What the panel ordered
Findings and Order of November 3, 2020, affirmed except amended to defer psychiatric injury issues and remanded to WCJ for amended decision.
Petition for Reconsideration filed by applicant, denied by WCJ, then reviewed by WCAB panel which affirmed WCJ's Findings and Order except to defer psychiatric injury issues and remand to WCJ for further analysis.
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.
The WCJ and WCAB found the QME reports by Dr. Hohl and Dr. Yousefi to be substantial evidence that applicant did not sustain orthopedic injuries AOE/COE.
From the decision · page 3We first note, as the WCJ stated in the Report, Dr. Hohl and Dr. Yousefi each took a complete history, reviewed medical records, examined applicant, and explained the basis for their opinions. Applicant's disagreement with the doctors' conclusions do not make them invalid or render them to be not substantial evidence. "Applicant had the opportunity to question the doctors about their findings, but depositions were not scheduled." (Report, p. 4.) Thus, we agree that the reports are substantial evidence and we will not disturb the WCJ's Finding that applicant did not sustain the orthopedic injuries as claimed.
The WCAB deferred the issues of psychiatric injury and entitlement to psychiatric QME evaluation to the WCJ for further analysis because the record did not clearly show the WCJ's analysis under Labor Code section 3208.3(e).
From the decision · page 4Accordingly, we affirm the F&O except that we amend the F&O to defer the issues of
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
QME reports by Dr. Hohl and Dr. Yousefi are substantial evidence that applicant did not sustain orthopedic injuries AOE/COE.
Favours Defendant prevailed
These reports formed the basis for affirming the WCJ's finding of no compensable orthopedic injury.
From the decision · page 3We first note, as the WCJ stated in the Report, Dr. Hohl and Dr. Yousefi each took a complete history, reviewed medical records, examined applicant, and explained the basis for their opinions. Applicant's disagreement with the doctors' conclusions do not make them invalid or render them to be not substantial evidence. "Applicant had the opportunity to question the doctors about their findings, but depositions were not scheduled." (Report, p. 4.) Thus, we agree that the reports are substantial evidence and we will not disturb the WCJ's Finding that applicant did not sustain the orthopedic injuries as claimed.
Record did not clearly show WCJ's analysis under Labor Code section 3208.3(e) for psychiatric injury claim.
Favours neutral
This lack of clear analysis led to deferral of psychiatric injury and psychiatric QME evaluation issues to WCJ for further consideration.
From the decision · page 4was considered by the WCJ in the context of section 3208.3(e), in reaching the conclusion that
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.
Applicant is permanent and stationary with 0% whole person impairment due to work; symptoms attributed to fibromyalgia; no work-related impairment found.
Dr. Hohl took history, examined applicant, reviewed records, and diagnosed fibromyalgia; found no work-related impairment; opinion given great weight as substantial evidence.
From the decision · page 2On January 31, 2019, orthopedic QME Dr. Hohl evaluated applicant. Dr. Hohl took a history, examined applicant, reviewed the medical record, and diagnosed "Fibromyalgia." (Def. Exh. C, Dr. Hohl, January 31, 2019, p. 7.) He stated:
Applicant does not meet diagnostic criteria for fibromyalgia or autoimmune connective-tissue disorder; 0% whole person impairment from rheumatology standpoint; reached MMI.
Dr. Yousefi examined applicant, reviewed records including Dr. Zamiri's reports, and concluded no fibromyalgia or autoimmune disorder; no impairment found; opinion given great weight as substantial evidence.
From the decision · page 2I agree with Dr. Zamiri, the claimant's private rheumatologist, that the claimant does not meet the diagnostic criteria for lupus or any other autoimmune connective-tissue disorder. The claimant's clinical examination does not reveal greater than 11 tender points. Therefore, I do not believe that she meets the diagnostic criteria for fibromyalgia syndrome. The claimant has reached MMI status from the rheumatology standpoint. She qualifies for O% whole person impairment from rheumatology standpoint. (Def. Exh. B, Dr. Yousefi, February 21, 2020, p. 3.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
California Labor Code
Labor Code section 3208.3
Applied to determine compensability of psychiatric injury and post-termination defense.
From the decision · page 3Regarding applicant's contention that she is entitled to be evaluated by a psychiatric QME, Labor Code section 3208.3 states in part:
Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473, 475-476 (Appeals Board en banc)
Cited for the requirement to analyze evidence in the context of Labor Code section 3208.3(e) for psychiatric injury claims.
What proof carried it
The evidence the panel weighed, by kind.
Reports by Dr. Hohl and Dr. Yousefi constitute substantial medical evidence; applicant's disagreement does not invalidate them.
From the decision · page 3We first note, as the WCJ stated in the Report, Dr. Hohl and Dr. Yousefi each took a complete history, reviewed medical records, examined applicant, and explained the basis for their opinions. Applicant's disagreement with the doctors' conclusions do not make them invalid or render them to be not substantial evidence. "Applicant had the opportunity to question the doctors about their findings, but depositions were not scheduled." (Report, p. 4.) Thus, we agree that the reports are substantial evidence and we will not disturb the WCJ's Finding that applicant did not sustain the orthopedic injuries as claimed.
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About this page
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