ADJ9261579 · April 29, 2021

The WCJ's prior award of no increase in permanent disability was not supported by substantial evidence because the QME's opinion was based on an incorrect application of the timing for impairment rating; the WCAB remanded for further development and a new decision.

From the decision · page 1Applicant contends that the reports and deposition testimony of internal medicine qualified medical examiner (QME) Staley J. Majcher, M.D., are substantial evidence that applicant sustained 93% permanent disability as a result of the cumulative injury at issue herein.

Dr. Majcher's opinion was based on an incorrect application of the timing for impairment rating, leading to uncertainty about which blood pressure readings to use.

Favours Defendant prevailed

This undermined the substantiality of the evidence supporting the prior award of no increase in permanent disability.

From the decision · page 5On January 29, 2018, during his deposition, Dr. Majcher clarified his opinions on the WPI for Applicant's hypertensive cardiovascular atherosclerosis. He acknowledged that at the time of the November 13, 2017 examination, Applicant had a normal blood pressure reading (Joint Exhibit 1, page 18, lines 20-21). He opined that if he was supposed to assign a WPI to Applicant based on his readings at the time of his November 13, 2017 examination and Applicant's condition, he would assign Applicant a 30% WPI for his hypertensive cardiovascular atherosclerosis. (Joint Exhibit 1, page 19, lines 21-25 and page 20, lines 1-4). He also clarified that the 70% WPI that he assigned the Applicant in his previous report was based on Applicant's readings at the time of his 2013 stroke and taken from the medicals that were provided to him by the parties. Dr. Majcher also acknowledged that he was not sure which of the Applicant's readings he should use - the ones done at the time of Applicant's stroke that he reviewed in the medical reports provided by the parties or the readings that he did himself at the time of Applicant's MMI examination on November 13, 2017. (Report, pp. 4 § 5.)

Initially rated 32% WPI in 2012 for hypertensive cardiovascular disease; later rated 70% WPI in 2017 including stroke as industrial; acknowledged uncertainty about which blood pressure readings to use for rating; opinion on 93% permanent disability contested; recommended to provide supplemental opinion on correct timing and analysis of impairment.

The WCJ and WCAB discussed Dr. Majcher's opinions extensively, noting his uncertainty about the timing of impairment rating and the need for further development of his opinion to be substantial evidence.

From the decision · page 1Applicant contends that the reports and deposition testimony of internal medicine qualified medical examiner (QME) Staley J. Majcher, M.D., are substantial evidence that applicant sustained 93% permanent disability as a result of the cumulative injury at issue herein.

Labor Code §§ 5903, 5952

An award must be supported by substantial evidence in light of the entire record.

The WCJ's prior award was not supported by substantial evidence because the QME's opinion was based on an incorrect application of timing for impairment rating.

From the decision · page 5evidence in light of the entire record. ((Lab. Code, § 5903, 5952; Garza v. Workmen's Comp.

Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (1983) 34 Cal.3d 159

The Appeals Board's decision may be based on the opinion of a single physician which is substantial evidence.

The WCJ's prior award relied on Dr. Majcher's opinion, but that opinion was found not to be substantial evidence due to methodological issues.

From the decision · page 5(Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (1983) 34 Cal.3d 159, 169 [48

Dr. Majcher's uncertainty about which blood pressure readings to use for impairment rating

From the decision · page 5On January 29, 2018, during his deposition, Dr. Majcher clarified his opinions on the WPI for Applicant's hypertensive cardiovascular atherosclerosis. He acknowledged that at the time of the November 13, 2017 examination, Applicant had a normal blood pressure reading (Joint Exhibit 1, page 18, lines 20-21). He opined that if he was supposed to assign a WPI to Applicant based on his readings at the time of his November 13, 2017 examination and Applicant's condition, he would assign Applicant a 30% WPI for his hypertensive cardiovascular atherosclerosis. (Joint Exhibit 1, page 19, lines 21-25 and page 20, lines 1-4). He also clarified that the 70% WPI that he assigned the Applicant in his previous report was based on Applicant's readings at the time of his 2013 stroke and taken from the medicals that were provided to him by the parties. Dr. Majcher also acknowledged that he was not sure which of the Applicant's readings he should use - the ones done at the time of Applicant's stroke that he reviewed in the medical reports provided by the parties or the readings that he did himself at the time of Applicant's MMI examination on November 13, 2017. (Report, pp. 4 § 5.)