ADJ10618904 — California WCAB decision

What the panel ordered

Petition for Reconsideration denied.

Applicant, represented by counsel but filing pro per, petitioned for reconsideration of a WCJ's Findings and Award dated June 15, 2023, which found admitted industrial injury to some body parts, denied others, and awarded 48% permanent disability and further medical treatment.

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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.

AOE/COEDefendant prevailedtrunk · teeth · hypertension

The WCJ found admitted injury to head, neck, and back, but no evidence supported injury to trunk, teeth, or hypertension; applicant pointed to no evidence for teeth/gum injury.

From the decision · page 1Applicant, who has filed his own Petition for Reconsideration although he is represented by counsel, seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Award of June 15, 2023, wherein it was found that, while employed on August 11, 2016 as a security guard, applicant sustained admitted industrial injury to his head, neck and back, but did not sustain industrial injury to his trunk, teeth and in the form of hypertension. It was found that applicant's injury caused permanent disability of 48% and the need for further medical treatment.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Applicant pointed to no evidence in the record or outside the record that teeth or gums were injured arising out of employment; Dr. Opoku's diagnoses did not list any teeth or gum condition.

Favours Defendant prevailed

No evidence supported compensability for teeth/gum injury, so the WCJ's finding of noncompensability was upheld.

From the decision · page 2With regard to injury to the teeth and gums, which the WCJ found noncompensable, applicant points to no evidence in the record (or even outside the record) that these body parts were injured arising out of and in the course of applicant's employment. Even the page attached to applicant's Petition listing diagnoses found by applicant's prior treating physician Edward Opoku, M.D. on February 13, 2018, does not list any teeth or gum condition.

The only evidence in the record for permanent disability was the reporting of panel QMEs Dr. Moore and Dr. Watkin, which the WCJ relied on.

Favours Defendant prevailed

Applicant did not show why this evidence was insufficient or why the record should be further developed, so the permanent disability rating was upheld.

From the decision · page 2A "decision [of the WCAB] must be based on admitted evidence in the record." Hamilton v. Lockheed Corp. (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Board en banc). To the extent that applicant is arguing that the permanent disability awarded to him is insufficient, he must point to evidence in the record, or attach new evidence to his Petition for Reconsideration (Cal. Lab. Code, § 5903, subd. (d)) supporting a higher permanent disability rating. The only evidence in the record was the reporting of panel qualified medical evaluators neurologist Robert Moore, M.D. and orthopedist George Watkin, M.D. It appears that the WCJ relied on this evidence and applicant has not articulated a basis why this evidence was insufficient, or why the record should be further developed.

What the panel did with the medical opinions

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.

QMERelied upon · neurology

Panel QME reporting was relied upon by the WCJ for permanent disability rating; applicant did not show why this evidence was insufficient.

The only evidence in the record was the reporting of panel QMEs Dr. Moore and Dr. Watkin, which the WCJ relied on.

From the decision · page 2A "decision [of the WCAB] must be based on admitted evidence in the record." Hamilton v. Lockheed Corp. (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Board en banc). To the extent that applicant is arguing that the permanent disability awarded to him is insufficient, he must point to evidence in the record, or attach new evidence to his Petition for Reconsideration (Cal. Lab. Code, § 5903, subd. (d)) supporting a higher permanent disability rating. The only evidence in the record was the reporting of panel qualified medical evaluators neurologist Robert Moore, M.D. and orthopedist George Watkin, M.D. It appears that the WCJ relied on this evidence and applicant has not articulated a basis why this evidence was insufficient, or why the record should be further developed.

QMERelied upon · orthopedics

Panel QME reporting was relied upon by the WCJ for permanent disability rating; applicant did not show why this evidence was insufficient.

The only evidence in the record was the reporting of panel QMEs Dr. Moore and Dr. Watkin, which the WCJ relied on.

From the decision · page 2A "decision [of the WCAB] must be based on admitted evidence in the record." Hamilton v. Lockheed Corp. (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Board en banc). To the extent that applicant is arguing that the permanent disability awarded to him is insufficient, he must point to evidence in the record, or attach new evidence to his Petition for Reconsideration (Cal. Lab. Code, § 5903, subd. (d)) supporting a higher permanent disability rating. The only evidence in the record was the reporting of panel qualified medical evaluators neurologist Robert Moore, M.D. and orthopedist George Watkin, M.D. It appears that the WCJ relied on this evidence and applicant has not articulated a basis why this evidence was insufficient, or why the record should be further developed.

PTPRelied upon

Dr. Opoku's diagnoses as of February 13, 2018, did not list any teeth or gum condition.

The page attached to applicant's Petition listing diagnoses by Dr. Opoku did not list any teeth or gum condition.

From the decision · page 2With regard to injury to the teeth and gums, which the WCJ found noncompensable, applicant points to no evidence in the record (or even outside the record) that these body parts were injured arising out of and in the course of applicant's employment. Even the page attached to applicant's Petition listing diagnoses found by applicant's prior treating physician Edward Opoku, M.D. on February 13, 2018, does not list any teeth or gum condition.

ADJ10618904 · October 31, 2023

What the panel ordered

What was disputed, and how it came out

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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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