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 · chiropractor
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.)
QMERelied upon · podiatrist
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
secondary_treaterRelied upon · podiatrist
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.