ADJ11554890 — California WCAB decision

What the panel ordered

Petition for Reconsideration denied; Second Findings and Award affirmed.

Petition for Reconsideration filed by Subsequent Injuries Benefits Trust Fund (SIBTF) seeking review of the April 7, 2022 Second Findings and Award; WCJ issued a Report and Recommendation to deny the petition; WCAB panel decision issued denying reconsideration.

Read the official decision →

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.

Permanent disability ratingApplicant prevailedleft shoulder

The WCJ found that the applicant had a pre-existing left shoulder disability supported by substantial medical evidence including a long history of complaints, diagnostic testing, and medical diagnoses, despite the PQME's opinion of full range of motion. The 3% disability rating by Dr. Chen was found reasonable and supported by objective evidence.

From the decision · page 4As discussed in detail in the Opinion on Decision, the primary dispute here is over existence of disability to the left shoulder and whether the determination of pre-existing disability to the left shoulder is substantial medical evidence.

Other disputed issue

The facts that decided it

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

Applicant had a long history of left shoulder complaints and diagnostic evidence including MRI showing tear and bursitis.

Favours Applicant prevailed

This objective medical evidence supported the finding of a pre-existing left shoulder disability despite the PQME's contrary opinion.

From the decision · page 4- 04/23/2007 office visit for left shoulder complaints since long time; - 04/23/2008 x-ray of left shoulder due to left shoulder pain; - 05/03/2008 MRI of left upper extremity joint; partial tear of the rotator

Dr. Chen's 3% disability rating for the left shoulder was based on multiple factors including weakness, pain, impingement, prior sprain, tenderness, and muscle spasms, not solely range of motion.

Favours Applicant prevailed

This supported the substantial medical evidence finding for pre-existing disability and justified the SIBTF benefits award.

From the decision · page 5Defendant stresses that Dr. Chen gave impairment to the left shoulder solely due to the range of motion measurements, and this is not accurate. Referring the page 14 of Dr. Chen's report, he indicates that there is left shoulder weakness, pain, impingement, and that there was a prior documented sprain of the left rotator capsule, plus he found tenderness and muscle spasms.

The overall disability from the subsequent injury met the 5% threshold for SIBTF benefits, even though the right shoulder impairment alone was 3%.

Favours Applicant prevailed

This satisfied the legal threshold for SIBTF benefits eligibility under Labor Code section 4751.

From the decision · page 6In other words, SIBTF's reading of the threshold requirements in Labor Code section 4751 is too restrictive. It is not required that the 5% be to the opposite and corresponding member, but rather than there be an opposite and corresponding member involved, with the overall disability from the subsequent injury resulting in at least 5% or more disability. Applicant has met those requirements here, as she has 3% disability to the right shoulder. It was not error to award SIBTF benefits.

ADJ11554890 · July 5, 2022

What the panel ordered

What was disputed, and how it came out

Your case already resembles someone else’s. Find whose.

The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

About this page