What the panel ordered
Petition for Reconsideration denied.
Petition for Reconsideration filed by Defendant challenging the denial of apportionment; WCJ report recommending denial of reconsideration; WCAB panel decision denying the petition.
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.
The WCJ and WCAB found that the medical opinion of Dr. Renbaum on apportionment was not substantial medical evidence because it lacked detailed reasoning and explanation required by law, thus denying apportionment and awarding permanent disability without apportionment.
From the decision · page 2We now turn to the merits. The defendant has the burden of proof on apportionment. (Lab. Code, § 5705; Pullman Kellogg v. Workers Comp. Appeals Bd. (Normand) (1980) 26 Cal.3d 450, 456 [45 Cal.Comp.Cases 170]; Kopping v. Workers' Comp. Appeals Bd. (Kopping) (2006) 142 Cal.App.4th 1099, 1115 [71 Cal.Comp.Cases 1229]; Escobedo v. Marshalls (Escobedo) (2005) 70 Cal.Comp.Cases 604, 613 (Appeals Board en banc).) To meet this burden, the defendant "must demonstrate that, based upon reasonable medical probability, there is a legal basis for apportionment." (Gay v. Workers' Comp. Appeals Bd. (Gay) (1979) 96 Cal.App.3d 555, 564 [44 Cal.Comp.Cases 817]; see also Escobedo, supra, at p. 620.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Renbaum's apportionment opinion failed to provide detailed reasoning or explanation as required by law.
Favours Applicant prevailed
This failure meant the opinion was not substantial medical evidence to support apportionment, leading to denial of apportionment and awarding permanent disability without apportionment.
From the decision · page 3For the reasons stated in the Report, we agree with the WCJ that the opinion of agreed medical evaluator (AME) Joel Renbaum, M.D., is not substantial medical evidence that supports a finding of apportionment. (Hegglin v. Workers' Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93]; Place v. Workmen's Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372, 378-379 [35 Cal.Comp.Cases 525]; Escobedo, supra, 70 Cal.Comp.Cases at p. 621 [a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions].) In order to consist of substantial medical evidence on the issue of apportionment, a medical opinion
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.
Dr. Renbaum opined apportionment of 10% to degenerative changes and 90% to industrial injury but failed to provide adequate reasoning or explanation, and later increased apportionment to 20% without sufficient support, which was found not to be substantial medical evidence.
The opinion lacked detailed explanation and reasoning as required by Escobedo and related case law, making it insufficient to support apportionment.
From the decision · page 3For the reasons stated in the Report, we agree with the WCJ that the opinion of agreed medical evaluator (AME) Joel Renbaum, M.D., is not substantial medical evidence that supports a finding of apportionment. (Hegglin v. Workers' Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93]; Place v. Workmen's Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372, 378-379 [35 Cal.Comp.Cases 525]; Escobedo, supra, 70 Cal.Comp.Cases at p. 621 [a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions].) In order to consist of substantial medical evidence on the issue of apportionment, a medical opinion
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 5705; Pullman Kellogg v. Workers Comp. Appeals Bd. (Normand) (1980) 26 Cal.3d 450, 456; Kopping v. Workers' Comp. Appeals Bd. (Kopping) (2006) 142 Cal.App.4th 1099, 1115; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 613 (Appeals Board en banc)
The defendant has the burden of proof on apportionment and must demonstrate a legal basis based on reasonable medical probability.
The WCJ and WCAB applied this standard to evaluate the sufficiency of Dr. Renbaum's apportionment opinion and found it lacking.
From the decision · page 2We now turn to the merits. The defendant has the burden of proof on apportionment. (Lab. Code, § 5705; Pullman Kellogg v. Workers Comp. Appeals Bd. (Normand) (1980) 26 Cal.3d 450, 456 [45 Cal.Comp.Cases 170]; Kopping v. Workers' Comp. Appeals Bd. (Kopping) (2006) 142 Cal.App.4th 1099, 1115 [71 Cal.Comp.Cases 1229]; Escobedo v. Marshalls (Escobedo) (2005) 70 Cal.Comp.Cases 604, 613 (Appeals Board en banc).) To meet this burden, the defendant "must demonstrate that, based upon reasonable medical probability, there is a legal basis for apportionment." (Gay v. Workers' Comp. Appeals Bd. (Gay) (1979) 96 Cal.App.3d 555, 564 [44 Cal.Comp.Cases 817]; see also Escobedo, supra, at p. 620.)
What proof carried it
The evidence the panel weighed, by kind.
Dr. Renbaum's apportionment opinion lacked detailed reasoning and explanation, failing to meet the standard for substantial medical evidence.
From the decision · page 3For the reasons stated in the Report, we agree with the WCJ that the opinion of agreed medical evaluator (AME) Joel Renbaum, M.D., is not substantial medical evidence that supports a finding of apportionment. (Hegglin v. Workers' Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93]; Place v. Workmen's Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372, 378-379 [35 Cal.Comp.Cases 525]; Escobedo, supra, 70 Cal.Comp.Cases at p. 621 [a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions].) In order to consist of substantial medical evidence on the issue of apportionment, a medical opinion
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
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