The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
QMEPartially credited
Dr. Lewis diagnosed thoracic outlet syndrome (TOS) and related conditions but deferred impairment rating to Dr. Newkirk, acknowledging his own analysis was outdated and incomplete.
Dr. Lewis's reports were considered but found incomplete and outdated; he deferred to Dr. Newkirk for impairment rating.
From the decision · page 8to the findings on which the award is based.
Petitioners assert that the opinions set forth by the QME, Dr. Lewis, do not rise to the level
of substantial medical evidence. They further allege that Dr. Lewis violated Labor Code section
4628 and Regulation 32 (Cal. Code Regs., tit. 8, § 32) when he deferred to Dr. Newkirk with
respect to TOS-related impairment. While neither the statute nor the regulation appear to actually
apply here, it is true that Dr. Lewis did not produce an impairment opinion that can be considered
substantial evidence. The analysis in his 2018 report in exhibit 2 is outdated and incomplete in
light of subsequent medical developments. In later reporting and testimony, he opted to rely on
Dr. Newkirk's analysis in lieu of his own in a way that cannot be characterized as substantial.
Petitioners' ultimate contention is flawed, however, in that the record does include
substantial medical evidence on the issue of impairment (the reports of Dr.
PTPRelied upon
Dr. Newkirk diagnosed neurovascular compression syndrome and found the applicant permanently totally disabled with work restrictions precluding return to work.
Dr. Newkirk's opinions were credited as persuasive and unrebutted, supporting permanent total disability.
From the decision · page 24Having carefully analyzed the evidence, I conclude that applicant met her burden of proof
with respect to permanent total disability arising from the industrial injury herein. Dr. Newkirk's
findings and opinions are not only unequivocal with regard to her symptoms and limitations, they
are also unrebutted, given Dr. Lewis's complete abdication of his reporting responsibilities in favor
of deferring to the PTP. And while a physician's opinion regarding someone's lack of employment
prospects cannot, in most instances, form the only basis for a finding of total disability absent a
concordant scheduled rating, Dr. Newkirk's opinions are persuasive, easy to follow, and consistent
with the reporting of Dr. Avery and, to a large extent, Dr. Lewis as well.
otherRelied upon · ENT specialist
Dr. Carrigg found tinnitus industrially caused by thoracic outlet syndrome, supporting compensability of hearing issues.
Dr. Carrigg's opinion supported compensability of tinnitus as industrial.
From the decision · page 73. Trial decisions.
After carefully considering the entire record, I concluded that applicant met her burden of
proof with respect to injury to her nervous and circulatory systems, consisting of Dr. Newkirk's
reports which describe her condition as a "neurovascular compression syndrome." As mentioned
above, I specifically excluded from this finding applicant's alleged cardiac arrhythmias. Likewise,
I found sufficient support in Dr. Newkirk's reporting to deem applicant's legs and face
compensable. And, on the basis of Dr. Carrigg's opinion in exhibit 13, I concluded that applicant's
tinnitus arises from her industrially caused TOS and is therefore itself industrial. On the other
hand, I found no compensable injury to the brain.
Turning to the appropriate level of permanent disability, I was persuaded by the opinions
of Dr. Newkirk and Ms.