What the panel ordered
Petition for Reconsideration denied by the Appeals Board panel.
Defendant sought reconsideration of the Findings and Award issued by the WCJ on July 2, 2021, which found 45% permanent partial disability.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
Permanent disability ratingApplicant prevailedchest · left shoulder · lumbar spine
Dr. Lineback's reports and opinions on applicant's disability rating constitute substantial evidence, properly applying Almaraz/Guzman and AMA Guides by analogy due to lack of specific AMA criteria for chest wall pain.
From the decision · page 4First, Dr. Lineback clearly stated that "Unfortunately, no AMA criteria address chest wall pain" (Joint Exh. 1, p. 3), and "... no AMA Guidelines exist for chronic injuries to the chest wall." (Joint Exh. 5, p. 2.) Based on our review of the AMA Guides, we agree with Dr. Lineback that they do not contain any criteria for addressing applicant's chest injury. Thus, there is no means by which the doctor could provide a strict rating and in turn he could not explain why a strict rating would not be accurate. Under these circumstances, Dr. Lineback must exercise his professional skill and judgment to determine an accurate rating of applicant's disability. Also, Dr. Lineback did provide an alternative rating "within the four corners of AMA Guides" by analogizing applicant's chest injury with "the AMA Guidelines pertaining to the respiratory system" (Joint Exh. 5, p. 2.) He then explained why applicant's symptoms were consistent with "the criteria for Class 2 (15%) impairment of the whole person..." (Joint Exh. 5, p. 2.) For these reasons, we agree with the WCJ