ADJ11221216 · March 23, 2026

The WCJ's finding of total permanent disability was upheld because the defendant failed to provide substantial medical evidence to support apportionment, and the vocational evidence showed the applicant could not compete in the open labor market.

From the decision · page 1Defendant seeks reconsideration of the Findings of Fact, Award issued by the workers' compensation administrative law judge (WCJ) on December 29, 2025. Therein, and as relevant here, the WCJ found that applicant sustained admitted injury arising out of and occurring in the course of employment (AOE/COE) to the psyche while employed as a patrol officer during the period to and including November 5, 2017. The WCJ further found that applicant "cannot benefit from the provision of rehabilitation, as his restrictions from the industrial injury render him unable to compete for work in the general labor market. Therefore, he is found to be totally permanently disabled."

Applicant is totally permanently disabled due to admitted injury to psyche and cannot compete in the open labor market.

Favours Applicant prevailed

This fact supports the finding of 100% permanent disability and denial of apportionment.

From the decision · page 1Defendant seeks reconsideration of the Findings of Fact, Award issued by the workers' compensation administrative law judge (WCJ) on December 29, 2025. Therein, and as relevant here, the WCJ found that applicant sustained admitted injury arising out of and occurring in the course of employment (AOE/COE) to the psyche while employed as a patrol officer during the period to and including November 5, 2017. The WCJ further found that applicant "cannot benefit from the provision of rehabilitation, as his restrictions from the industrial injury render him unable to compete for work in the general labor market. Therefore, he is found to be totally permanently disabled."

Dr. Palmer's apportionment opinion lacked sufficient explanation and reasoning to be substantial evidence.

Favours Applicant prevailed

This led to rejection of defendant's apportionment argument and upheld total permanent disability finding.

From the decision · page 12The standard for establishing legal apportionment was set forth by the Board in Escobedo v. Marshalls (2005) 70 CCC 604, and specifically on page 621. There, the board stated that to be substantial evidence on the issue of apportionment, a doctor must describe in detail the exact nature of the apportionable disability. To be substantial evidence, the medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, and most importantly, must set forth the reasoning in support of its conclusion. To illustrate the application of these principles, the Board stated "For example, if a physician opines that approximately 50% of an employee's back disability is directly caused by the industrial injury, the physician must explain how and why the disability is causally related to the industrial injury (e.g., the certain restrictions) and how and why the injury is responsible for approximately 50% of the disability. And, if a physician opines that 50% of an employee's back disability is caused by degenerative disc disease, the physician must explain the nature of the degenerative disc disease, how and why it is causing permanent disability at the time of the evaluation, and how and why it is responsible for approximately 50% of the disability."

Dr. Palmer found the applicant had a GAF score of 45 and apportioned 90% of the disability to work stress, but his apportionment opinion was found not to be substantial evidence for apportionment of permanent disability.

The Board found Dr. Palmer's apportionment opinion lacked sufficient explanation and reasoning to constitute substantial evidence on apportionment.

From the decision · page 3OPINION ON DECISION FACTS This is an accepted injury to the applicant's psyche, arising out of cumulative trauma from the necessity to observe and deal with disturbing accidents and injuries as part of his job as a California Highway Patrolman. The parties used Dr. Richard Palmer as a PQME, and Dr. Palmer has written multiple reports, twelve of which are in evidence as joint exhibits AA through JJ, and MM and NN. Further, Dr. Palmer was deposed by the parties, and that deposition transcript in in evidence as Joint Exhibit KK.

Escobedo v. Marshalls (2005) 70 CCC 604

A medical opinion must be framed in terms of reasonable medical probability, not speculative, based on pertinent facts and adequate examination, and must set forth reasoning in support of conclusions to be substantial evidence on apportionment.

Applied to reject Dr. Palmer's apportionment opinion as not substantial evidence.

From the decision · page 12The standard for establishing legal apportionment was set forth by the Board in Escobedo v. Marshalls (2005) 70 CCC 604, and specifically on page 621. There, the board stated that to be substantial evidence on the issue of apportionment, a doctor must describe in detail the exact nature of the apportionable disability. To be substantial evidence, the medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, and most importantly, must set forth the reasoning in support of its conclusion. To illustrate the application of these principles, the Board stated "For example, if a physician opines that approximately 50% of an employee's back disability is directly caused by the industrial injury, the physician must explain how and why the disability is causally related to the industrial injury (e.g., the certain restrictions) and how and why the injury is responsible for approximately 50% of the disability. And, if a physician opines that 50% of an employee's back disability is caused by degenerative disc disease, the physician must explain the nature of the degenerative disc disease, how and why it is causing permanent disability at the time of the evaluation, and how and why it is responsible for approximately 50% of the disability."

Vocational expert opinions showing applicant could only work in a sheltered environment and could not compete in the open labor market.

From the decision · page 8A finding of permanent total disability can be based on vocational evidence. In such cases, the applicant is not precluded from working on a medical basis, per se, but is instead given permanent work restrictions. Depending on the facts of each case, the effects of such work restrictions can cause the applicant to lose the ability to compete for jobs on the open labor market, which results in total loss of earning capacity.