ADJ13465387 — California WCAB decision

What the panel ordered

Defendant's Petition for Reconsideration of the WCJ's Findings and Award is denied.

Petition for Reconsideration filed by defendant and denied by the Appeals Board.

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.

Permanent total disabilityApplicant prevailedcervical spine · lumbar spine · left shoulder · left hip

The AME's medical opinions and vocational experts' reports support a finding of 100% permanent total disability due to severe work restrictions and loss of earning capacity.

From the decision · page 3In this case, John Lavorgna, M.D., served as the Agreed Medical Evaluator (AME), and his opinions provided the sole medical evidence submitted by the parties. We presume that the AME was chosen by the parties because of his expertise and neutrality, and that his opinions should ordinarily be followed unless there is good reason to find those opinions unpersuasive. (Power v. Workers' Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114, 117].) In his report dated December 17, 2020, the AME determined that applicant had reached Maximal Medical Improvement and assigned Whole Person Impairment percentages for applicant's cervical spine (8 percent for a Cervical Category II Diagnosis-Related Estimate according to The AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition), lumbar spine (8 percent for a Lumbar Category II Diagnosis-Related Estimate per the AMA Guides), left shoulder (16 percent whole person impairment), and left hip (20 percent for full-time use of a cane and moderately severe gait derangement). (Joint Exhibit 101, Report of AME John Lavorgna, M.D., dated December 17, 2020, page 10, paragraphs 3-6.) The AME apportioned 100 percent of these impairments to applicant's industrial injury of June 23, 2018. (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.

AMERelied upon

Assigned whole person impairment percentages for cervical spine, lumbar spine, left shoulder, and left hip; apportioned 100% to industrial injury; provided severe work restrictions including limited sedentary work, full-time cane use, no lifting over 2-3 pounds, and need to lie down most of the day.

The AME's opinions were relied upon as the sole medical evidence and supported the finding of permanent total disability.

From the decision · page 3In this case, John Lavorgna, M.D., served as the Agreed Medical Evaluator (AME), and his opinions provided the sole medical evidence submitted by the parties. We presume that the AME was chosen by the parties because of his expertise and neutrality, and that his opinions should ordinarily be followed unless there is good reason to find those opinions unpersuasive. (Power v. Workers' Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114, 117].) In his report dated December 17, 2020, the AME determined that applicant had reached Maximal Medical Improvement and assigned Whole Person Impairment percentages for applicant's cervical spine (8 percent for a Cervical Category II Diagnosis-Related Estimate according to The AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition), lumbar spine (8 percent for a Lumbar Category II Diagnosis-Related Estimate per the AMA Guides), left shoulder (16 percent whole person impairment), and left hip (20 percent for full-time use of a cane and moderately severe gait derangement). (Joint Exhibit 101, Report of AME John Lavorgna, M.D., dated December 17, 2020, page 10, paragraphs 3-6.) The AME apportioned 100 percent of these impairments to applicant's industrial injury of June 23, 2018. (Id.)

otherNot substantial evidence · neuropsychology

Found no residual neurological issues on an industrial basis.

From the decision · page 7Stephen Francis, PhD performed a neuropsychological consult on August 22, 2022. He found that there were no residual neurological issues on an industrial basis.

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

California Labor Code

Labor Code section 4660.1

Applied to adjust Whole Person Impairment percentages for permanent disability rating.

From the decision · page 3Applicant's Whole Person Impairment percentages, when adjusted in accordance with Labor Code section 4660.1 and the current rating schedule, produce the following percentages of permanent disability:

California Workers' Compensation Appeals Board

East Bay Municipal Utility District v. Workers' Compensation Appeals Board (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.)

Applied for combining impairments in permanent disability rating.

From the decision · page 3In his subsequent report dated January 5, 2021, the AME opined that these impairments should be added instead of combined because they "act synergistically to create a greater level of impairment" as contemplated in the case of East Bay Municipal Utility District v. Workers' Compensation Appeals Board (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.). (Joint Exhibit 102, Report of AME John Lavorgna, M.D., dated January 5, 2021, page 1, last paragraph, and page 2, first paragraph.) Dr. Lavorgna confirmed this opinion at his deposition of May 11, 2021. (Joint Exhibit 104, Transcript of the Deposition of John Lavorgna, M.D., dated May 11, 2021, page 20, line 6 to page 21, line 24.) In his re-evaluation of December 13, 2023, Dr. Lavorgna revised the Whole Person Impairment of the left shoulder to 13 percent. (Joint Exhibit 103, Report of AME John Lavorgna, M.D., dated December 19, 2023, page 6, paragraph 2.)

California Workers' Compensation Appeals Board

Vigil v. County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc)

Applied to assess rebuttal of Combined Values Chart in impairment rating.

From the decision · page 4If added, the adjusted Whole Person Impairment percentages would total 90 percent. However, because Dr. Lavorgna's discussion of the interaction between applicant's impairments lacks specificity and does not apply the current standards for rebuttal of the Combined Values Chart set forth in Vigil v. County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc), a strict rating of applicant's impairments would have to be based upon the Combined Values Chart in the rating schedule. On that chart, permanent disability of 36, 24, 15, and 15 percent combine to a total of 64 percent permanent disability.

ADJ13465387 · August 1, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

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The rules the panel named

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