2011) 197 Cal.App.4th 1262, 1274§ 1277 [76
Cal.Comp.Cases 624] (Ogilvie).) The PDRS provides that the ratings for multiple body parts
arising out of the same injury are "generally" combined using the Combined Values Chart (CVC),
which is appended to the PDRS. (2005 PDRS, at p. 1-10.) Yet, because it is part of the PDRS, the
CVC is rebuttable and a reporting physician is not precluded from utilizing a method other than
the CVC to determine an employee's whole person impairment so long as the physician's opinion
remains within the four comers of the AMA Guides. (Lab. Code, § 4660; Milpitas Unified School
Dist. v. Workers' Comp. Appeals Bd. (Guzman) (2010) 187 Cal.App.4th 808, 818§ 829 [75
Cal.Comp.Cases 837].)
Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc)
Medical opinion must be framed in reasonable medical probability, not speculative, based on pertinent facts and adequate examination, with reasoning supporting conclusions.
Applied to evaluate validity of additive approach medical opinions.
From the decision · page 7We cannot emphasize enough that to constitute substantial evidence "...a
medical opinion must be framed in terms of reasonable medical probability, it
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, 621
(Appeals Board en banc), (emphasis added).) The term `synergy' is not a "magic
word" that immediately rebuts the use of the CVC. Instead, a physician must set
forth a reasoned analysis explaining how and why synergistic ADL overlap
exists. If parties are searching for a magic word to use during a doctor's
deposition, that word is "Why?". Rather than focusing on whether a specific
term, including the term synergy, was used, it is imperative that parties focus on
an analysis that applies critical thinking based on the principles articulated in
Escobedo to support a conclusion based on the facts of the case. Such an analysis
must include a detailed description of the impact of ADLs and how those ADLs
interact.
Nunes v. State of California, Dept. of Motor Vehicles (2023) 88 Cal.Comp.Cases 741 (Appeals Board en banc)
Vocational evidence may rebut PDRS but cannot substitute for valid medical apportionment; 'vocational apportionment' is invalid under Labor Code section 4663.
Applied to reject vocational expert's apportionment theory as invalid.
From the decision · page 9However, following our grant of reconsideration in this matter, we addressed the required
analysis of apportionment in the context of vocational expert reporting in Nunes v. State of
California, Dept. of Motor Vehicles (2023) 88 Cal.Comp.Cases 741 [2023 Cal. Wrk. Comp.
LEXIS 30I] (Appeals Board en banc) (Nunes). Therein, we held that Labor Code2 section 4663
requires a reporting physician to make an apportionment determination and prescribes the standard
for apportionment, but that the Labor Code makes no statutory provision for "vocational