What the panel ordered
Defendant's Petition for Reconsideration of the October 27, 2025 Findings and Award is denied.
Defendant filed a timely Petition for Reconsideration of the October 27, 2025 Findings and Award by the WCJ, which found injury arising out of employment to applicant's left knee and right hip, and industrial hypertension, but deferred finding on heart and internal organs injury. The WCJ had previously issued a stipulated award on October 31, 2022 for 33% permanent disability to left knee and right hip only.
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 found new and further disability of the left knee and hypertension based on substantial medical evidence, including unrebutted opinions of PQME Dr. Mahmoudi and Dr. Sclafani, and concluded the stipulated award was properly reopened under section 5410 and 5803.
From the decision · page 12Internal medicine PQME Dr. Mahmoudi also provides a substantial opinion regarding the worsening of applicant's hypertension. As noted in the WCJ's Report, Dr. Mahmoudi opined that applicant has industrial hypertension due to deconditioning and the cumulative effects of his injury. (See Applicant's Exhibit 4, Deposition of Dr. Mahmoudi, p. 8, lines 3-12). He felt that applicant had an increase in hypertension from stage 1 to stage 2 and that increase is industrial, especially given applicant's use of NSAIDs. (Id. at p. 9, lines 17-25). He confirmed that all the prior blood pressure measurements that he is using to find causations for the hypertension predate the stipulated award of October 31, 2022. (Id. at p. 16, lines 21-25). He also testified that applicant's first class 2 diagnosis for hypertension was on April 14, 2021. (Id. at p. 35, lines 6-16). The QME reaffirmed that he felt this was industrial due to the NSAIDs, weight gain, and total knee replacement, especially since NSAIDs can increase blood pressure. (Id. at pp.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Unrebutted medical expert opinions of Dr. Mahmoudi and Dr. Sclafani found new and further disability of left knee and hypertension.
Favours Applicant prevailed
These opinions constituted substantial medical evidence supporting reopening of the stipulated award and additional benefits.
From the decision · page 12Internal medicine PQME Dr. Mahmoudi also provides a substantial opinion regarding the worsening of applicant's hypertension. As noted in the WCJ's Report, Dr. Mahmoudi opined that applicant has industrial hypertension due to deconditioning and the cumulative effects of his injury. (See Applicant's Exhibit 4, Deposition of Dr. Mahmoudi, p. 8, lines 3-12). He felt that applicant had an increase in hypertension from stage 1 to stage 2 and that increase is industrial, especially given applicant's use of NSAIDs. (Id. at p. 9, lines 17-25). He confirmed that all the prior blood pressure measurements that he is using to find causations for the hypertension predate the stipulated award of October 31, 2022. (Id. at p. 16, lines 21-25). He also testified that applicant's first class 2 diagnosis for hypertension was on April 14, 2021. (Id. at p. 35, lines 6-16). The QME reaffirmed that he felt this was industrial due to the NSAIDs, weight gain, and total knee replacement, especially since NSAIDs can increase blood pressure. (Id. at pp.
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.
Found industrial hypertension due to deconditioning and cumulative effects of injury, with increase from stage 1 to stage 2 hypertension, related to NSAID use and weight gain.
Based on medical records, examination, and deposition testimony.
From the decision · page 3Massoud Mahmoudi, M.D., evaluated applicant as a PQME in the specialty of internal
Found injury AOE/COE to left knee and right hip with 33% permanent disability in 2022. Later found new and further disability of left knee including compensable consequence fall in 2023.
Based on examination before and after stipulated award and medical records.
From the decision · page 2On October 27, 2022, the parties executed Stipulations with Request for Award (Stipulations) in which they stipulated that on February 20, 2018, applicant sustained injury AOE/COE to the "left knee and right hip only" with 33% permanent disability. On October 31, 2022 the Stipulations were approved in an Award issued by a WCJ. The Stipulations state that settlement is based on the opinions of Panel Qualified Medical Evaluator (PQME) Joseph A. Sclafani, M.D. (Stipulations 9/21/2022, p. 7, para. 9.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
California Labor Code section 5410
Petition to reopen for new and further disability under Labor Code section 5410
The stipulated award was timely reopened because applicant alleged new and further disability and instituted further proceedings within five years of injury.
From the decision · page 10Under the provisions of section 5410, the October 31, 2022 stipulated award has been timely reopened because applicant has alleged new and further disability and instituted further proceedings to attempt to prove and collect additional compensation in the form of additional medical care, additional temporary disability if any within five years of the date of injury that does not exceed the limits of section 4656,6 and permanent disability. It therefore has no finality until a future amended award is issued to fully address the extent of any new and further disability.
California Labor Code section 5803
Good cause for reopening under Labor Code section 5803
New evidence showing significant worsening after stipulated award constituted good cause to reopen the award.
From the decision · page 12The appeals board has continuing jurisdiction over all its orders, decisions, and awards made and entered under the provisions of this division, and the decisions and orders of the rehabilitation unit established under Section 139.5. At any time, upon notice and after an opportunity to be heard is given to the parties in interest, the appeals board may rescind, alter, or amend any order, decision, or award, good cause appearing therefor.
What proof carried it
The evidence the panel weighed, by kind.
Unrebutted medical expert opinions of Dr. Mahmoudi and Dr. Sclafani
From the decision · page 12Internal medicine PQME Dr. Mahmoudi also provides a substantial opinion regarding the worsening of applicant's hypertension. As noted in the WCJ's Report, Dr. Mahmoudi opined that applicant has industrial hypertension due to deconditioning and the cumulative effects of his injury. (See Applicant's Exhibit 4, Deposition of Dr. Mahmoudi, p. 8, lines 3-12). He felt that applicant had an increase in hypertension from stage 1 to stage 2 and that increase is industrial, especially given applicant's use of NSAIDs. (Id. at p. 9, lines 17-25). He confirmed that all the prior blood pressure measurements that he is using to find causations for the hypertension predate the stipulated award of October 31, 2022. (Id. at p. 16, lines 21-25). He also testified that applicant's first class 2 diagnosis for hypertension was on April 14, 2021. (Id. at p. 35, lines 6-16). The QME reaffirmed that he felt this was industrial due to the NSAIDs, weight gain, and total knee replacement, especially since NSAIDs can increase blood pressure. (Id. at pp.
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About this page
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