California WCABDecision and order

ADJ9649059 · April 13, 2021

RESCINDED and RETURNED to the WCJ to conduct further proceedings consistent with this opinion, and to issue a new decision from which any aggrieved person may timely seek reconsideration

Issues decided: 2
Medical opinions weighed: 2
Authorities named: 2
District office: San Luis Obispo

What the panel ordered

RESCINDED and RETURNED to the WCJ to conduct further proceedings consistent with this opinion, and to issue a new decision from which any aggrieved person may timely seek reconsiderationp. 6

Defendant seeks reconsideration of the Findings and Award issued by the WCJ on February 5, 2020

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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 ratingRemandedright shoulder

Dr. Ovadia provided a strict rating and an alternative rating but did not explain why the strict rating was not accurate nor why the alternative rating more accurately reflects applicant’s level of disability

From the decision · page 4Ovadia provided a strict rating of applicant’s right shoulder and an alternative rating, he did not explain why the strict rating was not accurate nor why the alternative rating more accurately reflects applicant’s level of disability. Absent an explanation as to the rating issues as noted, Dr. Ovadia’s August 30, 2019 report (Exh.

Apportionment

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The rules the panel named

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

Milpitas Unified School Dist. v. Workers' Compensation Appeals Board

To properly rate an injured worker's disability by applying an Almaraz/Guzman analysis, the doctor is expected to 1) provide a strict rating per the AMA Guides, 2) explain why the strict rating does not accurately reflect the applicant's disability, 3) provide an alternative rating using the four corners of the AMA Guides, and 4) explain why that alternative rating more accurately describes the applicant's level of disability

From the decision · page 4To properly rate an injured worker’s disability by applying an Almaraz/Guzman analysis, the doctor is expected to 1) provide a strict rating per the AMA Guides, 2) explain why the strict rating does not accurately reflect the applicant’s disability, 3) provide an alternative rating using the four corners of the AMA Guides, and 4) explain why that

In order to constitute substantial evidence as to the issue of apportionment, the physician must explain the nature of the other factors, how and why those factors are causing permanent disability at the time of the evaluation, and how and why those factors are responsible for the percentage of disability assigned by the physician

Dr. Ovadia did not explain how he was able to apportion applicant's permanent disability when the level of that disability had yet to be determined, nor how and why the underlying glenohumeral arthritis caused disability at the time of the evaluation

From the decision · page 4In order to constitute substantial evidence as to the issue of apportionment, the physician must explain the nature of the other factors, how and why those factors are causing permanent disability at the time of the evaluation, and how and why those factors are responsible for the percentage of disability assigned by the physician. ( Escobedo v.

ADJ9649059 · April 13, 2021

What the panel ordered

What was disputed, and how it came out

Your case already resembles someone else’s. Find whose.

The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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