California WCABPanel decision

ADJ6660378 · June 12, 2023

Petition for Reconsideration denied

Issues decided: 2
Medical opinions weighed: 1
Authorities named: 1
District office: Marina del Rey

What the panel ordered

Petition for Reconsideration denied

Petition for Reconsideration filed by applicant and denied by WCAB panel after review of WCJ report

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.

AOE/COEDefendant prevailedhips

The WCJ found no medical evidence supporting injury to the hips in the immediate or intermediate aftermath of the injury date, and the AME Dr. Newton opined the hip problems were caused by age-related degenerative changes, not the work injury.

From the decision · page 4A. FINDING THAT HIPS NOT INCLUDED AS BODY PARTS AOE/COE

Medical treatment / UR / IMRDefendant prevailedhips

The WCJ found no need for a Medicare review because the parties chose to take the case to trial and the right to future medical care remains open.

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The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

No medical records supported injury to the hips in the immediate or intermediate aftermath of the injury date 03-30-2008.

Favours Defendant prevailed

This lack of early medical evidence led the WCJ and WCAB to find the hip injuries were not industrially related.

From the decision · page 4Applicant said in his trial testimony that he may have been semi-conscious or unconscious when he fell on the date of the injury, and he "was in extreme pain, including in his lower extremities." (See SOE, page 2, lines 23-24). However, the medical reports reviewed by the AME seem to indicate that applicant had pain in his cervical and lumbar spine and emotional problems in the time immediately after the slip and fall injury. There are no medical records supporting injury to the hips in the immediate or intermediate aftermath of the date of injury.

Orthopedic AME Dr. Newton opined that the hip problems were caused by age-related degenerative changes, not the work injury.

Favours Defendant prevailed

Dr. Newton's opinion was based on substantial medical evidence and was relied upon by the WCJ and WCAB to deny compensability of the hips.

From the decision · page 4The applicant stated at trial that the labrums were torn on both of his hips; he indicated he went to a place called OrthoNorCal in Capitolo, where he saw a Dr. Abidi. It was this physician, Dr. Abidi who told the applicant that the labrums on his hips were torn. The applicant believes he first saw Dr. Abidi in 2015, seven years after the injury happened. (See SOE page 3, lines 11-13). Orthopedic AME Dr. Newton prepared a records review dated 06-06-2018, as set out in Court Exhibit X8. Dr. Newton spent three and a half hours reviewing medical records for this report. On page 9 of this report Dr. Newton indicated that there is no evidence that the applicant has worked anywhere since March of 2008. The records shortly after the injury of 03-30-2008 show that there was no mention of any injury or abnormalities to applicant's hips. Dr.

What proof carried it

The evidence the panel weighed, by kind.

Testimony and credibilityfavours Defendant prevailed

Applicant's trial testimony that he was in extreme pain including lower extremities and that labrums were torn on both hips, but no medical records supported hip injury immediately after the injury date.

From the decision · page 4Applicant said in his trial testimony that he may have been semi-conscious or unconscious when he fell on the date of the injury, and he "was in extreme pain, including in his lower extremities." (See SOE, page 2, lines 23-24). However, the medical reports reviewed by the AME seem to indicate that applicant had pain in his cervical and lumbar spine and emotional problems in the time immediately after the slip and fall injury. There are no medical records supporting injury to the hips in the immediate or intermediate aftermath of the date of injury.

Medical recordsfavours Defendant prevailed

The AME reports were agreed to be substantial medical evidence by the parties in Trial Stipulation 10.

From the decision · page 3According to the Summary of Evidence dated 03-16-2023 on page 2, lines 21-22, on 03-30-2008 the applicant suggested he fell on some concrete steps, while in the course of his employment. This is his trial testimony. The AME medical reports (including Dr. Preston in Court Exhibit X1 and Dr. Peter Newton in Court Exhibits X2-X8) suggest the same history of injury. He had follow up medical treatment and received 104 weeks of temporary disability/EDD state disability benefits. (See Trial Stipulations). The parties used Dr. Peter Newton as the orthopedic agreed medical examiner (AME) and Dr. Thomas Preston as the psychiatric AME. The parties agreed that the body parts of psyche, sleep, cervical and lumbar were admitted and that the body parts of both hips were disputed. Applicant testified at trial and no one else testified. Importantly, in Trial Stipulation Number 10, the parties agreed that the AME reports were indeed substantial medical evidence.

ADJ6660378 · June 12, 2023

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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