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 · Chiropractor
Dr. Stone diagnosed Complex Regional Pain Syndrome (CRPS) based on his own examinations, review of medical records, and consideration of the Budapest Criteria, rejecting the contrary opinion of Dr. Navani.
Dr. Stone's opinion was found to be substantial medical evidence and was relied upon by the WCJ and WCAB.
From the decision · page 1Defendant questions the substantiality of the CPRS diagnosis by treating physicians
Robert Aptekar, M.D., and Peter Abaci, M.D., in part, because there is "no evidence that any type
of physical examination took place." (Petition for Reconsideration, at p. 4:13-15.) However, the
summary of applicant's August 27, 2019 office visit with Dr. Aptekar, contained within the
September 23, 2019 report of panel qualified medical examiner (PQME) Robert Stone, D.C.,
specifically states, "The applicant was here for a follow up..." (Dr. Stone's 9/23/19 report, at
p. 2, Joint Exhibit 4, emphasis added.) Dr. Aptekar's August 13, 2020 report, as summarized in
Dr. Stone's March 8, 2021 report clearly describes a physical examination of applicant noting,
"The patient was seen for routine follow up.... Left wrist was tender to palpation. Motion was
limited. Rotation was painful. Grip strength was reduced...." (Dr. Stone's 3/8/21 report, at p. 18,
Joint Exhibit 1, emphasis added.) The same evidence of a physical examination is true of
Dr. Abaci's September 21, 2020 visit note, which was also summarized in Dr. Stone's March 8,
2021 report. The summary states:
PTPRelied upon
Dr. Aptekar diagnosed CRPS based on physical examinations showing tenderness, limited motion, pain, and reduced grip strength in the left wrist and hand.
His diagnosis was relied upon by Dr. Stone and the WCJ as substantial evidence.
From the decision · page 1Defendant questions the substantiality of the CPRS diagnosis by treating physicians
Robert Aptekar, M.D., and Peter Abaci, M.D., in part, because there is "no evidence that any type
of physical examination took place." (Petition for Reconsideration, at p. 4:13-15.) However, the
summary of applicant's August 27, 2019 office visit with Dr. Aptekar, contained within the
September 23, 2019 report of panel qualified medical examiner (PQME) Robert Stone, D.C.,
specifically states, "The applicant was here for a follow up..." (Dr. Stone's 9/23/19 report, at
p. 2, Joint Exhibit 4, emphasis added.) Dr. Aptekar's August 13, 2020 report, as summarized in
Dr. Stone's March 8, 2021 report clearly describes a physical examination of applicant noting,
"The patient was seen for routine follow up.... Left wrist was tender to palpation. Motion was
limited. Rotation was painful. Grip strength was reduced...." (Dr. Stone's 3/8/21 report, at p. 18,
Joint Exhibit 1, emphasis added.) The same evidence of a physical examination is true of
Dr. Abaci's September 21, 2020 visit note, which was also summarized in Dr. Stone's March 8,
2021 report. The summary states:
PTPRelied upon
Dr. Abaci diagnosed CRPS based on physical signs including atrophy, limited mobility, sensory testing abnormalities, and weakness in the left hand and wrist.
His diagnosis was relied upon by Dr. Stone and the WCJ as substantial evidence.
From the decision · page 1Defendant questions the substantiality of the CPRS diagnosis by treating physicians
Robert Aptekar, M.D., and Peter Abaci, M.D., in part, because there is "no evidence that any type
of physical examination took place." (Petition for Reconsideration, at p. 4:13-15.) However, the
summary of applicant's August 27, 2019 office visit with Dr. Aptekar, contained within the
September 23, 2019 report of panel qualified medical examiner (PQME) Robert Stone, D.C.,
specifically states, "The applicant was here for a follow up..." (Dr. Stone's 9/23/19 report, at
p. 2, Joint Exhibit 4, emphasis added.) Dr. Aptekar's August 13, 2020 report, as summarized in
Dr. Stone's March 8, 2021 report clearly describes a physical examination of applicant noting,
"The patient was seen for routine follow up.... Left wrist was tender to palpation. Motion was
limited. Rotation was painful. Grip strength was reduced...." (Dr. Stone's 3/8/21 report, at p. 18,
Joint Exhibit 1, emphasis added.) The same evidence of a physical examination is true of
Dr. Abaci's September 21, 2020 visit note, which was also summarized in Dr. Stone's March 8,
2021 report. The summary states:
otherRejected
Dr. Navani, a treatment consult, concluded no evidence of CRPS based on absence of skin, hair, nail changes, temperature or sweating abnormalities, allodynia, and hyperpathia at her examination.
Her opinion was considered and rejected by Dr. Stone and the WCJ as not substantial evidence due to lack of record review and expertise.
From the decision · page 4Applicant was examined by PQME Robert Stone, D.C., who issued several reports. There
was a dispute amongst the medical providers as to whether or not Applicant had developed CRPS.
PQME Stone requested and received a consult from Annu Navani, M.D., on this issue. Dr. Navani
concluded that Applicant did not have CRPS. PQME Stone considered Dr. Navani's opinion and
rejected it, ultimately agreeing with doctors Aptekar, Abaci, Kaisler- Meza and Cheng that
Applicant DID have CRPS.