ADJ10175755 · June 2, 2026

Applicant failed to establish pre-existing partial permanent disability to the left shoulder prior to the subsequent industrial injury as required by Labor Code Section 4751 and relevant case law; medical evidence and testimony were insufficient and not corroborated.

From the decision · page 4III DISCUSSION Standard to qualify for SIBTF benefits under Labor Code § 4751 To be eligible for Subsequent Injuries Benefits Trust Fund (SIBTF) under Labor Code Section 4751, applicant must demonstrate that (1) he had pre-existing permanent partial disability; (2) the permanent disability from the subsequent industrial injury either (a) produces 35 percent disability or more or (b) 5 percent disability or more to an "opposite and corresponding member, (3) the combined pre-existing and subsequent permanent partial disability is greater than the subsequent permanent partial disability alone; and (4) the combined pre-existing and subsequent permanent partial disability is equal to 70 percent or more.

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.

Provided a med-legal report for the subsequent industrial injury claim evaluating back and right shoulder injury; did not document complaints or limitations to the left shoulder.

Dr. Newman was the primary treating physician for the subsequent industrial injury claim and his report did not include any complaints to the left upper extremity, which was relevant to the pre-existing disability issue.

From the decision · page 5Applicant's subsequent industrial injury was resolved based on Dr. Newman's med-legal report of 12/1/2016. Dr. Newman was applicant's treating physician for the subsequent industrial injury claim. Dr. Newman, in preparation for his med-legal report, conducted thorough evaluation of the applicant for his back and right shoulder injury. Dr. Newman's report included detailed history of all prior claims and complaints, supported by medical history. However, Dr. Newman's report did not include any complaints to the left upper extremity. At the time of this evaluation, applicant confirmed prior right hand injury as a child that resulted in 11 surgeries, 2011 prior 2011 industrial injury as well as 2014 prior industrial injury which he did not seek medical care.3 No complaints nor limitations to left shoulder was documented. Applicant did not report that he relied on his right upper extremity when working at Tesla to compensate for the alleged pre-existing left

Reported pre-existing left shoulder disability based solely on applicant's self-reporting without corroborating medical evidence; opinion found speculative and lacking foundation by the WCJ.

Dr. Chen's report was found speculative and not supported by sufficient evidence; relied solely on applicant's reporting and was internally inconsistent.

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.

Labor Code Section 4751

Eligibility requirements for SIBTF benefits under Labor Code Section 4751, including pre-existing permanent partial disability and thresholds for combined disability.

Applicant must demonstrate pre-existing disability meeting specific thresholds to qualify for SIBTF benefits.

From the decision · page 4III DISCUSSION Standard to qualify for SIBTF benefits under Labor Code § 4751 To be eligible for Subsequent Injuries Benefits Trust Fund (SIBTF) under Labor Code Section 4751, applicant must demonstrate that (1) he had pre-existing permanent partial disability; (2) the permanent disability from the subsequent industrial injury either (a) produces 35 percent disability or more or (b) 5 percent disability or more to an "opposite and corresponding member, (3) the combined pre-existing and subsequent permanent partial disability is greater than the subsequent permanent partial disability alone; and (4) the combined pre-existing and subsequent permanent partial disability is equal to 70 percent or more.

Applicant's testimony and his brother's testimony at trial regarding the 2011 left shoulder injury were unrebutted but insufficient to establish pre-existing partial disability without corroborating medical evidence.

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.