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 · orthopedics
Found 100% apportionment to the industrial injury for bilateral knees, with subjective and objective factors and work restrictions yielding PD ratings per the 1988 PDRS.
The applicant's bilateral knee injury was considered permanent and stationary with 100% apportionment to the industrial injury.
otherRejected · chiropractic
Reported prior non-industrial left knee injury and non-industrial bilateral carpal tunnel syndrome; apportioned 20% to a cumulative trauma injury without explanation, which was rejected as substantial evidence.
Apportionment opinion lacked explanation and was not substantial evidence.
From the decision · page 2Per Applicant's SIBTF evaluator, Demeil Betoushana, D.C., The applicant had
suffered a prior non-industrial left knee injury on 7/10/1980 that resulted in
arthroscopic surgery with partial medial meniscectomy. (APPL'S EX. A-4:
SIBTF report, Demeil Betoushana, D.C., 9/12/22, p. 140.) Regarding the 1980
non-industrial left knee injury, Dr. Betoushana stated, "Concerning the 07-10-
80 specific nonindustrial injury the applicant sustained to his left knee after falling
off a bike and eventually needing arthroscopic surgery with partial medial
meniscectomy, with reasonable medical probability it is my opinion that his
condition was permanent, labor disabling, and ratable as of 07-08-83, which is
one year following his 07-08-82 left knee surgery." (Ib., p. 139.) Dr. Betoushana
did not provide a separate rating for the 1980 injury separate from the 1991
industrial bilateral knee injury.
AMERejected · orthopedics
Found permanent total disability from combined injuries but apportionment opinion attributing 20% to a non-accepted injury was not substantial evidence due to lack of rationale.
Apportionment opinion did not meet Escobedo requirements for substantial evidence due to lack of explanation.
From the decision · page 3However, the second requirement that the subsequent industrial injury (SII) must
have caused permanent partial disability is not met, because the applicant is
permanently totally disabled as a result of the SII. In his 2/23/12 report, Dr. Robert
Carson, the parties' AME, stated that the applicant had suffered permanent total
disability as a result of his injury. Dr. Carson stated,
otherRejected · psychiatry
Apportioned 50% of psychiatric impairment to industrial injury and 50% to non-industrial conditions related to morbid obesity; apportionment rejected as not substantial evidence.
Apportionment opinion lacked substantial medical evidence due to inadequate explanation.
From the decision · page 4Dr. Morton Scheinbaum evaluated the applicant to address his psychological claim
for the SIBTF case. Dr. Scheinbaum's 50% apportionment to a pre-existing non-
industrial psyche condition does not constitute substantial medical evidence, either.
Dr. Scheinbaum opined, "I would apportion 50% of the claimant's psychiatric
impairment to the industrial injury of February 27, 2001, and 50% to nonindustrial,
for the reasons as indicated above, predominantly related to the development of
morbid obesity related to his Axis II personality disorder and the development of
the complications related to the morbid obesity, both cerebrovascular and
cardiovascular, but to also include chronic gastroesophageal reflux disease, chronic
diabetes, insomnia, fatty liver and hiatal hernia, and chronic obstructive sleep
apnea." (Dr. Scheinbaum, 12/6/22, pp. 132-133.) Dr. Scheinbaum stated that all of
the alleged nonindustrial conditions such as the stroke of 2009, diabetes, fatty liver,
etc., are related to the development of his morbid obesity. (APPL'S EX. A-6: SIBTF
report, Morton J. Scheinbaum, M.D., 12/6/22., p. 131-132.)
AMERelied upon · internal medicine
Found applicant's weight gain and associated co-morbidities occurred after the industrial injury and could not cause preexisting labor-disabling disabilities.
Supported rejection of apportionment to preexisting conditions related to weight gain.
From the decision · page 4With respect to the weight gain, Dr. Jonathan Ng, AME in internal medicine for the
SII, found that Applicant's weight gain occurred subsequent to the industrial injury.
(APPL'S EX. A-14: AME report, Jonathan Ng, M.D., 4/7/10, pp. 40-41.) Therefore,
his weight gain and associated co-morbidities could not cause preexisting labor-
disabling disabilities.