ADJ10997880 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted; Findings and Award of June 20, 2023 amended to defer permanent disability and hypertension injury issues pending further medical development; other findings affirmed.

Applicant sought reconsideration of the WCJ's Findings and Award of June 20, 2023, challenging permanent disability rating, EDD lien credit, and attorney fees; WCJ filed a Report and Recommendation on Petition for Reconsideration; WCAB granted reconsideration and amended the Findings and Award.

Read the official decision →

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 ratingRemandedheart · psyche · hemorrhagic system · hypertension

The WCJ found the physical injuries did not constitute a catastrophic injury under Cal. Lab. Code sec. 4660.1(c)(2)(B), and deferred the permanent disability rating and hypertension injury issues pending further medical development.

From the decision · page 72. The issue of injury in the form of hypertension is deferred with jurisdiction reserved.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

What the panel did with the medical opinions

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 · internal medicine

Found 20% whole person impairment (WPI) for coronary artery disease (CAD) with 20% apportionment to non-industrial factors; found 10% WPI for hypertension but not work-related; found 5% WPI for hemorrhagic disorder due to Plavix use; supported 40% WPI for CAD in supplemental report; rejected apportionment for hemorrhagic dysfunction as it was a direct result of work injury.

His detailed medical file showed pre-existing hypertension not worsened by work; hemorrhagic dysfunction was caused by work injury medication; supported increased CAD rating in supplemental report.

From the decision · page 3The parties selected Dr. Paul Grodan as the PQME in internal medicine. His initial report showed a very stressful work environment (Court's Ex. X-1). But the doctor had no records, so he could not finalize his analysis. After reviewing a voluminous file Dr. Grodan declared Applicant to be P&S in Ex. X-2 (12/9/2018). The factors were 20% wpi for coronary artery disease as described in Ch. 3 of the AMA Guides. He apportioned 20% to non-industrial factors most of which was pre-existing hypertension that was often out of control, obesity and a previous bought with cancer. He felt the patient had a 10% wpi for hypertension as described in Ch.4 of the AMA Guides, but that the detailed medical file demonstrated pre-existing hypertension. Hence hypertension was not work-related since his blood pressure was worse before his employment.

QMERelied upon

Diagnosed ratable depression with anxiety; found 2/3 of psychiatric impairment was compensable consequence of heart injury; 1/3 impairment due to work stress per se.

His report concluded psychiatric impairment was largely due to heart injury, with a portion due to work stress; this was considered in the permanent disability rating.

From the decision · page 4Dr. Grodan did recommend a psychiatric consult which resulted in Dr. Joshua Pretzky acting as QME (Ex. Y-2). He diagnosed ratable depression with anxiety. There is no doubt at all that the depression and anxiety were caused by the patient's concern for his heart condition. In fact, virtually the entire report from Dr. Pretzky only leads to that conclusion. However, at the end of the report he comments that much of the unreliable results on the MMPI testing stem from Applicant's response to the employment stress per se. Consequently Dr. Pretsky concludes that a portion of the impairment (1/3) is the result of work stress per se. The remaining impairment (2/3) is a compensable consequence of the heart injury. (Ex. Y-2).

ADJ10997880 · August 28, 2023

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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What the panel did with the medical opinions

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