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.
PTPRelied upon · orthopedic surgeon
Declared applicant permanent and stationary from the November 30, 2011 injury with 0% whole person impairment; described injury as contusion to right knee and mild injury to left knee; did not expect surgery.
From the decision · page 3On January 29, 2014, orthopedic surgeon Brian Solberg, M.D., who started treating
applicant on September 11, 2013, declared her permanent and stationary from the November 30,
2011 specific injury with 0% whole person impairment. (Joint Exh. A, report of panel qualified
medical evaluator (PQME) Brian D. Rothi, M.D., October 7, 2020, p. 5.) Dr. Solberg described
the injury as a contusion to her right knee and a "`very mild'" injury to her left knee. (Ibid.) Dr.
Solberg did not expect applicant to require any surgery resulting from her industrial injury. (Ibid.)
QMERelied upon · orthopedic surgeon
Opined that the November 30, 2011 injury aggravated pre-existing arthritis in right knee; left knee symptoms are compensable consequence; apportionment similar for both knees.
From the decision · page 8Having reviewed these new medical records, it is my opinion that the claimant's
initial injury of November 30, 2011 aggravated a pre-existing condition of
developing arthritis in the right knee; and the subsequent development on
the left knee symptoms and findings are a compensable consequence to her
right knee injury, therefore, apportionment is basically the same for the
right and left knees.
PTPRelied upon · orthopedic surgeon
Concluded industrial injury occurred; some degenerative changes not work related; treatment necessary on industrial basis; medical treatment was for industrial injury.
From the decision · page 9confirm the conclusions of the PQME. In the August 19, 2020 report, Dr. Haronian reviewed
medical records dating from December 1, 2011 through February 11, 2020. (App. Exh. 1, Report
of Edwin Haronian, M.D., August 19, 2020, pp. 1-49.) Dr. Haronian concluded that a review of
applicant's medical records results in "a clear indication that an industrial injury did occur...that
the patient may have had some degenerative changes, which are not work related in the State of
California..." and that "[t]reatment is necessary on an industrial basis." (App. Exh. 1, Report of
Edwin Haronian, M.D., August 19, 2020, pp. 49-50.) Dr. Haronian concludes that the medical
treatment applicant received for her November 30, 2011 specific injury and her cumulative trauma
injury was treatment for industrial injury:
secondary_treaterRelied upon · orthopedic surgeon
Performed MRI revealing destroyed knees; recommended bilateral total knee replacements; performed left and right knee replacement surgeries with post-operative complications.
From the decision · page 5Her employer's workers' compensation carrier made it difficult to get regular treatment
and therefore she started treating through her private physician, Jonathan Saluta, M.D. (Joint Exh.
B, PQME Report, September 17, 2020, p. 3.) Dr. Saluta performed an MRI which had not been
taken before, which the doctor stated revealed "destroyed knees" and that she required knee joint
replacement surgery. (Ibid.) Applicant underwent left knee replacement surgery on January 14,
2019, followed by physical therapy and improvement. (Ibid.) Applicant had her right knee
replacement surgery on July 10, 2019, with a post-operative infection requiring as second surgery
requiring six weeks of antibiotics which ended in November 2019. (Ibid.) Applicant underwent
another knee surgy on February 10, 2020 due to remaining restricted mobility in the right knee,
but she still has restricted range of motion and pain in that knee. (Id., at p. 4.) She still has some
pain in her left knee as well and has to walk with a quad cane to maintain her balance. (Ibid.)
Applicant reported that overhead use of her left arm caused her pain her left shoulder but does not
prevent her from activities. (Id. at p. 5.) The PQME's conclusions were as follows:
secondary_treaterRelied upon · orthopedic surgeon
Reluctant to recommend surgery due to obesity and risk of infection from leg ulcers.
From the decision · page 8Dr. Rothi reviewed the surgical records including those records from Jonathan Saluta,
M.D., orthopedic surgeon. (Joint Exh. A, October 7, 2020, p. 8.) Dr. Rothi noted that Dr. Saluta
reported applicant's "sudden onset of pain" beginning two years prior to August 23, 2019, and
recommended an MRI. (Ibid.) Thereafter, Dr. Saluta recommended bi-lateral total knee
replacements. (Ibid.) Dr. Rothi noted that another physician, Kathleen Savage, M.D., remained
reluctant to recommend surgery based on her obesity and because she believed applicant wold be
"set-up for infection because of multiple ulcers presumably on her legs." (Id. at pp. 8-9.)