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.
AMERejected · urology
Diagnosed neurogenic bladder and erectile dysfunction related in part to injury and surgery; opined approximately 50% of erectile dysfunction complaints were nonindustrial; lowered impairment rating after reviewing surveillance video; opinion on apportionment was speculative and not substantial evidence.
The opinion was found speculative and not substantial medical evidence to support apportionment.
From the decision · page 1Labor Code section 4663(a) provides that "[a]pportionment of permanent disability shall
be based on causation." (Lab. Code, § 4663(a).) Section 4664(a) states that "[t]he employer shall
only be liable for the percentage of permanent disability directly caused by the injury arising out
of and occurring in the course of employment." (Lab. Code, § 4664(a).) The defendant has the
burden of proof on the issue of apportionment. (Kopping v. Workers' Comp. Appeals Bd. (2006)
142 Cal.App.4th 1099, 1114 [71 Cal.Comp.Cases 1229].)
QMERelied upon · psychiatry
Diagnosed major depressive disorder predominantly caused by the 2008 lumbar spine injury with unapportioned disability; reviewed surveillance video and did not change assessment.
His opinion supported the finding of unapportioned disability related to the industrial injury.
From the decision · page 5As to the psychiatric injury, Dr. St. Martin determined that Applicant suffered from a major
depressive disorder predominantly caused by the 2008 lumbar spine injury [Ex JJ, P5] with
resulting unapportioned disability based on a GAF score of 57 [Ex JJ, P6]. After reviewing
surveillance video, the doctor's assessment did not change [Ex II, P3].
PTPRelied upon · orthopedics
Assessed 20% whole person impairment using DRE method category IV for back injury; found no basis for apportionment.
His opinion was substantial evidence for the impairment rating and no apportionment.
From the decision · page 20The primary disability is due to Applicant's back injury. In that regard, Dr. Sherman stated his
opinion that the DRE method, category IV, at 20% whole person impairment, was the most
accurate assessment of impairment [Ex BB, P6; See also Ex CC, P13]. He said there was no
basis for apportionment [Ex BB, P6]. Given Applicant's 2-level surgery, and Dr. Sherman's
explanation, the Court finds this to be an appropriate assessment. The Court finds Dr. Sherman's
opinion to be substantial evidence upon which it can rely for a rating.