ADJ9116799 · July 15, 2026

The WCJ found 100% permanent disability but the Appeals Board deferred permanent disability and apportionment issues for further development due to incomplete medical opinions and the need to address the en banc Vigil decision.

Applicant sustained industrial injury to multiple body systems during March 27, 2001 to May 15, 2013.

Favours Applicant prevailed

This established the basis for permanent disability and apportionment issues.

Dr. Weissman opined 35% WPI gastrointestinal impairment and 100% permanent disability with no apportionment to pre-existing factors.

Favours Applicant prevailed

Supported applicant's claim of permanent disability and no apportionment.

Favours Applicant prevailed

Supported permanent total disability finding.

Applicant sustained industrial injury causing multiple system impairments and permanent disability; work restrictions increased over time; opined 35% WPI gastrointestinal impairment, 100% permanent disability, and no apportionment to pre-existing factors.

Provided detailed impairment ratings and vocational impact supporting permanent disability and no apportionment.

From the decision · page 2Applicant, while employed during the period March 27, 2001 to April 15, 2013, as an attorney, sustained an industrial injury to his brain, heart, circulatory system, internal organs, intestinal system, digestive system, and excretory system (including IBS). On April 30, 2007, applicant and State Compensation Insurance Fund executed Joint Stipulations with Request for Award (Stipulations) wherein he sustained, during the period up through March 2001 and on March 27, 2001, industrial injuries to his vascular system and in the form of high blood pressure resulting in 45% permanent disability with the need for further medical treatment. (ADJ3416484 and ADJ 3761342.) The Joint Stipulations relied on the qualified medical evaluation (QME) report of Robert Weissman, M.D., dated January 24, 2003 (Joint Ex. E) based on preclusion from undue emotional distress and very heavy work, contemplating a 25% loss of applicant’s preinjury capacity for bending, lifting, stooping, pushing, pulling and climbing or other comparable physical activities. (Id. at p. 8.)

Diagnosed irritable bowel syndrome and explosive diarrhea related to work stress; provided impairment ratings for heart, hypertension, and gastrointestinal system; noted severe ADL limitations.

Supported impairment ratings and functional limitations relevant to permanent disability.

From the decision · page 7Given the above considerations, I believe it is a reasonable probability, as noted, that these other medical problems that have been accepted as industrially related have had a synergistic effect with his progressive renal failure. (Id. at pp. 2-3.) In Dr. Brautbar’s report dated July 31, 2018 (App. Ex. 11), after evaluating applicant, diagnosed him with irritable bowel syndrome (Id. at p. 51) and explosive diarrhea (Id. p. 53) related to severe work stress requiring him to plan his life near a bathroom before consuming food and fluids, impacting his activities of daily living (ADLs). (Ibid.) Dr. Brautbar opined that, with respect to applicant’s heart, he has 40% WPI, consistent with Class 3 under Table 3-6a on page 36 of the AMA Guides based on his recovery from coronary artery surgery and continued treatment. (Id. at p. 54.) With respect to his hypertension, he has 45% WPI, consistent with Class 2 under Table 4- on page 66 of the AMA Guides based on asymptomatic and decreased creatinine clearance of 20% to 50%. (Ibid.) With respect to the upper gastrointestinal system, applicant has 20% WPI, consistent with Class 2 under Table 6-3 on page 121 of the AMA Guides, based on clinical signs and symptoms of upper digestive disease, the need for ongoing dietary modification and 7

Defendant's PQME whose opinions were challenged by applicant and defendant for lack of substantial evidence support.

Defendant's PQME whose opinions were challenged by applicant and defendant for lack of substantial evidence support.

California Labor Code

Labor Code sections 4663(a) and 4664(a)

Apportionment is based on causation of permanent disability; employer liable only for disability caused by employment injury.

From the decision · page 14Apportionment is the process utilized to segregate permanent disability or the residuals caused by an industrial injury from those attributable to other industrial injuries or to nonindustrial factors, to allocate legal responsibility fairly. (Brodie v. Workers’ Comp. Appeals Bd. (2007) Cal.4th 1313, 1321 [72 Cal.Comp.Cases 565]; Marsh v. Workers’ Comp. Appeals Bd. (2005) 130 Cal.App.4th 906, 911 [70 Cal.Comp.Cases 787.].) A medical evaluator must parcel out industrial and non-industrial causation of permanent disability. (E.L. Yeager Construction v. Workers’ Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 927 [71 Cal.Comp.Cases 1687].) Apportionment of permanent disability is “based on causation” and the “employer shall only be liable for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of employment.” (Lab.

California Labor Code

Labor Code section 4659(c)

Applicant contended the WCJ erred in failing to apply this section to increase the permanent total disability indemnity rate.

CA-WCAB en banc decision

Almaraz/Guzman II

Requires physicians to provide strict AMA Guides rating and reasoned explanation for alternative ratings reflecting functional limitations.

CA-WCAB en banc decision

Vigil v. County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc)

Requires further development of record to address addition of impairments and impact on activities of daily living for permanent disability rating.

From the decision · page 13Therefore, their opinions regarding addition of applicant’s impairments require further development to address our holdings in Vigil. “[I]n order to ensure reliance on substantial evidence, and a complete adjudication of the issues consistent with due process,” the WCJ and the Appeals Board both have a duty to further develop the record where there is an absence of, or insufficient evidence to determine the issues raised for trial. (Tyler v. Workers’ Comp. Appeals Bd. (1997) 56 Cal. App.4th 389, 393-395 [62 Cal.Comp.Cases 924]; McClune v. Workers’ Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261]; see Lab. Code, §§ 5701 and 5906; McDuffie v.

CA-WCAB panel decision

Vocational evidence must address apportionment and support permanent total disability based on medically supported work restrictions.

Applicant's medically supported work restrictions preclude him from working in the open labor market, supported by vocational expert opinion.