ADJ15833920 · February 13, 2026

The WCAB found substantial medical evidence supporting the addition rather than combination of neurological impairments based on distinct activities of daily living affected by headaches and vertigo, leading to a finding of permanent and total disability.

From the decision · page 2On November 13, 2025, the WCJ issued the instant F&A, determining in relevant part that applicant's industrial injury resulted in permanent and total disability. (Finding of Fact No. 4.) The accompanying Opinion on Decision explains that neurology QME Dr. McQuinn rated applicant's industrial vertigo at 29 percent whole person impairment (WPI), and applicant's headaches at 22 percent WPI. (Opinion on Decision, at pp. 6-7.) Dr. McQuinn further opined that the impairment for applicant's vertigo and headache impairments should be added, rather than combined, because there was no significant overlap in the affected Activities of Daily Living (ADLs). (Id. at p. 7.) The WCJ observed that after adjustment for age, occupation, and future earnings modifier, applicant's vertigo resulted in 60 percent permanent disability, while the headaches resulted in 50 percent permanent disability.

Neurology QME Dr. McQuinn's medical opinion that applicant's headaches and vertigo affect different activities of daily living and should be added rather than combined.

Favours Applicant prevailed

This opinion provided substantial medical evidence to rebut the Combined Values Chart and supported the finding of permanent and total disability.

From the decision · page 2On November 13, 2025, the WCJ issued the instant F&A, determining in relevant part that applicant's industrial injury resulted in permanent and total disability. (Finding of Fact No. 4.) The accompanying Opinion on Decision explains that neurology QME Dr. McQuinn rated applicant's industrial vertigo at 29 percent whole person impairment (WPI), and applicant's headaches at 22 percent WPI. (Opinion on Decision, at pp. 6-7.) Dr. McQuinn further opined that the impairment for applicant's vertigo and headache impairments should be added, rather than combined, because there was no significant overlap in the affected Activities of Daily Living (ADLs). (Id. at p. 7.) The WCJ observed that after adjustment for age, occupation, and future earnings modifier, applicant's vertigo resulted in 60 percent permanent disability, while the headaches resulted in 50 percent permanent disability.

The WCJ's finding that applicant's permanent disability exceeded 100 percent when adding neurological impairments, resulting in permanent and total disability.

Favours Applicant prevailed

This finding was affirmed by the WCAB panel as supported by substantial evidence.

From the decision · page 2On November 13, 2025, the WCJ issued the instant F&A, determining in relevant part that applicant's industrial injury resulted in permanent and total disability. (Finding of Fact No. 4.) The accompanying Opinion on Decision explains that neurology QME Dr. McQuinn rated applicant's industrial vertigo at 29 percent whole person impairment (WPI), and applicant's headaches at 22 percent WPI. (Opinion on Decision, at pp. 6-7.) Dr. McQuinn further opined that the impairment for applicant's vertigo and headache impairments should be added, rather than combined, because there was no significant overlap in the affected Activities of Daily Living (ADLs). (Id. at p. 7.) The WCJ observed that after adjustment for age, occupation, and future earnings modifier, applicant's vertigo resulted in 60 percent permanent disability, while the headaches resulted in 50 percent permanent disability.

Rated applicant's post-traumatic headache and vertigo impairments and opined they should be added rather than combined due to no significant overlap in affected activities of daily living.

Dr. McQuinn explained that vertigo affected balance-related ADLs while headaches affected concentration-related ADLs, supporting addition of impairments.

From the decision · page 2On November 13, 2025, the WCJ issued the instant F&A, determining in relevant part that applicant's industrial injury resulted in permanent and total disability. (Finding of Fact No. 4.) The accompanying Opinion on Decision explains that neurology QME Dr. McQuinn rated applicant's industrial vertigo at 29 percent whole person impairment (WPI), and applicant's headaches at 22 percent WPI. (Opinion on Decision, at pp. 6-7.) Dr. McQuinn further opined that the impairment for applicant's vertigo and headache impairments should be added, rather than combined, because there was no significant overlap in the affected Activities of Daily Living (ADLs). (Id. at p. 7.) The WCJ observed that after adjustment for age, occupation, and future earnings modifier, applicant's vertigo resulted in 60 percent permanent disability, while the headaches resulted in 50 percent permanent disability.

Confirmed applicant sustained concussion and post-concussion syndrome and addressed the method of combining permanent disability percentages.

Dr. Sussman provided medical opinion supporting the extent of neurocognitive impairment.

From the decision · page 13The parties' neuropsychology AME, Dr. Sussman, has similarly addressed the issue of the most accurate method of combining applicant's permanent disability percentages. In his report of August 30, 2023, Dr. Sussman indicated that "with reasonable medical probability that the applicant sustained a concussion and subsequent post-concussion syndrome on June 3, 2020 while working for the East Bay Regional Park District." (Ex. 110, Report of Jed Sussman, Ph.D., dated August 30, 2023, at p. 15.) In order to quantify applicant's neurocognitive impairment,

Reported an additional 7 percent whole person impairment for ophthalmic injury.

Supported the finding of permanent disability due to ophthalmic injury.

From the decision · page 2Added together, and without consideration of applicant's ophthalmological and neuropsychology impairments, applicant's permanent disability exceeded 100 percent, rendering applicant permanently and totally disabled. (Id. at p. 12.) The WCJ observed that applicant suffered cognitive impairment as a result of her injuries, and that applicant's psychiatric disability was ratable under the "catastrophic injury" exception found in Labor Code1 section 4660.1(c)(2)(B). (Id. at p. 12.) In addition, the reporting of QME Dr. Edington supported an additional 7 percent WPI for ophthalmic injury. (Id. at p. 12-14.)

Permanent Disability Rating Schedule (PDRS) and Combined Values Chart (CVC) principles

The PDRS and CVC are rebuttable; a physician may add impairments if supported by substantial medical evidence showing no overlap in ADLs or synergistic effects.

From the decision · page 7The Permanent Disability Rating Schedule (PDRS) is prima facie evidence of an injured employee's permanent disability. (Lab. Code, § 4660, 4660.1; Ogilvie v. Workers' Comp. Appeals Bd. (2011) 197 Cal.App.4th 1262, 1274§ 1277 [76 Cal.Comp.Cases 624] (Ogilvie).) The PDRS provides that the ratings for multiple body parts arising out of the same injury are "generally" combined using the Combined Values Chart (CVC), which is appended to the PDRS. (2005 PDRS, at p. 1-10.)Yet, because it is part of the PDRS, the CVC is rebuttable and a reporting physician is not precluded from utilizing a method other than the CVC to determine an employee's whole person impairment so long as the physician's opinion remains within the four comers of the AMA Guides. (Lab. Code, § 4660; Guzman, supra, 187 Cal.App.4th at pp. 818§ 829.)

Subjective complaints supported by clinical evaluation and medical records

From the decision · page 6neurologists, speech and vestibular therapy regimens, and medication usage. The QME took particular note of AME Dr. Sussman's determination that upon neurocognitive testing, applicant demonstrated "very slow processing," and demonstrating the need for additional vision, vestibular, and cognitive therapy. (Ex. 103, Report of Barbara McQuinn, M.D., dated July 9, 2024, at p. 16.) The QME further inventoried applicant's activities of daily living (ADLs) at each evaluation, and after synthesizing the clinical evaluation with the medical records, assigned corresponding impairment percentages. We are thus persuaded that the QME has appropriately evaluated the entire breadth of available medical evidence, and utilizing her "experience, training, skill, [and] thoroughness in clinical evaluation," reached an "appropriate and reproducible assessment to be made of clinical impairment." (AMA Guides, 5th Edition, p. 11.)

Detailed analysis of activities of daily living showing no significant overlap

From the decision · page 13concentrate, read, use a screen for prolonged periods, or tolerate loud noise or physical jarring (hammer impacts, etc.)." (Id. at p. 7.) And in this respect, the QME's deposition testimony confirms that she conducted a comprehensive discussion with applicant regarding her activities of daily living, resulting in the QME reevaluating her assessment of impairment generally. (Ex. 104, Transcript of Deposition of Barbara McQuinn, M.D., dated October 31, 2024, at p. 18:9.) The QME subsequently restated her analysis in deposition testimony, noting that "the disequilibrium more affects her outdoor or physical exercise related ADLs and job duties" while applicant's post- traumatic headache condition "affects more her ability to do administrative tasks" such as reading, office work, and other activities requiring focus and concentration. (Id. at p. 29:18.) The QME has thus evaluated applicant's ADLs and has explained why she felt applicant's disequilibrium condition would impact a separate subset of ADLs from applicant's post-traumatic headaches. Accordingly, we conclude that the QME has adequately addressed the issue of overlap such that the most accurate reflection of applicant's impairment is reflected in the addition, rather than the combination through the CVC, of applicant's neurologically-mediated impairment ratings.