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.
QMERelied upon · neurology
Found applicant permanent and stationary with 28% WPI for traumatic brain injury and 20% WPI for vertigo; stated applicant will not be able to return to any form of gainful employment.
Opinion supports total permanent disability and inability to return to work.
From the decision · page 4Following completion of the Panel Qualified Medical Evaluator process,
the applicant was evaluated by Steven L. McIntire, M.D. in the medical specialty
of neurology. In report dated April 3, 2014 (Exhibit C), Dr. McIntire found the
applicant permanent and stationary. He found a 28% WPI related to the traumatic
brain injury and altered mental status per the AMA Guides, Table 13-6, plus 20%
WPI for vertigo and deficits in vestibular function per Table 13-13. He further
stated that "he will not be able to return to any form of gainful employment" (ibid,
page 2).
QMERelied upon · neuropsychology
Found applicant permanent and stationary with 15% WPI for Clinical Dementia; diagnosed Major Neurocognitive Disorder, Mood Disorder secondary to TBI, Personality Change, and Male Hypoactive Sexual Desire Disorder; opined applicant is 100% permanently and totally disabled and unable to function independently in any competitive work environment.
Opinion supports total permanent disability and inability to compete in open labor market.
From the decision · page 4Dr. Cantrell referred the applicant to Fernando Gonzalez, Ph.D. for
evaluation in the medical specialty of neuropsychology. Applicant complained of
cognitive processing problems, memory issues, dizziness and problems with
balance, hearing loss, vision problems and depression (report dated January 22,
2013, Joint Exhibit 1, page 3). Applicant's spouse and son were also interviewed
and noted increased irritability and obsessive-compulsive behavior including
hoarding (ibid, page 4). A number of neuropsychological tests were administered.
IQ was noted to be average, verbal intellectual abilities in the high average range,
low average in perceptual reasoning and average in processing speed (ibid, pages
14-15). His scores varied as to language functioning and mental control. Verbal
memory scores were low average to average. In summary, Dr. Gonzalez stated that
the applicant has suffered "significant losses in terms of both intellectual ability and
emotional control, and suffers from frequent headaches, visual difficulty, dizziness,
and tinnitus, all of which negatively affect and limit his ability to function (ibid,
Page 19).
QMERelied upon · otolaryngology
Diagnosed left temporal bone fracture, vertigo, traumatic brain injury with loss of consciousness, rib fractures, clavicle fracture, pulmonary contusion, tinnitus, hearing loss, and vestibular disorder; found 28% WPI for traumatic brain injury, 10% WPI for vestibular disorder, and 3.13% WPI for left sensorineural hearing loss.
Supports the extent of permanent disability and multiple impairments.
From the decision · page 6A supplemental report from the QME in otolaryngology, Dr. May was
submitted (Court Exhibit 3, full report found at EAMS Doc ID# 31847023). Dr.
May found a 28% WPI related to traumatic brain injury per Table 13-6 of the AMA
Guides, 10% WPI for Class 2 impairment per Table 11-4 Vestibular disorder and
3.13% WPI for left sensorineural hearing loss.
QMEPartially credited · psychiatry
Diagnosed depressive disorder, cognitive disorder, traumatic brain injury with multiple residual neurological and cognitive deficits; opined applicant is totally and permanently disabled but not at maximum medical improvement and recommended psychotherapy.
Supports total permanent disability but notes applicant not at MMI and needs treatment.
From the decision · page 5The parties completed the panel QME process and Paul Michaels, M.D. was
selected in the medical specialty of psychiatry (Court Exhibit 1). He diagnosed
applicant with Depressive Disorder, Cognitive Disorder, traumatic brain injury
with multiple residual neurological and cognitive deficits, multiple non-industrial
conditions including thyroid, hypertension, prostate and high cholesterol,
psychosocial stressors, serious traumatic brain injury with residual neurological and
QMERejected · internal medicine
Found applicant's hypertension was non-industrial, contrary to Board's finding.
Disputes industrial causation of hypertension but does not affect total disability finding.
From the decision · page 6The parties also obtained a PQME report from James M. Schmitz, M.D.
dated 12/14/2017 in the specialty of internal medicine (Court Exhibit 2). Dr.
Schmitz found that applicant's hypertension was non-industrial, contrary to the
finding of the Board.