What the panel ordered
Findings and Award of March 14, 2023, affirmed except issues of permanent disability and attorney fees deferred; Award amended and matter returned to WCJ for further proceedings; clerical error corrected.
Defendant sought reconsideration of the Findings and Award issued by the WCJ on March 14, 2023, challenging the permanent disability rating and Almaraz/Guzman analysis; the WCJ recommended denial of the Petition for Reconsideration; the WCAB affirmed the Findings and Award except it deferred permanent disability and attorney fee issues and returned the matter to the WCJ for further proceedings.
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.
Dr. Wolfson's report did not constitute substantial evidence due to failure to perform the required four-step Almaraz/Guzman analysis; therefore, the permanent disability caused by the injury was deferred for further development.
From the decision · page 4and Category IV weakness in flexion strength using Almaraz/Guzman.... I am combining them [weakness and motion impairment] using the Almaraz/Guzman rule...." (Joint Exh. 2, p. 27.) Having reviewed his report, it is not clear what aspect of the Almaraz/Guzman analysis Dr. Wolfson was referring to, but it does not appear that he utilized the four-step analysis noted above. Absent that analysis, Dr. Wolfson's report does not constitute substantial evidence. (Milpitas Unified School Dist. v. Workers' Comp. Appeals Bd., supra.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Wolfson's report did not include the required four-step Almaraz/Guzman analysis.
Favours Applicant prevailed
Without this analysis, the report was not substantial evidence to support the permanent disability rating.
From the decision · page 4and Category IV weakness in flexion strength using Almaraz/Guzman.... I am combining them [weakness and motion impairment] using the Almaraz/Guzman rule...." (Joint Exh. 2, p. 27.) Having reviewed his report, it is not clear what aspect of the Almaraz/Guzman analysis Dr. Wolfson was referring to, but it does not appear that he utilized the four-step analysis noted above. Absent that analysis, Dr. Wolfson's report does not constitute substantial evidence. (Milpitas Unified School Dist. v. Workers' Comp. Appeals Bd., supra.)
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.
Diagnosed industrially related right shoulder sprain with inflammation and capsulitis, mild acromioclavicular joint osteoarthritis, and limitation of motion; initially found condition not permanent and stationary; later found condition permanent and stationary with 17% permanent disability rating combining motion impairment and Category IV weakness using Almaraz/Guzman; report lacked proper four-step Almaraz/Guzman analysis, thus not substantial evidence.
Report lacked the required four-step Almaraz/Guzman analysis to constitute substantial evidence.
From the decision · page 2BACKGROUND Applicant claimed injury to his right shoulder and right hand while employed by defendant as a PST (patient services technician) specialist on October 29, 2019. QME Dr. Wolfson evaluated applicant on April 7, 2020. Dr. Wolfson examined applicant, took a history, and reviewed the medical record. He diagnosed applicant as having an "industrially related" right shoulder sprain with inflammation and capsulitis, mild acromioclavicular joint osteoarthritis, and limitation of motion. (Joint Exh. J6, Ronald B. Wolfson, M.D., April 7, 2020, p. 8.) Dr. Wolfson concluded that applicant's condition had not reached maximum medical improvement (MMI). (Joint Exh. J6, p. 9.) On January 12, 2021, applicant underwent a right shoulder arthroscopic surgery with decompression and rotator cuff repair. (Joint Exh. J3, Ronald B. Wolfson, M.D., July 14, 2021, p. 8, medical record review.) QME Dr. Wolfson re-evaluated applicant on July 14, 2021, but applicant's condition was not permanent and stationary. (Joint Exh. J3, p. 22.) Dr. Wolfson again re-evaluated applicant on June 21, 2022, and he found that applicant's condition had reached permanent and stationary status. (Joint Exh. 2, Ronald B. Wolfson, M.D., June 21, 2022, p. 27.) Regarding applicant's whole person impairment (WPI), Dr. Wolfson concluded:
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 5952(d)
An award, order, or decision of the Appeals Board must be supported by substantial evidence.
The Appeals Board found Dr. Wolfson's report did not constitute substantial evidence due to lack of proper Almaraz/Guzman analysis.
From the decision · page 4It is well established that an award, order, or decision of the Appeals Board must be supported by substantial evidence. (Lab. Code, § 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274, 281 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 317 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 635 [35 Cal.Comp.Cases 16].) The Appeals Board has the discretionary authority to further develop the record where there is insufficient evidence to determine an issue that was submitted for decision. (Lab. Code, § 5701, 5906; Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389 [62 Cal.Comp.Cases 924]; McClune v. Workers' Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261].)
What proof carried it
The evidence the panel weighed, by kind.
Dr. Wolfson's failure to perform the four-step Almaraz/Guzman analysis as required by case law.
From the decision · page 4and Category IV weakness in flexion strength using Almaraz/Guzman.... I am combining them [weakness and motion impairment] using the Almaraz/Guzman rule...." (Joint Exh. 2, p. 27.) Having reviewed his report, it is not clear what aspect of the Almaraz/Guzman analysis Dr. Wolfson was referring to, but it does not appear that he utilized the four-step analysis noted above. Absent that analysis, Dr. Wolfson's report does not constitute substantial evidence. (Milpitas Unified School Dist. v. Workers' Comp. Appeals Bd., supra.)
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