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.
QMENot substantial evidence
concluded no ADL overlap between cardiovascular, skin, and orthopedic impairments; adding impairments more accurate than CVC
strictly conclusory opinion that failed to substantiate why cardiovascular endurance limitations do not overlap with structural mobility deficits
From the decision · page 9PQME Dr. Weber offered a strictly conclusory opinion that failed to substantiate exactly why the cardiovascular endurance limitations do not overlap with the structural mobility deficits caused by the orthopedic injuries.
QMENot substantial evidence · physiatry
assessed 8% WPI lumbar, 8% WPI cervical, 6% WPI left shoulder, 3% WPI pain; identified overlapping ADL limitations but concluded restrictions were synergistic
failed to adequately explain how overlapping restrictions interact; conclusion that restrictions were synergistic was legally insufficient under Vigil
From the decision · page 6Sharma accurately identified overlapping ADL limitations, specifically noting that the lumbar spine overlaps with the cervical spine and shoulder regarding lifting and carrying, and overlaps with the cardiac condition regarding walking and standing tolerance, he failed to adequately explain how these overlapping restrictions interact.
QMENot substantial evidence · otolaryngology
documented mild to moderate high-frequency hearing loss and tinnitus with Tinnitus Handicap Inventory score of 10/100 indicating mild ADL impact
parties stipulated 0% PD based on testing; further reporting needed to consider Almaraz-Guzman rebuttal for tinnitus
From the decision · page 11Here, the parties’ stipulation that applicant’s tinnitus caused 0% permanent disability relied on the testing done by PQME Dr. Burres. While the AMA Guides provides no standard rating for tinnitus, it does not state that the rating for the impairment is 0. PQME Dr.