ADJ14431348 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted; Findings and Award of July 14, 2023 rescinded; matter returned to WCJ for further proceedings.

Applicant sought reconsideration of the WCJ's Findings and Award issued July 14, 2023, which found no permanent disability from the December 2, 2020 injury. The WCAB granted reconsideration, rescinded the F&A, and returned the matter to the WCJ for further proceedings.

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The facts that decided it

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

PTP Dr. Mahboubian was unaware of applicant's prior motor vehicle accidents and did not review related medical records.

Favours Applicant prevailed

This lack of medical history rendered Dr. Mahboubian's opinions not substantial evidence, undermining the WCJ's decision on permanent disability.

From the decision · page 5Having reviewed the reports from Dr. Mahboubian, we agree with the WCJ, it appears that he was not aware of applicant's prior motor vehicle accidents, and he did not review any medical records addressing the results of those accidents. Therefore, Dr. Mahboubian's opinions are based on an inadequate medical history and do not constitute substantial evidence. (Place v. Workmen's Comp. Appeals Bd. supra; Bracken v. Workers' Comp. Appeals Bd. supra; Escobedo v. Marshalls, supra.)

QME Dr. Sherman's opinion that applicant's left shoulder "looked normal" was inconsistent with MRI findings showing tendon tears, and he did not explain this inconsistency.

Favours Applicant prevailed

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.

QMERejected · orthopedic

Dr. Sherman found no objective abnormalities to support applicant's subjective complaints and concluded 0% whole person impairment, but did not explain inconsistency with MRI showing left shoulder tendon tears.

Dr. Sherman's opinion was found not to be substantial evidence due to lack of explanation for inconsistency with MRI findings.

From the decision · page 5Regarding the reports from QME Dr. Sherman, as quoted above, Dr. Sherman said applicant complained of constant global left shoulder aching pain, but he then said applicant was able to do all activities of daily living, and that upon examination, applicant's left shoulder looked normal without any instability or tenderness. (Def. Exh. B, p. 6.) However, Dr. Sherman's review of the medical record included the January 26, 2021, left shoulder MRI that showed moderate subscapularis tendinopathy [inflammation of the shoulder tendons and muscles] with intrasubstance tearing [partial-thickness rotator cuff tear] and a split tear of the long head of the biceps tendon [split tendon, torn from the bone]. (Def. Exh. B, Review of Medical Records p. 21, [EAMS p. 31]; see also Webster's New World Medical Dictionary.) Dr. Sherman's statement that applicant's left shoulder "looked normal" appears to be inconsistent with the left shoulder condition identified by the January 26, 2021 MRI. Dr. Sherman did not provide any analysis or reasoning as to his conclusion that applicant's left shoulder "looked normal." After having reviewed the MRI, absent an explanation of the basis for his opinion and its inconsistency with the MRI, Dr. Sherman's report is not substantial evidence regarding applicant's left shoulder condition nor the issue of disability caused by the December 2, 2020 injury.

PTPRejected · orthopedic

Dr. Mahboubian assigned permanent impairment percentages and apportioned 80% to the industrial injury, but his opinion was based on an inadequate medical history as he was unaware of prior motor vehicle accidents.

Dr. Mahboubian's opinion was found not to be substantial evidence due to inadequate medical history.

From the decision · page 5Having reviewed the reports from Dr. Mahboubian, we agree with the WCJ, it appears that he was not aware of applicant's prior motor vehicle accidents, and he did not review any medical records addressing the results of those accidents. Therefore, Dr. Mahboubian's opinions are based on an inadequate medical history and do not constitute substantial evidence. (Place v. Workmen's Comp. Appeals Bd. supra; Bracken v. Workers' Comp. Appeals Bd. supra; Escobedo v. Marshalls, supra.)

What proof carried it

The evidence the panel weighed, by kind.

Medical recordsfavours Applicant prevailed

Applicant's prior motor vehicle accidents and lack of medical records review by PTP Dr. Mahboubian

From the decision · page 5Having reviewed the reports from Dr. Mahboubian, we agree with the WCJ, it appears that he was not aware of applicant's prior motor vehicle accidents, and he did not review any medical records addressing the results of those accidents. Therefore, Dr. Mahboubian's opinions are based on an inadequate medical history and do not constitute substantial evidence. (Place v. Workmen's Comp. Appeals Bd. supra; Bracken v. Workers' Comp. Appeals Bd. supra; Escobedo v. Marshalls, supra.)

objective testingfavours Applicant prevailed

MRI showing moderate subscapularis tendinopathy with intrasubstance tearing and split tear of the long head of the biceps tendon

From the decision · page 5Regarding the reports from QME Dr. Sherman, as quoted above, Dr. Sherman said applicant complained of constant global left shoulder aching pain, but he then said applicant was able to do all activities of daily living, and that upon examination, applicant's left shoulder looked normal without any instability or tenderness. (Def. Exh. B, p. 6.) However, Dr. Sherman's review of the medical record included the January 26, 2021, left shoulder MRI that showed moderate subscapularis tendinopathy [inflammation of the shoulder tendons and muscles] with intrasubstance tearing [partial-thickness rotator cuff tear] and a split tear of the long head of the biceps tendon [split tendon, torn from the bone]. (Def. Exh. B, Review of Medical Records p. 21, [EAMS p. 31]; see also Webster's New World Medical Dictionary.) Dr. Sherman's statement that applicant's left shoulder "looked normal" appears to be inconsistent with the left shoulder condition identified by the January 26, 2021 MRI. Dr. Sherman did not provide any analysis or reasoning as to his conclusion that applicant's left shoulder "looked normal." After having reviewed the MRI, absent an explanation of the basis for his opinion and its inconsistency with the MRI, Dr. Sherman's report is not substantial evidence regarding applicant's left shoulder condition nor the issue of disability caused by the December 2, 2020 injury.

ADJ14431348 · October 6, 2023

What the panel ordered

The facts that decided it

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What the panel did with the medical opinions

The rules the panel named

What proof carried it

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