ADJ9195893 · April 1, 2026

From the decision · page 1Both applicant and defendant seek reconsideration of the Findings & Award (F&A) issued on October 21, 2022, by the workers' compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that applicant, while employed as a plumber on April 23, 2012, sustained industrial injury to his back, right foot and psyche resulting in 100% permanent disability.

Applicant sustained industrial injury on April 23, 2012 causing permanent disability to back, right foot, and psyche.

Favours Applicant prevailed

This injury and resulting conditions form the basis for the permanent disability award.

From the decision · page 1Both applicant and defendant seek reconsideration of the Findings & Award (F&A) issued on October 21, 2022, by the workers' compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that applicant, while employed as a plumber on April 23, 2012, sustained industrial injury to his back, right foot and psyche resulting in 100% permanent disability.

PQME Dr. Lane's orthopedic assessment and PQME Dr. Mednitsky's psychiatric diagnosis support 100% industrial cause of disability.

Favours Applicant prevailed

Their medical opinions provide substantial evidence for the extent and cause of disability.

From the decision · page 2In his report dated September 17, 2015, PQME Dr. Lane, after evaluating applicant, took a history that applicant sustained a work-related low back injury on April 23, 2012 while employed by RotoRooter as a plumber when he lifted a snake machine weighing over 100 pounds and immediately experienced back pain. He initially treated with Frederick Arbenz, M.D., who diagnosed a sacroiliac joint and lumbosacral sprain. An MRI dated May 26, 2012 by Donald Wade, M.D., showed a broad-based disc protrusion at L3-4 with mild central canal stenosis and moderate lateral recess stenosis and a broad-based disc bulge at L4-5. Travis Calvin, M.D., took over treatment for applicant, provided him electrodiagnostic testing, and, ultimately, a two-level decompression and fusion at L3-4 and L4-5 on January 28, 2013. The surgery led to a poor outcome and he continued to require substantial medication. (Def. Ex. A, p. 2.)

Favours Applicant prevailed

This vocational opinion bridges medical restrictions and labor market realities, supporting total disability.

Applicant's permanent disability indemnity payments shall commence on February 27, 2014, amended from the original award date.

Favours Applicant prevailed

This amendment affects the timing of benefits payments but not the extent of disability.

From the decision · page 2We have considered the allegations in the Petitions and the contents of the WCJ's Report with respect thereto. Based on our review of the record and the reasons discussed below, as our Decision After Reconsideration, we amend the F&A to reflect that permanent disability begins on February 27, 2014 (Finding of Fact 2). We otherwise affirm the F&A.

42% WPI orthopedic assessment supported by detailed history of industrial injury and objective findings.

Predicated on accurate histories, objective clinical findings, and correct application of AMA Guides, supporting 100% industrial cause of disability.

From the decision · page 2In his report dated September 17, 2015, PQME Dr. Lane, after evaluating applicant, took a history that applicant sustained a work-related low back injury on April 23, 2012 while employed by RotoRooter as a plumber when he lifted a snake machine weighing over 100 pounds and immediately experienced back pain. He initially treated with Frederick Arbenz, M.D., who diagnosed a sacroiliac joint and lumbosacral sprain. An MRI dated May 26, 2012 by Donald Wade, M.D., showed a broad-based disc protrusion at L3-4 with mild central canal stenosis and moderate lateral recess stenosis and a broad-based disc bulge at L4-5. Travis Calvin, M.D., took over treatment for applicant, provided him electrodiagnostic testing, and, ultimately, a two-level decompression and fusion at L3-4 and L4-5 on January 28, 2013. The surgery led to a poor outcome and he continued to require substantial medication. (Def. Ex. A, p. 2.)

Diagnosed Pain Disorder and Major Depressive Disorder; found 15% apportionment to nonindustrial causes but overall 100% industrial disability.

Her psychiatric diagnosis and apportionment opinion were considered but the vocational expert found the orthopedic and pain impairments alone caused total disability, making psychological apportionment moot.

From the decision · page 4In her report dated May 25, 2018, PQME Dr. Mednitsky, after evaluating applicant, took a history that, despite conservative treatment and a subsequent lumbar laminotomy and fusion surgery, applicant developed "failed back syndrome" with chronic, severe pain radiating down his right leg. (App. Ex. 3, pp. 3-4.) Consequently, he has become highly reliant on opiate medications, including Percocet and Oxycodone. (Id. at p. 5.) An exacerbation of his pain led to a profound psychological decompensation, resulting in a suicide attempt wherein he lacerating his wrist and subsequently received a 72-hour involuntary psychiatric hold. (Id. at pp. 4-5.) PQME Dr. Mednitsky diagnosed him with a Pain Disorder and Major Depressive Disorder (Severe without Psychotic Features), and noted that applicant suffers from feelings of hopelessness, severe anxiety, and panic attacks. (Id. at p. 24.)

Opined applicant is permanently totally disabled vocationally due to combined orthopedic and psychological impairments, supported by objective vocational testing.

Provided a well-reasoned bridge between medical restrictions and labor market realities, supporting 100% loss of earning capacity due to industrial injury.

Lab. Code, § 4650(b)(1); Brower v. David Jones Construction (2014) 79 Cal.Comp.Cases 550 (Appeals Board en banc)

Permanent disability indemnity payments must commence 14 days after last temporary disability payment, or retroactively if permanent disability is later determined.

Applied to amend the start date for permanent disability payments to February 27, 2014.

Lab. Code, §§ 4663(a), 4664(a); Brodie v. Workers' Comp. Appeals Bd.; Escobedo v. Marshalls; Nunes I (2023)

Apportionment of permanent disability must be based on causation and supported by substantial evidence explaining how and why other factors cause disability.

Applied to evaluate and reject nonindustrial apportionment in this case.

From the decision · page 11II. APPORTIONMENT Apportionment is the process utilized to segregate permanent disability or the residuals caused by an industrial injury from those attributable to other industrial injuries or to nonindustrial factors, to allocate legal responsibility fairly. (Brodie, supra, 40 Cal.4th at p. 1321; Marsh v. Workers'Comp. Appeals Bd. (2005) 130 Cal.App.4th 906, 911 [70 Cal.Comp.Cases 787.].) The mere fact that a medical report assigns approximate percentages of industrial and nonindustrial causation does not make the report reliable medical evidence by itself. (E.L. Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 927-928 [71Cal.Comp.Cases 1687].) Instead, apportionment of permanent disability is "based on causation" and the "employer shall only be liable for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of employment." (Lab.Code, § 4663(a) and 4664(a).) "The plain reading of `causation' in this context is causation of the permanent disability." (Escobedo v.

Applicant's significant limitations with basic activities of daily living and extremely limited physical and mental tolerances/stamina documented in medical file and vocational testing.

From the decision · page 6[A]bsent the industrial low back injury resulting in a diagnosis of "Failed Back Syndrome" and residual and incapacitating chronic pain disorder, despite adherence to heavy narcotic medication regimen and use of a cane for ambulation, the applicant now has significant limitations with basic activities of daily living, in addition to extremely limited physical and mental tolerances/stamina as documented in the medical file and observed during the 3 separate days of vocational testing; it can be concluded by all reasonable vocational assessment. the applicant would have been able to continue to carry out his job duties without incident and/or significant impact to his pre-injury earning capacity absent the industrial injury of 04/23/2012 and residual chronic pain disorder and heavy narcotic medication intake, despite his family related difficulties which resulted in a 15% apportionment of his overall psych impairment to nonindustrial causes per QME in Psychology, Dr. Mednitsky (05/23/2020).

Objective observations from three separate days of vocational testing showing inability to sustain sitting tolerances or cognitive persistence for sedentary work.