ADJ9485504 — California WCAB decision

What the panel ordered

Findings and Award of April 15, 2021 rescinded; findings substituted deferring apportionment issues and returning matter to trial level

Petition for reconsideration granted to further study factual and legal issues; matter returned to trial level for further proceedings

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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.

ApportionmentRemandedcervical spine · right shoulder · right hip · bilateral knees

The AME Dr. Renbaum's apportionment report lacks explanation of the nature of degenerative changes and their contribution to disability, requiring further development of the record.

From the decision · page 6In this case, AME Dr. Renbaum's reporting apportions 15% of applicant's permanent disability of the cervical spine, right shoulder, right hip and bilateral knees to pre-existing degenerative changes and 85% to the August 7, 2009 work injury but does not disclose what pre- existing degenerative changes resulted in injury which contributed to the disability or how or why the pre-existing degenerative changes caused the extent of disability attributed to them. (Ex. AA, Report of Dr. Joel Renbaum, February 5, 2020, pp. 10-12; Report, pp. 2-3.)

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.

AMERelied upon · orthopedic surgeon

Apportions 15% of permanent disability of cervical spine, right shoulder, right hip and bilateral knees to pre-existing degenerative changes and 85% to the industrial injury; defers psychiatric evaluation to appropriate specialist.

Dr. Renbaum's apportionment is based on diagnostic studies showing degenerative changes but lacks detailed explanation of how these changes cause disability.

From the decision · page 3I would defer evaluation of her issues with stress and depression to the appropriate psychologist or psychiatrist as these conditions are outside of my area of expertise as an orthopedic surgeon.... Using a reasonable degree of medical probability, it is my opinion that it is appropriate to apportion 15% of her cervical spine, right shoulder, right hip and bilateral knee impairment to pre-existing degenerative changes and 85% to the August 7, 2009 work injury. I would be glad to review medical records regarding her lumbar spine and issue a supplemental report regarding apportionment at that time. (Ex. AA, Report of Dr. Renbaum, February 5, 2020, pp. 10-12.)

AMERejected · psychiatrist

Finds 50% of permanent disability of psyche caused by industrial injury and 50% by other factors; relies on Dr. Renbaum's orthopedic apportionment without independent justification.

Dr. Cole's apportionment is considered 'pass-through' and not substantial evidence as it lacks independent justification.

From the decision · page 8In the case before us, AME Dr. Cole apportions 50% of applicant's permanent disability of the psyche to non-industrial factors by relying on AME Dr. Renbaum's 15% apportionment of orthopedic disability but does not provide independent justification for doing so. (Ex. GG, Report of James Cole, Ph.D., May 17, 2018, pp. 31-32; Report, p. 3.)

What proof carried it

The evidence the panel weighed, by kind.

objective testingfavours Defendant prevailed

Diagnostic studies showed degenerative changes at apportioned body parts

From the decision · page 4Applicant developed psychiatric symptoms and was evaluated by Dr. James Cole acting as Agreed Evaluator. Dr. Cole issued reports dated May 17, 2018, and October 30, 2019. (Exhibits FF, GG.)... While Dr. Renbaum's reports are terse, each finding of apportionment is supported by the review of records, which shows that diagnostic studies showed degenerative changes at the apportioned parts of body. Notably, for the carpal tunnel and lumbar spine impairments, there was no corresponding diagnostic findings of degenerative disease processes and likewise, no apportionment.... While one would have hoped for a more substantial discussion of the apportionment, it is not difficult to understand the doctor's rationale for apportionment. Further, the amount is seen as reasonable. Dr. Renbaum has made a modest apportionment of 15% for those body parts for which there were

objective testingfavours Defendant prevailed

Personality testing supportive of apportionment to nonindustrial causation

From the decision · page 5underlying nonsymptomatic findings. He did not provide any apportionment for those parts of body for which there were no such studies.... While recognizing that it is defendant's burden on apportionment, it would be unfair to accept Dr. Renbaum's terse, one-line findings on impairment, while rejecting the equally terse findings on apportionment. Recognizing Dr. Renbaum's role as an AME, his reporting was understood and accepted as substantial medical evidence, even if not a model of thorough reporting.... Dr. Cole, also serving as an AME, found that applicant had pre-existing psychiatric disability which was supported by his review of a prior psychiatric AME resulting from a previous industrial injury. He noted that subsequent to the injury applicant had significant emotional response to the deaths of her mother, aunt, and another family member. Dr. Cole also found that personality testing was supportive of apportionment to nonindustrial causation. (Exhibit GG, pages 31 to 32.)

ADJ9485504 · April 22, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

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The rules the panel named

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