What the panel ordered
The Appeals Board granted defendant's Petition for Reconsideration, rescinded the June 2, 2023 Joint Findings, Award and Order, and returned the matter to the WCJ for further proceedings and a new decision.
Defendant filed a timely Petition for Reconsideration of the WCJ's June 2, 2023 Joint Findings, Award and Order, which was not timely acted upon by the Appeals Board due to lack of notice until November 3, 2023. The Appeals Board granted reconsideration, rescinded the F&A, and returned the matter to the WCJ for further proceedings.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. Rutchik's reports lacked sufficient explanation and reasoning for his opinion that applicant was temporarily totally disabled since February 2022, thus not constituting substantial evidence. The Appeals Board found the record insufficient and remanded for further development.
From the decision · page 5Here, as quoted above, in his November 7, 2022 report, (referring to his July 15, 2022 report), Dr. Rutchik stated that in his January 27, 2022 report he had concluded that applicant's condition had reached MMI status "with 100% of his impairment attributed to the industrial activities; however, given his continued pain and difficulties, I would concur that the applicant is TTD at this time.... Therefore, I would opine that the applicant was TTD since at least February of 2022." (Joint Exh. 102, p. 11.) Clearly, Dr. Rutchik stated his conclusion but did not set forth the reasoning or the basis for his opinion. It appears that his only explanation for changing his previously stated opinion that applicant had reached MMI status was applicant's "continued pain and difficulties." However, "[a] temporary disability is an impairment reasonably expected to be cured or improved with proper medical treatment." (Signature Fruit Co. v. Workers' Comp. Appeals Bd.; Chavira v. Workers' Comp. Appeals Bd.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Rutchik stated applicant was at MMI status in January 2022 but later opined applicant was temporarily totally disabled since February 2022 without sufficient explanation for the change.
Favours Defendant prevailed
The lack of explanation for the change in opinion led the Appeals Board to find the reports not substantial evidence and remand for further development.
From the decision · page 5Here, as quoted above, in his November 7, 2022 report, (referring to his July 15, 2022 report), Dr. Rutchik stated that in his January 27, 2022 report he had concluded that applicant's condition had reached MMI status "with 100% of his impairment attributed to the industrial activities; however, given his continued pain and difficulties, I would concur that the applicant is TTD at this time.... Therefore, I would opine that the applicant was TTD since at least February of 2022." (Joint Exh. 102, p. 11.) Clearly, Dr. Rutchik stated his conclusion but did not set forth the reasoning or the basis for his opinion. It appears that his only explanation for changing his previously stated opinion that applicant had reached MMI status was applicant's "continued pain and difficulties." However, "[a] temporary disability is an impairment reasonably expected to be cured or improved with proper medical treatment." (Signature Fruit Co. v. Workers' Comp. Appeals Bd.; Chavira v. Workers' Comp. Appeals Bd.
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.
Initially opined applicant was not permanent and stationary; later opined applicant was temporarily totally disabled since at least February 2022 but did not provide sufficient reasoning for this change in opinion.
The Appeals Board found Dr. Rutchik's reports lacked sufficient explanation and reasoning for his opinion on temporary disability, thus not constituting substantial evidence.
From the decision · page 5Here, as quoted above, in his November 7, 2022 report, (referring to his July 15, 2022 report), Dr. Rutchik stated that in his January 27, 2022 report he had concluded that applicant's condition had reached MMI status "with 100% of his impairment attributed to the industrial activities; however, given his continued pain and difficulties, I would concur that the applicant is TTD at this time.... Therefore, I would opine that the applicant was TTD since at least February of 2022." (Joint Exh. 102, p. 11.) Clearly, Dr. Rutchik stated his conclusion but did not set forth the reasoning or the basis for his opinion. It appears that his only explanation for changing his previously stated opinion that applicant had reached MMI status was applicant's "continued pain and difficulties." However, "[a] temporary disability is an impairment reasonably expected to be cured or improved with proper medical treatment." (Signature Fruit Co. v. Workers' Comp. Appeals Bd.; Chavira v. Workers' Comp. Appeals Bd.
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 reviewed whether Dr. Rutchik's reports constituted substantial evidence on temporary disability.
From the decision · page 4It is well established that any 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].) To be substantial evidence a medical opinion must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth the reasoning behind the physician's opinion, not merely his or her conclusions. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).)
Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc)
To be substantial evidence a medical opinion must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth the reasoning behind the physician's opinion, not merely his or her conclusions.
The Appeals Board found Dr. Rutchik's opinion lacked reasoning and was therefore not substantial evidence.
From the decision · page 4It is well established that any 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].) To be substantial evidence a medical opinion must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth the reasoning behind the physician's opinion, not merely his or her conclusions. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Board en banc).)
What proof carried it
The evidence the panel weighed, by kind.
Dr. Rutchik's reports lacked sufficient explanation and reasoning for his opinion that applicant was temporarily totally disabled since February 2022.
From the decision · page 5Here, as quoted above, in his November 7, 2022 report, (referring to his July 15, 2022 report), Dr. Rutchik stated that in his January 27, 2022 report he had concluded that applicant's condition had reached MMI status "with 100% of his impairment attributed to the industrial activities; however, given his continued pain and difficulties, I would concur that the applicant is TTD at this time.... Therefore, I would opine that the applicant was TTD since at least February of 2022." (Joint Exh. 102, p. 11.) Clearly, Dr. Rutchik stated his conclusion but did not set forth the reasoning or the basis for his opinion. It appears that his only explanation for changing his previously stated opinion that applicant had reached MMI status was applicant's "continued pain and difficulties." However, "[a] temporary disability is an impairment reasonably expected to be cured or improved with proper medical treatment." (Signature Fruit Co. v. Workers' Comp. Appeals Bd.; Chavira v. Workers' Comp. Appeals Bd.
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About this page
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