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.
QMERelied upon · hand surgery
Opined that applicant's right hand condition and need for medical treatment stemmed from the January 14, 2020 industrial injury, supporting industrial causation.
His opinion was based on review of numerous medical records and was consistent with applicant's credible testimony.
From the decision · page 5The opinion of the QME, Dr. Fujinaka, on the other hand, deals more directly with the issue of
causation of applicant's right hand condition. Dr. Fujinaka reviewed numerous medical records,
including those of Dr. Slikker. Dr. Fujinaka's opinion on causation is also much more consistent
with applicant's unrebutted and credible testimony that she developed her right hand pain over a
prolonged period of time while mopping 24 private hospital rooms, each with an attached
bathroom over a workweek of 40 hours, with some overtime. Accordingly, I find that the medical
evidence supports a finding of industrial injury.
PTPRejected
Initially noted right hand pain from mopping and provided work restrictions; later opined non-industrial causation without adequate explanation or support from hand surgeon's opinion.
Her June 10, 2020 report was inconsistent with other medical evidence and lacked explanation for non-industrial causation conclusion.
From the decision · page 6This claim of injury has been denied by defendant. The medical evidence supports applicant's
claim of injury, with the exception of one inconsistent report from her treating physician, Dr.
Hadassah Rose Kreiman of June 10. 2020 (Exh. F). Prior to this report, Dr. Kreiman authored four
reports from January 14, 2020 through May 8, 2020 (Exh's A, B, C and E) which noted without
critique that she was complaining of right hand pain from mopping rooms at work. In each of these
four reports, she was provided with work restrictions. She was then seen by a hand surgeon, Dr.
William Slikker, who provided applicant with an injection to her right hand as documented in his
report of June 9, 2020 (Exh. G). Dr. Slikker does not opine one way or the other whether
applicant's claim of injury is industrial or non-industrial. In his June 10, 2020 report, Dr. Kreiman
states at page 3 of his June 10, 2020 report, "At this time I find that (sic) patient's right hand
condition is nonindustrial based on advanced imaging and [the] opinion of hand surgeon." Dr.
Kreiman does not explain what about the images supports his change in opinion on causation.
Moreover, there is no opinion of the hand surgeon, Dr. Slikker, which supports the non-industrial
conclusion of Dr. Kreiman.
secondary_treaterPartially credited · hand surgery
Provided diagnostic evaluation and treatment but did not opine on industrial causation, rendering his opinion inconclusive on causation.
His report listed possible diagnoses but did not conclude on causation, thus not supporting non-industrial causation.
From the decision · page 5Defendant is correct that the reports from the treating physician prior to the June 10, 2020 report
do not find industrial causation. They also do not, however, find that the injury is non-industrial.
The June 9, 2020 report of the hand specialist, Dr. Slikker, initially states his diagnosis as a generic
notation at page 2 of his report of simply "right hand pain." At page 3 of his report, he provided
numerous possible diagnoses, listing them as, "Possible flexor tendon middle finger chronic
tenosynovitis (lupus spectrum), vs soft tissue mass vs AVM, palmar arch anyerusyn, or foreign
body." He then states at page 4 of his report that he "ordered CRP and ESR to evaluate for possible
inflammatory arthritis/tenosynovitis." He also recommended that applicant applicant's condition
be observed over the next month, and that additional diagnostic studies be performed if her
symptoms did not improve. Taken as a whole, the opinion of Dr. Slikker is inconclusive of the
cause of applicant's right hand pain.