What the panel treated as outcome-determinative, and which side it favoured.
Lack of adequate medical history or sufficient evidence to support pre-existing partial permanent disability to the left shoulder prior to the subsequent industrial injury.
Favours Defendant prevailed
This failure meant applicant did not meet the threshold requirements for SIBTF benefits under Labor Code Section 4751.
From the decision · page 5In the present case, there simply was not adequate medical history nor sufficient evidence
to support pre-existing partial permanent disability to the left shoulder prior to applicant's
subsequent industrial injury to his right shoulder. There lacked any documented left shoulder
complaints or treatment to the left shoulder prior to his 2015 subsequent industrial injury.
Dr. Chen's medical-legal report was speculative and lacked foundation, relying solely on applicant's self-reporting without corroborating medical evidence.
Favours Defendant prevailed
The WCJ rejected this report as substantial evidence for pre-existing left shoulder disability, undermining applicant's claim.
From the decision · page 6Again, the undersigned did not find Dr. Chen's report to be substantial medical evidence
with respect to the pre-existing left shoulder disability. The undersigned found Dr. Chen's report
as to the pre-existing left shoulder disability to be speculative, not supported by factors or reasons
disclosed in the report, that his opinion lacked foundation. Dr. Chen relied solely on applicant's
reporting at the time of his evaluation and disregarded the absence of any left shoulder complaints
in any of the reports he reviewed. Also, Dr. Chen's report was internally inconsistent, not
supported by any sufficient evidence. It noted that applicant reported due to his pre-existing left
shoulder injury, he relied on his right shoulder to work at Tesla, and that 2015 subsequent right
shoulder injury worsened his pre-existing left shoulder condition. Again, nothing remotely close
to this was reported prior to his evaluation with Dr. Chen, which would have been relevant as to
causation and apportionment in the subsequent industrial claim.5 Per Dr. Chen's report, review of
Dr.
Applicant's unrebutted trial testimony about the left shoulder injury was insufficient without corroborating medical evidence to establish pre-existing partial disability.
Favours Defendant prevailed
Testimony alone did not meet the legal standard for establishing pre-existing disability under the relevant case law.
From the decision · page 7In the present case, while applicant and his brother's testimony at trial was unrebutted
regarding applicant's 2011 injury, testimony at trial alone was not sufficient to establish prior
partial disability to the left upper extremity. It is unrebutted that applicant fell from a tree while
vacationing in Mexico and hurt his left shoulder. Testimony was not sufficient to go beyond this
nor corroborated by any medical evidence. Unlike in Anzevnio where injured worker sought
physical therapy on and off for 15 years prior to his industrial injury, applicant testified he sought
a "bone setter" once in Mexico right after the fall. Unlike Anzevino, left shoulder complaint was
not documented nor mentioned anywhere prior to the SIBTF medical-legal evaluation within
applicant's extensive medical history. Applicant testified he had a hard time with the left shoulder
since the fall. Applicant did not testify as to any physical limitations or any disability. Testimonies
were insufficient to establish partial disability had it been industrially caused and were labor
disabling. Applicant's testimony could not be corroborated by any competent evidence.