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.
QMERecord developed further · internal medicine
Opined applicant suffered injury AOE/COE to body systems (GERD and hypertension), but opinions were predicated on applicant's reported workplace harassment and stress.
The WCJ rejected Dr. Sherman's opinions as unsupported due to lack of corroborating evidence for the alleged harassment/stress, but the WCAB found the record required further development to determine if his opinions constitute substantial evidence.
From the decision · page 4James Sherman, M.D., was the panel Qualified Medical Examiner ("QME") who
assessed applicant's internal condition. He concluded applicant's hypertension
disorder was caused on an industrial basis. (QME report by James Sherman, M.D.,
dated 6/17/20, Jt. Exh. 1, p. 9-10.) Dr. Sherman also opined applicant's
gastroesophageal reflux disorder industrial. (QME report by James Sherman, M.D.,
dated 3/27/21, Jt. Exh. 3, p. 3.) However, Dr. Sherman predicated his conclusions
on the alleged harassment at work and/or applicant's supervisor. The doctor stated
applicant had significant stress and anxiety in her workplace for the County of
Riverside. She was harassed by her supervisor for the past seven years. She has
been the victim of verbal abuse much of that time. (QME report of Dr. Sherman
dated 6/17/20, Jt. Exh. 1, p. 9.) The court cannot rely on Dr. Sherman's opinions
because the doctor's assessment was based on unsubstantiated facts; there was no
corroborating evidence of harassment or stress at the work place. Based on the
testimony presented at trial, Dr. Sherman's factual history has been undermined,
and therefore his conclusions including causation are unsupported.
QMERelied upon · psychiatry
Opined that if applicant's history was accurate, there would be industrial causation for psyche injury; otherwise, causation would be nonindustrial.
The WCJ found applicant not credible, so Dr. Lee's opinion resulted in a finding of no industrial causation for psyche injury.
From the decision · page 6Note that the opinions regarding causation of the psychiatric injury by the
mistreatment at work [] are such as long as the claimant's history is accurate.
Whether the claimant's history is accurate would be deferred to the trier of fact. If
the trier of fact determines that the claimant's history is not accurate and that the
mistreatment at work did not occur, then the amount of causation of the psychiatric
injury that was assigned to the mistreatment at work...would be nonindustrial.
PTPRejected
Opined applicant's psyche injury was AOE/COE, but his opinions were not found to be substantial medical evidence.
The WCJ and WCAB found Dr. Flores's opinions were not substantial evidence for psyche injury AOE/COE.
From the decision · page 7July 20, 2016, as a Health Services Assistant, at Riverside, California, by the County
of Riverside, did not sustain injury arising out of and in the course of employment to
psyche, head, and back.
2. The medical opinions of Nelson Flores, Ph.D., are not substantial medical evidence.
3. Applicant has an occupational group number of 112.
4. All other issues in the case are deferred.
QMERelied upon · orthopedics
Concluded there was no basis for finding orthopedic injury AOE/COE; opinion was found to satisfy substantial evidence requirements.
The WCJ adopted Dr. Wakim's opinion as substantial evidence and rejected applicant's orthopedic injury claim.
From the decision · page 7applicant's physical examination, and the basis for the conclusions reached. (Escobedo, supra, 70
Cal.Comp.Cases at p. 621.) Additionally, there is nothing to indicate that Dr. Wakim's medical
opinion was based upon speculation or surmise. Accordingly, we see no error in the WCJ's
decision to accept Dr. Wakim's medical opinion and to reject applicant's orthopedic injury claim.