ADJ9163216 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted; WCJ's decision amended to defer permanent disability and attorneys' fees for re-rating using Combined Values Chart.

Defendant sought reconsideration of the WCJ's Findings and Award of December 21, 2021, which found permanent total disability; WCJ filed a Report and Recommendation on Petition for Reconsideration.

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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.

Permanent disability ratingRemandedarms · hands · shoulders · neck · psyche · complex regional pain syndrome

The panel found the WCJ erred in adding psychiatric permanent disability to orthopedic and CRPS disabilities instead of combining them using the Combined Values Chart, deferring the permanent disability rating for re-rating.

From the decision · page 41. the applicant, while employed during on May 20, 2013 as a mechanic, occupational group number 460, at Lompoc, California by Sousa Tire Service, sustained injury arising out of and in the course of employment to his bilateral arms, hands, shoulders, neck, psych and CRPS.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

The rules the panel named

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

Athens Administrators v. Workers' Comp. Appeals Bd. (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.)

Use of the Combined Values Chart for permanent disability ratings unless substantial medical evidence supports adding impairments.

The panel applied Kite to reject adding psychiatric impairment to orthopedic impairment without substantial medical evidence.

From the decision · page 3In Athens Administrators v. Workers' Comp. Appeals Bd. (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.), we held that adding, rather than combining, two different impairments better reflected a worker's impairment when substantial medical evidence supported the notion that the two impairments had a synergistic effect where, in effect, the resultant impairment was more than the sum of the two impairments. In Kite, the evaluator explained why the disparate impairments were not actually disparate, and the impairments in question were all under the physician's expertise. In contrast, here one specialist is suggesting that we add impairments found by her in her own specialty to impairments in completely different body systems found by a different specialists. Dr. Fowkes-Muto incorporated Dr.

Applied Materials v. Workers' Comp. Appeals Bd. (D.C.) (2021) 64 Cal.App.5th 1042, 1097 [86 Cal.Comp.Cases 331]

Physicians may only make disability determinations within their own specialty.

The panel applied this standard to reject Dr. Fowkes-Muto's opinion to add impairments across specialties.

From the decision · page 3Mendelson's GAF score and does not explain how this GAF score does not adequately reflect the applicant's psychiatric permanent impairment. Dr.Fowkes-Muto did not give any compelling reason why these separate impairments should be added, and questions beyond applicant's psychological impairment are beyond Dr. Fowkes- Muto's expertise. (Applied Materials v. Workers' Comp. Appeals Bd. (D.C.) (2021) 64 Cal.App.5th 1042, 1097 [86 Cal.Comp.Cases 331].) Dr. Fowkes-Muto did not explain how the GAF score of 58, combined to whole person impairment, adjusted into a permanent disability rating, and combined with the other permanent disability ratings was inadequate.

ADJ9163216 · March 14, 2022

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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What the panel did with the medical opinions

The rules the panel named

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