ADJ10401484 · September 28, 2026

The Appeals Board found substantial medical evidence from AME Dr. Lavorgna supporting addition of disabilities rather than using the combined values chart, based on the impact on activities of daily living and the need for a scooter, thus increasing the permanent disability rating to 74%.

From the decision · page 4County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc) (Vigil), the Appeals Board held that an injured employee can rebut the CVC in the Permanent Disability Rating Schedule and add impairments where they can establish the impact of each impairment on the activities of daily living (ADLs). In addition, they must show either (a) there is no overlap between the effects on ADLs between the body parts rated, or (b) there is overlap but the overlap increases or amplifies the impact on the overlapping ADLs. We explained that medical expertise is required: In determining whether the application of the CVC table has been rebutted in a case, an applicant must present evidence explaining what impact applicant’s impairments have had upon their ADLs. Where the medical evidence demonstrates that the impact upon the ADLs overlaps, without more, an applicant has not rebutted the CVC table. Where the medical evidence demonstrates that there is effectively an absence of overlap, the CVC table is rebutted, and it need not be used.

Applicant's worsened condition affects activities of daily living requiring a scooter.

Favours Applicant prevailed

This medical evidence supported the addition of disabilities rather than use of the combined values chart, increasing the permanent disability rating.

From the decision · page 5a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions.” (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) “Medical reports and opinions are not substantial evidence if they are known to be erroneous, or if they are based on facts no longer germane, on inadequate medical histories and examinations, or on incorrect legal theories. Medical opinion also fails to support the Board’s findings if it is based on surmise, speculation, conjecture or guess.” (Hegglin v. Workmen’s Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93, 97].) The parties presumably choose an AME because of the AME’s expertise and neutrality. (Power v. Workers’ Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].) We will follow the opinions of the AME unless good cause exists to find his/her opinion unpersuasive. (Ibid.) Here, AME Dr. Levorgna supports his opinion to add the disabilities by noting that applicant’s worsened condition has affected her ADLs requiring her current need for a scooter.

Supports addition of disabilities rather than combined values chart for permanent disability rating, based on impact on activities of daily living and need for scooter.

Applicant's worsened condition affects activities of daily living requiring a scooter, supporting addition of disabilities.

From the decision · page 5a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions.” (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) “Medical reports and opinions are not substantial evidence if they are known to be erroneous, or if they are based on facts no longer germane, on inadequate medical histories and examinations, or on incorrect legal theories. Medical opinion also fails to support the Board’s findings if it is based on surmise, speculation, conjecture or guess.” (Hegglin v. Workmen’s Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93, 97].) The parties presumably choose an AME because of the AME’s expertise and neutrality. (Power v. Workers’ Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].) We will follow the opinions of the AME unless good cause exists to find his/her opinion unpersuasive. (Ibid.) Here, AME Dr. Levorgna supports his opinion to add the disabilities by noting that applicant’s worsened condition has affected her ADLs requiring her current need for a scooter.

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

An injured employee can rebut the combined values chart (CVC) by showing the impact of each impairment on activities of daily living (ADLs) and either no overlap or amplified overlap of effects on ADLs.

The Appeals Board applied this standard to find that the applicant rebutted the CVC and supported addition of disabilities.

From the decision · page 4County of Kern (2024) 89 Cal.Comp.Cases 686 (Appeals Board en banc) (Vigil), the Appeals Board held that an injured employee can rebut the CVC in the Permanent Disability Rating Schedule and add impairments where they can establish the impact of each impairment on the activities of daily living (ADLs). In addition, they must show either (a) there is no overlap between the effects on ADLs between the body parts rated, or (b) there is overlap but the overlap increases or amplifies the impact on the overlapping ADLs. We explained that medical expertise is required: In determining whether the application of the CVC table has been rebutted in a case, an applicant must present evidence explaining what impact applicant’s impairments have had upon their ADLs. Where the medical evidence demonstrates that the impact upon the ADLs overlaps, without more, an applicant has not rebutted the CVC table. Where the medical evidence demonstrates that there is effectively an absence of overlap, the CVC table is rebutted, and it need not be used.

Applicant's worsened condition affects activities of daily living requiring a scooter.

From the decision · page 5a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions.” (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) “Medical reports and opinions are not substantial evidence if they are known to be erroneous, or if they are based on facts no longer germane, on inadequate medical histories and examinations, or on incorrect legal theories. Medical opinion also fails to support the Board’s findings if it is based on surmise, speculation, conjecture or guess.” (Hegglin v. Workmen’s Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93, 97].) The parties presumably choose an AME because of the AME’s expertise and neutrality. (Power v. Workers’ Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].) We will follow the opinions of the AME unless good cause exists to find his/her opinion unpersuasive. (Ibid.) Here, AME Dr. Levorgna supports his opinion to add the disabilities by noting that applicant’s worsened condition has affected her ADLs requiring her current need for a scooter.