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
Found no underlying heart defect; emotions caused right ventricular outflow tract ventricular tachycardia; injury extended to sleep apnea but well controlled and no permanent disability; applicant extremely sensitive and anxious, unable to cope with everyday life; supported 100% permanent disability rating.
His opinion supported the 100% permanent disability rating and was not challenged by defense counsel.
From the decision · page 3On 7/24/2019, I appointed Dr. Gary Stewart as a regular [physician] pursuant to Labor
Code § 5701 to address applicant's internal complaints, including heart. Dr. Stewart examined the
applicant and was deposed. A sleep study was finally provided. The court was then able to address
the remaining issues as to the body parts injured. Petitioner has not challenged the court's findings
as to the nature and extent of the parts of the body injured on 12/23/2009 in the 6/24/2022 Findings
Award & Order.
QMEGiven great weight · psychiatry
Diagnosed adjustment disorder with mixed anxiety and depression; psychiatric illness primarily caused by work injury; recommended GAF score of 60; apportioned 55% psychiatric disability to industrial injury.
Her psychiatric diagnosis and apportionment supported the permanent disability rating.
From the decision · page 4The applicant was evaluated for a Panel QME in psyche by Dr. Diane Weiss whose
1/11/2015 report is marked and admitted as Defendant's Exhibit H. Dr. Weiss described the
applicant's life as quite chaotic (page 133). She further describes on page 138 "As for the applicant'
concurrent, non-industrial, psychosocial stressors, they included those which were pre-existing."
These stressors were also described as "not only numerous, but they were severe and significant."
PTPPartially credited
Found industrial injury aggravated preexisting diabetes; described applicant overeating due to stress; assigned 9% WPI for gastroesophageal reflux disease (40% industrial); 5% WPI for diabetes (60% non-industrial).
His findings on diabetes and gastroesophageal reflux disease contributed to the overall disability assessment.
From the decision · page 4Applicant's primary treating physician, Dr. Stanley Majcher found that applicant's
industrial injury aggravated her preexisting diabetes. Applicant had now gained additional weight.
In his 10/16/2016 treating doctor's report, Dr. Majcher described the applicant as overeating due
to stress. He also finds 9% WPI due to applicant's gastroesophageal reflux disease. Only 40% is
attributed to this industrial injury. The diabetes has 5% WPI with 60% attributable to her
underlying non-industrial condition.
otherRejected
Initially found ventricular tachycardia partly caused by injury; later changed opinion to no heart abnormality or injury after reviewing additional reports; opinion not relied upon.
Her changed opinion was not relied upon by the court.
From the decision · page 5Both Dr. Stanley Majcher and Dr. Linda Cocchiarella had struggled with whether
applicant's elevated heart rate was due this industrial injury or some other mechanism. Dr.
Majcher's opinion could not be relied upon as to whether the heart was additionally injured due to
his opinion that the applicant had some type of underlying heart abnormality that contributed to
applicant's arrhythmia, even though he could not identify an abnormality. I also didn't feel
comfortable relying on the opinion of Dr. Linda Cocchiarella who initially found the applicant's
ventricular tachycardia at least partly caused by the 12/23/2009 injury. After receiving and
reviewing additional applicant medical reports, she changed her mind and found no heart
abnormality or injury.
otherNot substantial evidence
Cardiologist who treated applicant for arrhythmia; no direct opinion on permanent disability rating in decision.
From the decision · page 5the applicant testified that the cardiologist she saw at St. Joseph's Hospital on 3/10/2010, Dr.
Maged Azer, told her she only had two to five years to live and then "it is in god's hands." After
being off of work for four weeks, she returned to work with lifting restrictions taking medication.
the applicant described vomiting, dizziness, and palpations but continued to work until August 29,
2014. Dr. Lee had prescribed Flecainide Acetate but advised that she would need to follow up
with Dr. Azer who was now treating her for the arrythmia. There was a mix up with Dr. Azer's
office denying a refill request which led to her not having the Flecainide for 5 or 6 days. During