ADJ9229556 — California WCAB decision

What the panel ordered

The WCAB panel denied defendant's Petition for Reconsideration and affirmed the WCJ's determination that applicant is permanently totally disabled due to industrial cumulative trauma injury.

Read the official decision →

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.

Permanent total disabilityApplicant prevailedlumbar spine · bilateral knees · skin

The facts that decided it

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

Applicant sustained an admitted industrial cumulative trauma injury to lumbar spine, bilateral knees, and skin over the period ending December 19, 2012.

Favours Applicant prevailed

This established the basis for the permanent disability claim and the medical evaluations supporting it.

Dr. Henry diagnosed chronic low back pain with L4-5 herniation, degenerative disc disease with stenosis, and bilateral knee DJD, and found applicant temporarily totally disabled until permanent and stationary status with a 40% whole person impairment rating without apportionment to non-industrial causes.

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.

vocational_expertRelied upon

Concluded applicant lost ability to function in the open labor market due to synergistic effect of bilateral knees and lumbar spine impairments and chronic pain, rendering applicant permanently totally disabled and not amenable to vocational rehabilitation.

From the decision · page 6Applicant obtained a vocational evaluation from Frank Diaz, who reported on April 10,

QMERelied upon · Physiatrist

Diagnosed chronic low back pain with L4-5 herniation and degenerative disc disease with stenosis, bilateral knee DJD, and found applicant temporarily totally disabled until permanent and stationary status. Rated 40% whole person impairment for spine and knees with no apportionment to non-industrial causes. Recommended future bilateral total knee replacements and additional pain management.

Dr. Henry's medical reports and deposition supported the finding of permanent total disability and no apportionment to non-industrial causes.

From the decision · page 3Applicant was first evaluated by Dr. Henry in 2014. She reported applicant's history of experiencing a lot pain in early 2012, performing work that required "repetitive motions including lifting, walking, climbing and crawling, a lot of things that required him to be on his knees and strain and put a lot of weight on to the lumbar area of the spine." (Jt. Ex. 109, 7/10/14 Dr. Henry QME Report, p. 2.) Applicant reported that he worked through his pain until he was laid off on December 19, 2012, but his symptoms continued. Applicant had right knee surgery in January of 2013, for chondromalacia and torn medial meniscus. Subsequently, his left knee worsened and he required injections bilaterally to relieve pain. (Jt. Ex. 108, 1/13/16 Dr. Henry Report, p. 2.)

QMERelied upon · Dermatologist

Found lentigo maligna on applicant's left cheek caused by industrial sun exposure, assessed 8% whole person impairment with 50% industrial and 50% non-industrial apportionment. Work restrictions limited to sun exposure avoidance.

Dr. Alaiti's report supported the industrial causation of the skin injury and impairment rating.

From the decision · page 5Applicant's skin injury was evaluated by Dr. Alaiti, who reported on June 20, 2017, that applicant sustained an injury in the form of lentigo maligna on his left cheek. Dr. Alaiti found applicant's employment, causing him to spend an extensive amount of time working outdoors, was a contributing cause of the injury, and "there is reasonable medical probability to conclude the injury is industrial and should be treated on industrial basis." (Jt. Ex. 110, 6/20/17 Dr. Alaiti Report, p. 13-14.) The only work restrictions indicated was to avoid sun exposure as much as possible and use high SPF sunscreen and protective clothing. He assessed an 8% whole person impairment, and apportioned 50% to his sun exposure while working between 1993 and 2012, and 50% to non-industrial sun exposure.

What proof carried it

The evidence the panel weighed, by kind.

Testimony and credibilityfavours Applicant prevailed

Applicant's credible trial testimony of constant pain at level 7 out of 10 and inability to perform job duties due to pain and physical limitations.

From the decision · page 3He testified that he cannot do the job now. He cannot sit or stand for long. He described his body as torn up. Since his last evaluation by Dr. Henry in 2016, his pain and mobility have gradually deteriorated. He testified that he is in constant pain, normally at the level of 7 out of 10, but any type of activity can get him to level 10. His pain level prevents him from concentrating on a regular basis and his memory isn't as good as it used to be. He also avoids pain medications. He testified that it is very painful to bend. He can stoop or squat while hanging onto something, but it will cause pain. Climbing stairs is painful. He can walk 20 to 25 minutes, but then must sit. He cannot sit or stand for a long time. The heaviest thing he can lift is a case of water bottles, but cannot lift anything overhead.

Medical recordsfavours Applicant prevailed

Medical reports from Dr. Henry and Dr. Alaiti documenting industrial cumulative trauma injury and impairment ratings.

From the decision · page 3Applicant was first evaluated by Dr. Henry in 2014. She reported applicant's history of experiencing a lot pain in early 2012, performing work that required "repetitive motions including lifting, walking, climbing and crawling, a lot of things that required him to be on his knees and strain and put a lot of weight on to the lumbar area of the spine." (Jt. Ex. 109, 7/10/14 Dr. Henry QME Report, p. 2.) Applicant reported that he worked through his pain until he was laid off on December 19, 2012, but his symptoms continued. Applicant had right knee surgery in January of 2013, for chondromalacia and torn medial meniscus. Subsequently, his left knee worsened and he required injections bilaterally to relieve pain. (Jt. Ex. 108, 1/13/16 Dr. Henry Report, p. 2.)

expert methodologyfavours Applicant prevailed

Vocational expert Frank Diaz's report finding synergistic effect of impairments and chronic pain causing loss of labor market access, credited by WCJ and WCAB.

From the decision · page 6Applicant obtained a vocational evaluation from Frank Diaz, who reported on April 10,

ADJ9229556 · March 23, 2021

What the panel ordered

What was disputed, and how it came out

The facts that decided it

Your case already resembles someone else’s. Find whose.

What the panel did with the medical opinions

The rules the panel named

What proof carried it

About this page