What the panel ordered
Petition for Reconsideration denied by the WCAB panel on September 7, 2021.
Defendant sought reconsideration of the Amended Findings & Award issued by the WCJ on June 24, 2021, which found applicant's industrial injury caused 92% permanent disability.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The WCAB panel found substantial evidence in the reports and testimony of psychiatric AME Dr. Ann Allen supporting the addition rather than combination of orthopedic and psychiatric disability ratings, based on the distinct body parts affected and the synergistic effect of the disabilities.
From the decision · page 1Defendant seeks reconsideration of the Amended Findings & Award (F&A), issued by the workers' compensation administrative law judge (WCJ) on June 24, 2021, wherein the WCJ found in pertinent part applicant's August 6, 2013, industrial injury caused 92% permanent disability.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Allen's psychiatric AME reports and deposition testimony supported adding orthopedic and psychiatric disability ratings rather than combining them.
Favours Applicant prevailed
This was the basis for the WCAB panel's decision to deny defendant's petition for reconsideration and uphold the 92% permanent disability rating.
From the decision · page 5As noted above, Dr. Allen examined applicant three times over an approximately five year period. She reviewed the extensive medical records, including the reports from AME Dr. Jacob (See e.g. Joint Exh.106, p. 2; Joint Exh. 108, pp. 11 § 36; Joint Exh. 111 pp. 8 § 19) and she performed numerous psychological tests. (See e.g. Joint Exh. 111 pp. 7 -8, Joint Exh.110, pp. 6 - 9; Joint Exh. 108, pp. 8 § 11.) In her May 21, 2020 supplemental report Dr.
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.
Dr. Allen opined that the physical and psychiatric disabilities should be added rather than combined due to a synergistic effect, distinct body parts affected, and independent psychiatric rating based on GAF score and AMA Guides.
Dr. Allen's reports and deposition testimony provided substantial evidence supporting the addition of orthopedic and psychiatric disability ratings as the most accurate rating of the applicant's overall disability.
From the decision · page 1On August 27, 2014, applicant was evaluated by psychiatric agreed medical examiner (AME) Ann E. Allen, M.D. (Joint Exh. 111, Dr. Allen, August 27, 2014.) Dr. Allen took a history,
Dr. Jacob evaluated the applicant's orthopedic injuries, diagnosed cervical spine sprain/strain and right shoulder tendinosis, and assigned whole person impairment percentages for cervical spine and right shoulder, with a pain add-on.
Dr. Jacob's orthopedic evaluations and impairment ratings were reviewed and considered in the overall disability rating.
From the decision · page 2On December 10, 2014, chiropractic AME Moses Jacob, D.C., evaluated applicant. (Joint Exh. 105, Dr. Jacob, December 29, 2014.) Dr. Jacob examined applicant, took a history, and reviewed the medical record. He determined that applicant had reached maximum medical improvement/permanent and stationary status and diagnosed applicant as having cervical spine sprain/strain and right shoulder tendinosis. (Joint Exh. 105, pp. 11 and 13.) Dr. Jacob then stated that the injury caused 7% cervical spine whole person impairment (WPI), and 9% upper extremity (right shoulder) WPI, and included a 3% WPI pain add-on. (Joint Exh. 105, p. 14.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Almaraz v. Environmental Recovery Services / Guzman v. Milpitas Unified School District (2009) 74 Cal.Comp.Cases 1084 (Appeals Board en banc)
The medical evaluator must provide the most accurate rating of the injured worker's disability, using the AMA Guides and case law such as Almaraz/Guzman and Kite.
The WCAB panel applied this standard to uphold Dr. Allen's method of adding orthopedic and psychiatric disability ratings as the most accurate rating.
From the decision · page 6Again, there is no requirement that a doctor quote the term "synergistic effect" to actually be substantial evidence. Rather, where a physician's report is well-reasoned, is based on an adequate history and examination, and discloses a solid underlying basis for the opinion, the report is substantial evidence. (Granado v. Workmen's Comp. Appeals Bd., supra; McAllister v. Workmen's Comp. Appeals Bd., supra.) A medical evaluator is to provide the most accurate rating of the injured worker's disability. (Almaraz v. Environmental Recovery Services / Guzman v. Milpitas Unified School District (2009) 74 Cal.Comp.Cases 1084 (Appeals Board en banc) (Almaraz/Guzman II) affirmed by Milpitas Unified School Dist. v. Workers' Compensation Appeals Board (2010) 187 Cal.App.4th 808 [75 Cal.Comp.Cases 837] (modified on other grounds on September 1, 2010).)
What proof carried it
The evidence the panel weighed, by kind.
Dr. Allen's well-reasoned reports and deposition testimony based on extensive medical records and psychological testing.
From the decision · page 5As noted above, Dr. Allen examined applicant three times over an approximately five year period. She reviewed the extensive medical records, including the reports from AME Dr. Jacob (See e.g. Joint Exh.106, p. 2; Joint Exh. 108, pp. 11 § 36; Joint Exh. 111 pp. 8 § 19) and she performed numerous psychological tests. (See e.g. Joint Exh. 111 pp. 7 -8, Joint Exh.110, pp. 6 - 9; Joint Exh. 108, pp. 8 § 11.) In her May 21, 2020 supplemental report Dr.
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
- If you are named in this decision and want this page removed, write to privacy@similarcase.com.