What the panel ordered
The Findings of Fact and Award is affirmed as amended: applicant is entitled to temporary disability from September 27, 2016 through June 20, 2017, with jurisdiction reserved regarding payment of benefits, attorney fees, and possible EDD reimbursement.
Defendant sought reconsideration of the WCJ's Findings of Fact and Award issued June 8, 2022. The WCAB granted reconsideration to further study the issues and issued this Opinion and Decision After Reconsideration.
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.
Orthopedic QME Dr. Schwarz and treating physician Dr. Kattar found applicant's condition became permanent and stationary on June 21, 2017.
From the decision · page 66. Applicant's condition became permanent and stationary on June 21, 2017. ***
The medical record, specifically the orthopedic QME Dr. Schwarz, supports that applicant was temporarily totally disabled from September 27, 2016 through June 20, 2017, and the statutory cap of 104 weeks applies.
From the decision · page 4weeks for aggregate temporary disability payments per section 4656(c)(2). (Lab. Code, § 4656(c)(2).)3 The medical record reflects that his orthopedic condition was considered permanent and stationary as of June 21, 2017 per the orthopedic QME Dr. Schwarz. The WCJ explained in her Opinion on Decision that she based her decision regarding temporary disability and the permanent and stationary date on Dr. Schwarz's reporting. It appears that she inadvertently did not include the full year for the temporary disability end date in Finding of Fact No. 5 and also inadvertently stated 2021 as the permanent and stationary date in Finding of Fact No. 6.4 The record supports a finding that applicant was temporarily totally disabled from September 27, 2016 through June 20, 2017, with June 21, 2017 as the date his condition became permanent and stationary. We will consequently amend the F&A to reflect the correct temporary disability period and permanent and stationary date.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Orthopedic QME Dr. Schwarz found applicant's condition became permanent and stationary on June 21, 2017, consistent with treating physician Dr. Kattar.
Favours Defendant prevailed
Established the end date for temporary disability and the start of permanent and stationary status.
From the decision · page 2Charles Schwarz, M.D. evaluated applicant as the orthopedic qualified medical evaluator (QME) on July 11, 2017. (Joint Exhibit JJ, Medical report from Dr. Charles Schwarz, July 11, 2017.) In his July 11, 2017 report, Dr. Schwarz did not find applicant's condition to have reached maximum medical improvement yet and requested additional medical records. (Id. at p. 21.) Additional medical records were sent to Dr. Schwarz and he issued a supplemental report dated February 15, 2018. He found applicant's condition to have reached maximum medical improvement as of June 21, 2017, the date found by applicant's treating physician, Dr. Waleed Jean Kattar. (Joint Exhibit GG, Medical report from Dr. Charles Schwarz, February 15, 2018, p. 18.)
Internal medicine QME Dr. Tirmizi found no periods of temporary disability related to hypertension.
Favours Defendant prevailed
Limited temporary disability award to orthopedic conditions only.
From the decision · page 2Omar Tirmizi, M.D. evaluated applicant as the internal medicine QME. Dr. Tirmizi diagnosed applicant with hypertensive cardiovascular disease, which he considered industrially related. (Joint Exhibit BB, Medical report from Syed Omar Tirmizi, January 24, 2018, p. 16.) Dr. Tirmizi did not find any periods of temporary disability related to applicant's hypertension. (Id.)
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.
Found applicant had not reached MMI as of July 11, 2017; in supplemental report, found applicant's condition became permanent and stationary as of June 21, 2017, consistent with treating physician Dr. Kattar.
Relied upon for permanent and stationary date and temporary disability period.
From the decision · page 2Charles Schwarz, M.D. evaluated applicant as the orthopedic qualified medical evaluator (QME) on July 11, 2017. (Joint Exhibit JJ, Medical report from Dr. Charles Schwarz, July 11, 2017.) In his July 11, 2017 report, Dr. Schwarz did not find applicant's condition to have reached maximum medical improvement yet and requested additional medical records. (Id. at p. 21.) Additional medical records were sent to Dr. Schwarz and he issued a supplemental report dated February 15, 2018. He found applicant's condition to have reached maximum medical improvement as of June 21, 2017, the date found by applicant's treating physician, Dr. Waleed Jean Kattar. (Joint Exhibit GG, Medical report from Dr. Charles Schwarz, February 15, 2018, p. 18.)
Diagnosed hypertensive cardiovascular disease as industrially related but found no periods of temporary disability related to hypertension.
Relied upon for finding no temporary disability related to hypertension.
From the decision · page 2Omar Tirmizi, M.D. evaluated applicant as the internal medicine QME. Dr. Tirmizi diagnosed applicant with hypertensive cardiovascular disease, which he considered industrially related. (Joint Exhibit BB, Medical report from Syed Omar Tirmizi, January 24, 2018, p. 16.) Dr. Tirmizi did not find any periods of temporary disability related to applicant's hypertension. (Id.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, § 4656(c)(2)
Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.
Applied to limit applicant's temporary disability period to September 27, 2016 through June 20, 2017.
From the decision · page 43 Section 4656(c)(2) states: Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.
What proof carried it
The evidence the panel weighed, by kind.
Medical reporting of orthopedic QME Dr. Schwarz and treating physician Dr. Kattar regarding MMI and permanent and stationary date.
From the decision · page 2Charles Schwarz, M.D. evaluated applicant as the orthopedic qualified medical evaluator (QME) on July 11, 2017. (Joint Exhibit JJ, Medical report from Dr. Charles Schwarz, July 11, 2017.) In his July 11, 2017 report, Dr. Schwarz did not find applicant's condition to have reached maximum medical improvement yet and requested additional medical records. (Id. at p. 21.) Additional medical records were sent to Dr. Schwarz and he issued a supplemental report dated February 15, 2018. He found applicant's condition to have reached maximum medical improvement as of June 21, 2017, the date found by applicant's treating physician, Dr. Waleed Jean Kattar. (Joint Exhibit GG, Medical report from Dr. Charles Schwarz, February 15, 2018, p. 18.)
Medical reporting of internal medicine QME Dr. Tirmizi regarding hypertension and lack of temporary disability period for that condition.
From the decision · page 2Omar Tirmizi, M.D. evaluated applicant as the internal medicine QME. Dr. Tirmizi diagnosed applicant with hypertensive cardiovascular disease, which he considered industrially related. (Joint Exhibit BB, Medical report from Syed Omar Tirmizi, January 24, 2018, p. 16.) Dr. Tirmizi did not find any periods of temporary disability related to applicant's hypertension. (Id.)
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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.
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