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 · psychiatry
Applicant sustained a 12% whole person impairment for psychiatric injury with 95% apportioned to industrial injury; however, apportionment among multiple dates of injury was unclear and insufficient for apportionment.
Dr. Segal's opinion was found insufficient to meet the burden of proof for apportionment due to lack of adequate information and unclear apportionment among multiple injury dates.
From the decision · page 7Dr. Lin and Dr. McCreesh were able to parcel out causation of disability
for the musculoskeletal injuries among the two specific dates of injury and one
period of cumulative trauma ending 6/9/05. Dr. Segal, however, was not. In his
report dated 7/13/18, Dr. Segal noted that although he originally apportioned
10% of psychiatric impairment to non-industrial sleep apnea, he later changed
that apportionment to just 5% since the sleep apnea seemed to be playing a lesser
role than it was in 2008. The remaining 95% of psychiatric disability he found
attributable to the applicant's work injuries. (Exh. J-1) In his report dated 6/9/14,
Dr. Segal indicated that "truth be, from a psychiatric perspective, the injuries are
too inextricably intertwined to separate out and apportion between them." (Exh.
J-4) Dr. Segal explained that this determination was based on the fact that he did
not have an opportunity to examine applicant until December 2008, "many
years" after his industrial injuries and more than three years after his last day of
employment.
QMERelied upon · orthopedics
Applicant sustained a 25% whole person impairment for low back injury with apportionment among multiple injury dates; concluded applicant is unable to return to work and supports 100% permanent total disability.
Dr. Lin's detailed apportionment and opinion on disability supported the WCJ's conclusion of 100% permanent total disability.
From the decision · page 9In his report dated 7/10/13, Dr. Lin concludes that "I do not believe that
applicant would be able to return to work in any capacity given his current
condition." (Report, supra, p. 50; Exh. A-24.) Dr. Lin's opinion is supported by
the fact that applicant has undergone four right shoulder surgeries and an MRI
of the left shoulder reveals a rotator cuff tear of the supraspinatus and
instraspinatus muscles. Applicant has positive impingement signs in the bilateral
shoulders. (Report, supra, p. 46; Exh. A-24.) Referable to the lumbar spine,
multiple MRI's confirm that applicant has spinal stenosis and decreased active
range of motion of the lumbar spine. (Report, supra, p. 46; Exh. A-24.).
QMERejected · internal medicine
Applicant has an 8% whole person impairment for hypertension with 50% industrial causation; apportionment among multiple injury dates deferred to orthopedist's dictates, which was insufficient for apportionment.
Dr. Levy's apportionment opinion was insufficient as it deferred to orthopedist without clear apportionment among injury dates.
From the decision · page 8The apportionment determination provided by Dr. Levy is flawed in a
similar fashion to that of Dr. Segal. In his report dated 10/7/17, Dr. Levy finds
industrial causation for the applicant's hypertension and provides 8% whole person
impairment for same. He indicates that 50% of impairment for hypertension is
caused by "endogenous nonindustrial factors," and 50% of his impairment is
caused by "orthopedic work-related injuries." Dr. Levy further dictates that as
for parceling out disability among multiple dates of injury, he "would follow the
dictates of the orthopedist with respect to apportionment between the various
work-related and non-work related orthopedic impairments." (Exh. A-11) This
opinion is insufficient to allow the Court to actually apportion industrial
impairment for hypertension between multiple dates of injury for the same
reasons articulated previously with respect to Dr. Segal's apportionment
opinion.
vocational_expertRelied upon
Applicant is not amenable to rehabilitation and has sustained 100% loss of labor market access due to combined industrial injuries.
Vocational expert's opinion supported the conclusion of 100% permanent total disability due to inability to return to work.