Authorities as the decision cited them, with how this panel applied each one.
Gonzales v. Workers' Comp. Appeals Board (1998) 68 Cal.App.4th 843 [63 Cal.Comp.Cases 1477]
Temporary disability indemnity is paid during the time an injured worker is unable to work because of a work-related injury and is intended to substitute for lost wages.
Explains the purpose of temporary disability indemnity in the context of the applicant's claim.
From the decision · page 3Temporary disability indemnity is a workers' compensation benefit which is paid during
the time an injured worker is unable to work because of a work-related injury and is primarily
intended to substitute for lost wages. (Gonzales v. Workers' Comp. Appeals Board (1998) 68
Cal.App.4th 843 [63 Cal.Comp.Cases 1477]; J. T. Thorp, Inc. v. Workers' Comp. Appeals Bd.
(Butler) (1984) 153 Cal.App.3d 327, 333 [49 Cal.Comp.Cases 224].) The purpose of temporary
disability indemnity is to provide a steady source of income during the time the injured worker is
off work. (Gonzales, supra, at p. 1478.)
Lab. Code, §§ 4650-4657
A defendant's liability for temporary disability payments ceases when the employee returns to work, is deemed medically able to return to work, or becomes permanent and stationary.
Applied to determine when temporary disability payments should end.
From the decision · page 3Generally, a defendant's liability for temporary disability payments ceases when the
employee returns to work, is deemed medically able to return to work, or becomes permanent and
stationary. (Lab. Code, § 4650-4657; Huston v. Workers' Comp. Appeals Bd. (1979) 95
Cal.App.3d 856, 868 [44 Cal.Comp.Cases 798]; Bethlehem Steel Co. v. I.A.C. (Lemons) (1942) 54
Cal.App.2d 585, 586-587 [7 Cal.Comp.Cases 250]; Western Growers Ins. Co. v. Workers' Comp.
Appeals Bd. (Austin) (1993) 16 Cal.App.4th 227, 236 [58 Cal.Comp.Cases 323].)
Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (en banc); Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162; Place v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 372
All decisions by the WCAB requiring medical evidence must be supported by substantial medical evidence, which must be predicated on reasonable medical probability.
Applied to assess whether the medical evidence was sufficient to support the WCJ's findings.
From the decision · page 3It is well established that all decisions by the WCAB requiring medical evidence must be
supported by substantial medical evidence. Not all expert medical opinion constitutes substantial
evidence. (Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162 [36 Cal.Comp.Cases
93, 97]; Place v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 372, 378-379 [35
Cal.Comp.Cases 525].) To constitute substantial evidence, a medical opinion must be predicated
on reasonable medical probability. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (en
banc); McAllister v. Workmen's Comp. Appeals Bd., supra, 69 Cal.2d 408, 413, 416-417; Rosas v.
Workers' Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692, 1700-1702, 1705 [58 Cal.Comp.Cases
313].)
Lab. Code, §§ 5701, 5906; Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389
If there is insufficient evidence to determine an issue, the WCJ should order that the medical record be further developed.
Basis for deferring the issues and returning the matter for further development of the record.
From the decision · page 3In this case, the PQME did not offer an opinion on when applicant was permanent and
stationary, other than to state it was "long ago." In addition, Dr. Ross stated that applicant was not
disabled during the entire period she was not working, but did not offer an opinion on a reasonable
period of temporary disability. If there is insufficient evidence to determine an issue, such as
whether applicant was temporarily disabled during the disputed time period, the WCJ should order
that the medical record be further developed. (Lab. Code, § 5701, 5906; Tyler v. Workers' Comp.
Appeals Bd. (1997) 56 Cal.App.4th 389, 394 [62 Cal.Comp.Cases 924] ["principle of allowing full
Lab. Code, § 4600(b)
An award of future medical care is limited to medically necessary treatment reasonably required to cure or relieve the injured employee and is based on the guidelines of the Medical Treatment Utilization Schedule (MTUS).
Applied to affirm the award of future medical care.
From the decision · page 4Finally, with respect to defendant's contention that applicant is not entitled to future
medical care based on the reporting of the PQME, we disagree that the PQME's statement that "I
find no indication for orthopedic future medical care in this matter," is a sufficient basis to refuse
to award future medical care. An award of future medical care is limited to medically necessary
treatment which is treatment that is "reasonably required to cure or relieve the injured employee
of the effects of his or her injury" and is based on the guidelines of the Medical Treatment
Utilization Schedule (MTUS) adopted in accordance with Section 5307.27. (Lab. Code, § 4600(b).) Any request for medical care would also be subject to utilization review and independent
medical review. Therefore, we will affirm the award of future medical care.