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
Found previous partial permanent disability of lumbar spine, left ankle, and right hand based on extensive medical records and examination.
Report based on extensive medical records from 2002 to 2017 and examination; substantial medical evidence supporting previous permanent disability findings.
From the decision · page 13Pursuant to these authorities, we turn first to QME Dr. Boni's reporting that applicant had
preexisting permanent partial disability of (1) chronic back pain with radiculopathy resulting in
impairment of 12% WPI; (2) healed left tibia and fibula fractures, with ankle arthrodesis resulting
in impairment of 4% WPI; and (3) right hand numbness resulting in 7% WPI. (Report, p. 4.)
Notably, Dr. Boni's reporting as to applicant's back pain with radiculopathy and left tibia and
fibula fractures is based upon review of extensive medical records dating from 2002 until early
2017. (Ex. 8, QME report of Dr. Boni dated October 10, 2023, pp. 11-13.) These records reflect
that applicant underwent surgical intervention for left tibia and fibula fractures and x-rays, an MRI
scan, and referral for surgical consultation for lumbar pain and radiculopathy and thus provide
QMERejected · psychologist
Found 15% WPI cognitive impairment and 6% WPI psychiatric impairment but lacked adequate pre-injury medical records; opinion not substantial evidence.
Failed to identify pre-injury medical records indicating cognitive or psychiatric impairment; opinion not based on adequate history.
From the decision · page 14We turn next to Dr. Kirz's reporting that applicant has preexisting permanent partial
disability in the form of cognitive impairment of 15% WPI and psychiatric impairment of 6% WPI.
(Report, pp. 4-5.) In his report, however, Dr. Kirz fails to identify any medical records generated
before applicant's October 26, 2017 injury indicating that he had any signs or symptoms of any
cognitive or psychiatric impairment at any time within eight years of his subsequent injury. (Ex.
9, QME report of Dr. Kirz, October 25, 2023, pp. 11-12.) Thus, we agree with the WCJ that Dr.
Kirz's reporting is not based on adequate history and does not constitute substantial medical
evidence.
QMERejected · chiropractor
Reported preexisting disabilities but relied on applicant statements and chiropractic testing without adequate medical records; opinion not substantial evidence.
Relied on applicant statements and chiropractic testing without adequate pre-injury medical records; contrary to Dr. Boni's findings without explanation.
From the decision · page 15Here, the record shows that Dr. Ambrose relied upon applicant's statements made during
his August 25, 2023 examination and chiropractic testing performed during the exam--and not
any medical record generated before October 26, 2017 evidencing any preexisting permanent
disability of the cervical spine, thoracic spine, soft tissue lesion of the lumbar spine, or right knee.
(Ex. 11, QME report of Dr. Ambrose, December 15, 2023, pp. 1-37; Report, pp. 5-6.) It also offers
opinions contrary to those of Dr. Boni as to the permanent disability of the lumbar spine, right
upper extremity, and left ankle without setting forth reasons for doing so. (Ex. 11, QME report of
Dr. Ambrose, December 15, 2023, pp. 1-37; Ex. 8, QME report of Dr. Boni dated October 10,
2023, pp. 17-18, 20-21.) Thus, we agree with the WCJ that Dr. Ambrose's reporting does not
constitute substantial medical evidence.