ADJ8215781 · August 25, 2026

The WCAB found substantial medical evidence supporting the 100% permanent disability rating, correcting the occupational group number to reflect dual occupations (housekeeper and child monitor) and applying the appropriate combined and added impairment ratings under Vigil.

From the decision · page 1Defendant seeks reconsideration of the Findings and Award (F&A) issued on March 25, 2026, by the workers’ compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that applicant, while employed during the period September 12, 2008 to December 7, 2010, as a housekeeper, sustained an industrial injury arising out of and in the course of employment (AOE/COE) to her neck, right shoulder, low back, sleep, both wrists, psoriasis, psoriatic arthritis, stomach, fibromyalgia and psyche, resulting in 100% permanent disability. Defendant contends that the WCJ erred in awarding 100% permanent disability, arguing that the evidence does not support a total loss of future earning capacity. Specifically, defendant asserts that no medical reporting or vocational expert testimony establishes that applicant has sustained such a loss.

Applicant sustained industrial injury to multiple body parts including neck, right shoulder, low back, sleep, both wrists, psoriasis, psoriatic arthritis, stomach, fibromyalgia, and psyche during employment as housekeeper and child monitor.

Favours Applicant prevailed

This established the scope of injury and supported the permanent disability rating.

From the decision · page 191. the applicant, at age 48, while employed during the period September 12, 2008 to December 7, 2010, as a housekeeper (occupational group numbers: 240/340), by Armorcast Products Company, Inc., sustained injury arising out of and in the course of employment to her neck, right shoulder, low back, sleep, both wrists, psoriasis, psoriatic arthritis, stomach, fibromyalgia, and psyche.

Medical evidence from AMEs demonstrated substantial functional impairment and supported combining and adding impairments under Vigil, justifying the 100% permanent disability rating.

Favours Applicant prevailed

This medical evidence was the basis for affirming the permanent disability rating.

From the decision · page 16Workmen’s Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93].) Here, defendant contends that the medical reporting lacks the required ADL analysis to rebut the CVC under Vigil. This assertion is unpersuasive and mischaracterizes the comprehensive clinical evaluations provided by the AMEs. With respect to the bilateral upper extremities, AME Dr. Luciano explicitly analyzed the combined impact of applicant’s bilateral wrist impairments on her daily functions. He testified that impairments in both her dominant and non-dominant wrists amplify and synergistically restrict her ADLs, particularly fine-motor tasks such as buttoning clothing. This detailed clinical reasoning satisfies Vigil, providing solid evidentiary support for adding, rather than combining, the left wrist (5%) and right wrist (10%) permanent disabilities. With respect to internal medicine and dermatological impairments, AME Dr. Markovitz meticulously evaluated functional overlap across body systems. AME Dr. Markovitz recognized that the severe fatigue resulting from fibromyalgia and psoriatic arthritis overlaps directly with the sleep disorder, and he appropriately combined those conditions using the CVC (yielding 36% WPI).

Applicant's uncontradicted testimony established dual occupations of housekeeper and child monitor, affecting the occupational group number applied.

Favours Applicant prevailed

This testimony was critical to correcting the occupational group number and the permanent disability calculation.

Provided detailed orthopedic evaluations including impairment ratings and apportionment for cervical spine, lumbar spine, right shoulder, and bilateral wrists, supporting the industrial causation and functional impact on activities of daily living.

His reports and depositions provided substantial medical evidence supporting the permanent disability rating and rebuttal of the Combined Values Chart under Vigil.

Evaluated fibromyalgia as a direct consequence of industrial psoriatic arthritis, assessed 60% whole person impairment, and combined impairments with sleep and psychiatric conditions using the Combined Values Chart.

His detailed evaluation of overlapping and non-overlapping impairments supported the combined permanent disability rating and the award of 100% permanent disability.

From the decision · page 7338.) (Joint Ex. OO, p. 4.) He apportioned 90% to the now deemed industrially caused psoriatic arthritis and 10% to ADLs. (Id. at p. 5.) On October 22, 2024, AME Dr. Luciano provided further deposition testimony regarding the overlapping disabilities of applicant’s left and right wrists. AME Dr. Luciano stated that the bilateral wrist impairments create increased difficulty with ADLs, specifically citing the act of buttoning a button as an example of an impacted activity. He concluded that adding the left and right wrist impairments, rather than combining them using the CVC, more accurately reflected applicant’s impairment. (Joint Ex. DD, p. 5:11-25.) In his report dated August 19, 2019, AME Dr. Markovitz, after evaluating applicant in the field of internal medicine, determined that applicant developed fibromyalgia as a direct consequence of chronic pain stemming from her industrial psoriatic arthritis, compounded by associated sleep disturbances and mental health problems. Because he recognized the underlying psoriatic arthritis as an industrial injury, the consequential fibromyalgia was likewise an industrial injury. (Joint Ex. HH, p. 4.) 7

Documented moderate to severe deficits in social functioning, adaptation, and activities of daily living, corroborating profound functional impairment.

His psychiatric evaluation corroborated the extent of applicant's functional impairment supporting the permanent disability rating.

From the decision · page 17Conversely, he identified the psoriasis and upper gastrointestinal tract impairment as functionally distinct conditions that do not overlap with her musculoskeletal fatigue or sleep disruptions. The clinical record demonstrates that applicant’s skin impairment consists of localized psoriatic plaques requiring daily topical steroid application, while her gastrointestinal condition consists of medication-induced heartburn requiring antacids. Managing dermatological lesions and controlling chemical acid reflux represent independent, non-overlapping impacts on ADLs when compared to systemic fatigue and sleep deprivation. AME Dr. Jacks corroborated applicant’s profound functional impairment, documenting moderate to severe deficits in social functioning, adaptation, and ADL pace. The parties presumably chose these AMEs because of their expertise and neutrality. Their opinions therefore merit acceptance unless good cause exists to find them unpersuasive. (Power v. Workers’ Comp. Appeals Bd.

Labor Code section 5909

Petition for reconsideration must be acted upon within 60 days or deemed denied under former Labor Code section 5909.

The Board granted reconsideration within the statutory period and issued its decision accordingly.

From the decision · page 12Up through July 1, 2024, petitions for reconsideration were subject to former Labor Code section 5909 1, which provided that a petition for reconsideration was deemed denied unless the Appeals Board acted on the petition within 60 days from the date of filing. (Lab. Code, § 5909.) During the period from July 2, 2024 through June 30, 2026, petitions for reconsideration were subject to former section 5909, which stated in relevant part that: (a) A petition for reconsideration is deemed to have been denied by the appeals board unless it is acted upon within 60 days from the date a trial judge transmits a case to the appeals board.

Vigil v. County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc)

The Combined Values Chart (CVC) under Vigil v. County of Kern (2024) allows rebuttal by demonstrating impact on activities of daily living to combine impairments more accurately than the CVC alone.

The Board applied Vigil to accept medical opinions combining and adding impairments based on their distinct and synergistic impacts on activities of daily living.

From the decision · page 2Combined Values Chart (CVC) under Vigil v. County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc) (Vigil). We have received an Answer from applicant. The WCJ issued a Report and Recommendation on Petition for Reconsideration (Report) recommending that the permanent disability ratings for the skin and sleep disorders be corrected to reflect the 340 occupational code, but otherwise recommending that applicant is entitled to a finding of 100% permanent disability. We have considered the allegations in defendant’s Petition, applicant’s Answer, and the contents of the WCJ’s Report. Based on our review of the record and the reasons discussed below, we will grant reconsideration to correct the occupational group number but otherwise affirm the WCJ’s decision.

Applicant's uncontradicted testimony about dual occupations as housekeeper and child monitor, spending two to three hours daily on childcare duties.

AME Dr. Luciano's detailed analysis of bilateral wrist impairments amplifying and synergistically restricting activities of daily living, particularly fine-motor tasks such as buttoning clothing.

From the decision · page 16Workmen’s Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93].) Here, defendant contends that the medical reporting lacks the required ADL analysis to rebut the CVC under Vigil. This assertion is unpersuasive and mischaracterizes the comprehensive clinical evaluations provided by the AMEs. With respect to the bilateral upper extremities, AME Dr. Luciano explicitly analyzed the combined impact of applicant’s bilateral wrist impairments on her daily functions. He testified that impairments in both her dominant and non-dominant wrists amplify and synergistically restrict her ADLs, particularly fine-motor tasks such as buttoning clothing. This detailed clinical reasoning satisfies Vigil, providing solid evidentiary support for adding, rather than combining, the left wrist (5%) and right wrist (10%) permanent disabilities. With respect to internal medicine and dermatological impairments, AME Dr. Markovitz meticulously evaluated functional overlap across body systems. AME Dr. Markovitz recognized that the severe fatigue resulting from fibromyalgia and psoriatic arthritis overlaps directly with the sleep disorder, and he appropriately combined those conditions using the CVC (yielding 36% WPI).

AME Dr. Markovitz's evaluation of overlapping and non-overlapping impairments, combining fibromyalgia, sleep, and psychiatric conditions using the Combined Values Chart, and identifying distinct impacts of psoriasis and gastrointestinal impairments on activities of daily living.

From the decision · page 16Workmen’s Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93].) Here, defendant contends that the medical reporting lacks the required ADL analysis to rebut the CVC under Vigil. This assertion is unpersuasive and mischaracterizes the comprehensive clinical evaluations provided by the AMEs. With respect to the bilateral upper extremities, AME Dr. Luciano explicitly analyzed the combined impact of applicant’s bilateral wrist impairments on her daily functions. He testified that impairments in both her dominant and non-dominant wrists amplify and synergistically restrict her ADLs, particularly fine-motor tasks such as buttoning clothing. This detailed clinical reasoning satisfies Vigil, providing solid evidentiary support for adding, rather than combining, the left wrist (5%) and right wrist (10%) permanent disabilities. With respect to internal medicine and dermatological impairments, AME Dr. Markovitz meticulously evaluated functional overlap across body systems. AME Dr. Markovitz recognized that the severe fatigue resulting from fibromyalgia and psoriatic arthritis overlaps directly with the sleep disorder, and he appropriately combined those conditions using the CVC (yielding 36% WPI).