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.
Substantial evidence from QME Dr. DeSantis and Dr. Auerbach supported the finding of industrial injury to feet and back, with causation linked through altered gait and plantar fasciitis.
From the decision · page 3We agree with Dr. Auerbach and the WCJ that Dr. DeSantis found that applicant had an industrial condition in his feet, and that Dr. Auerbach's analysis thus constitutes substantial evidence of industrial back injury and disability. Dr. DeSantis wrote in his report, "with reasonable medical probability, that this patient's right foot pain is a result of both a local foot strain, or plantar fasciitis, and also a component of radiculopathy." (April 6, 2019 report at pp. 19-20.) Dr. DeSantis never contradicted this initial opinion. At his deposition he expressly stated that he was unable to state with "reasonable medical probability" that there was no plantar fasciitis. (October 28, 2019 deposition at p. 24) Only when asked by the defense attorney whether there was "certainty" that
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. DeSantis found industrial foot injury with plantar fasciitis and radiculopathy, supporting industrial causation of back injury.
Favours Applicant prevailed
This medical opinion provided substantial evidence for the finding of industrial injury and disability.
From the decision · page 3We agree with Dr. Auerbach and the WCJ that Dr. DeSantis found that applicant had an industrial condition in his feet, and that Dr. Auerbach's analysis thus constitutes substantial evidence of industrial back injury and disability. Dr. DeSantis wrote in his report, "with reasonable medical probability, that this patient's right foot pain is a result of both a local foot strain, or plantar fasciitis, and also a component of radiculopathy." (April 6, 2019 report at pp. 19-20.) Dr. DeSantis never contradicted this initial opinion. At his deposition he expressly stated that he was unable to state with "reasonable medical probability" that there was no plantar fasciitis. (October 28, 2019 deposition at p. 24) Only when asked by the defense attorney whether there was "certainty" that
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.
Testified that back condition was secondary to altered gait caused by feet condition; opined industrial causation of back depended on industrial causation of feet.
Back injury causation linked to feet condition causation; relied on treating podiatrist's opinion for plantar fasciitis diagnosis.
From the decision · page 2Applicant was evaluated for his back condition by qualified medical evaluator chiropractor Tami S. Auerbach, D.C. At her January 3, 2019 deposition, Dr. Auerbach testified that any back condition arising out of the cumulative trauma period was secondary to altered gait caused by applicant's feet condition. Thus, industrial causation of the back condition was dependent upon industrial causation of the feet condition. (January 3, 2019 deposition at p. 27.) Dr. Auerbach testified, "We've had discussion here today about the fact that if the origin of his lower back problems [was] precipitated from his foot and ankle condition, that an opinion from [treating podiatrist Michael Quinn, DPM] or another podiatrist would be appropriate." (January 3, 2019 deposition at p. 34.) "So until that determination is made, because the applicant informed me that the impetus for his back pain with regard to the [continuous trauma claim] was his limping from his problems with his [feet] it's like a `if that, but for.'" (January 3, 2019 deposition at p. 40.)
Found right foot pain due to local foot strain/plantar fasciitis and radiculopathy; opined foot strain caused by work on unyielding surfaces; could not rule out plantar fasciitis with reasonable medical probability.
Provided substantial evidence of industrial foot injury supporting back injury causation; testimony clarified reasonable medical probability standard.
From the decision · page 3We agree with Dr. Auerbach and the WCJ that Dr. DeSantis found that applicant had an industrial condition in his feet, and that Dr. Auerbach's analysis thus constitutes substantial evidence of industrial back injury and disability. Dr. DeSantis wrote in his report, "with reasonable medical probability, that this patient's right foot pain is a result of both a local foot strain, or plantar fasciitis, and also a component of radiculopathy." (April 6, 2019 report at pp. 19-20.) Dr. DeSantis never contradicted this initial opinion. At his deposition he expressly stated that he was unable to state with "reasonable medical probability" that there was no plantar fasciitis. (October 28, 2019 deposition at p. 24) Only when asked by the defense attorney whether there was "certainty" that
Diagnosed plantar fasciitis contemporaneously; his diagnosis was relied upon by Dr. Auerbach.
His contemporaneous diagnosis supported the industrial causation of foot injury and thus back injury.
From the decision · page 4applicant had plantar fasciitis, an incorrect legal standard, Dr. DeSantis testified that he agreed there was no certainty. The proper standard in workers' compensation proceedings is reasonable medical probability. (McAllister v. Workmen's Comp. App. Bd. (1968) 69 Cal.2d 408, 413, 416- 417, 419 [33 Cal. Comp. Cases 660].) Certainty is not the correct standard and Dr. DeSantis's testimony that certainty did not exist is irrelevant. In any case, we note that Dr. Quinn diagnosed applicant with plantar fasciitis, and Dr. Auerbach was free to rely upon Dr. Quinn's contemporaneous reporting of applicant's condition.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
McAllister v. Workmen's Comp. App. Bd. (1968) 69 Cal.2d 408
Reasonable medical probability is the correct standard for causation in workers' compensation cases, not medical certainty.
Applied to reject defense argument requiring certainty for plantar fasciitis diagnosis and to uphold industrial injury finding.
From the decision · page 4applicant had plantar fasciitis, an incorrect legal standard, Dr. DeSantis testified that he agreed there was no certainty. The proper standard in workers' compensation proceedings is reasonable medical probability. (McAllister v. Workmen's Comp. App. Bd. (1968) 69 Cal.2d 408, 413, 416- 417, 419 [33 Cal. Comp. Cases 660].) Certainty is not the correct standard and Dr. DeSantis's testimony that certainty did not exist is irrelevant. In any case, we note that Dr. Quinn diagnosed applicant with plantar fasciitis, and Dr. Auerbach was free to rely upon Dr. Quinn's contemporaneous reporting of applicant's condition.
What proof carried it
The evidence the panel weighed, by kind.
Credibility of Dr. DeSantis's testimony regarding industrial causation of foot injury and plantar fasciitis diagnosis.
From the decision · page 3We agree with Dr. Auerbach and the WCJ that Dr. DeSantis found that applicant had an industrial condition in his feet, and that Dr. Auerbach's analysis thus constitutes substantial evidence of industrial back injury and disability. Dr. DeSantis wrote in his report, "with reasonable medical probability, that this patient's right foot pain is a result of both a local foot strain, or plantar fasciitis, and also a component of radiculopathy." (April 6, 2019 report at pp. 19-20.) Dr. DeSantis never contradicted this initial opinion. At his deposition he expressly stated that he was unable to state with "reasonable medical probability" that there was no plantar fasciitis. (October 28, 2019 deposition at p. 24) Only when asked by the defense attorney whether there was "certainty" that
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