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.
QMERejected · orthopedics
Found no cumulative trauma but provided no analysis or reasoning, thus his opinion was found insufficient to rebut treating physicians' opinions.
Lacked specialized expertise in dentistry and did not provide analysis supporting his conclusion of no cumulative trauma.
From the decision · page 7It was found that the medical reports of orthopedic QME C. Thomas Vangsness,
Jr., M.D., issued under the specific injury case and admitted into evidence as
Joint 1 and Joint 2, do not constitute substantial medical evidence with respect
to the existence or non-existence of a cumulative trauma. Dr. Vangsness
provides no analysis whatsoever in support of his conclusory statement that he
finds no cumulative trauma, which he attributed simply to a lack of evidence.
While it is understandable why defendants might have wanted to rely upon this
comment by Dr. Vangsness, it was error to do so because it is a legally and
medically unsubstantiated conclusion. Defendants were provided an opportunity
to develop the record with supplemental reports or deposition testimony
following rescission of the February 5, 2024 Joint Findings and Order Re: Lien
Claims, but even after being apprised of the undersigned's assessment of the
deficiency of this evidence, defendants declined to obtain any supplemental
evidence to strengthen the record. Accordingly, based on the same record of
medical opinions, and after an opportunity to develop the record that was
declined by defendants, it should come as no surprise that the same findings
were made with respect to injuries and parts of body injured.
otherRelied upon · dentistry
Provided unrebutted reports supporting dental injury causation from employment injury, including direct injury and compensable consequences such as bruxism.
No expert opinion in dentistry rebutted his reports; his opinions were credited over the orthopedic QME's.
From the decision · page 5Based on the medical expert opinions of Mayer Schames, D.D.S., whose
completely unrebutted reports were admitted into evidence as Lien Claimant
Dental Trauma Center's 3, 4, 5, 6, and 8, it was found that applicant also
sustained dental injury arising out of and in the course of employment to his
face, jaw, gums, and teeth. The utilization review (UR) deferral letter from
defendants to the Dental Trauma Center admitted as Defendant's F, page 10,
shows that defendant regarded the body parts treated by Dr. Schames to be non-
compensable, and denied responsibility for medical care to these body parts. The
non-dental opinion of orthopedic QME C. Thomas Vangsness, Jr., MD, cited in
defendants' petition for reconsideration as evidence that there is no dental injury,
is found to constitute an insufficient rebuttal of Dr. Schames' opinions because
Dr. Vangsness lacks Dr. Schames' specialized expertise in dentistry.
Accordingly, it was found that applicant was permitted to treat outside
defendants' Medical Provider Network (MPN) for the denied body parts,
including dental.
PTPRelied upon
Provided substantial medical evidence of cumulative trauma injury to upper extremities, neck, back, and right lower extremity and foot, supporting compensability.
His reports considered applicant's job duties and affirmed mechanism for cumulative injury.
From the decision · page 7The reports of Albert Kandkhorov, DC and Kiet Nguyen, DC of North Valley
Health Center admitted as Lien Claimant Edwin Haronian's 3, 4, and 5, and Lien
Claimant North Valley Health Center's 9, and 11, as well as the reports of Edwin
Haronian, MD admitted as Lien Claimant Edwin Haronian's 15, 16, 17, and 18,
were found to provide sufficiently substantial medical evidence of cumulative
trauma injury to the upper extremities, neck, back, and right lower extremity and
foot, on which basis cumulative injury arising out of and in the course of
PTPRelied upon
Supported cumulative trauma injury findings consistent with primary treating physician and orthopedic secondary treater.
Reports found to provide substantial medical evidence of cumulative trauma injury.
From the decision · page 7The reports of Albert Kandkhorov, DC and Kiet Nguyen, DC of North Valley
Health Center admitted as Lien Claimant Edwin Haronian's 3, 4, and 5, and Lien
Claimant North Valley Health Center's 9, and 11, as well as the reports of Edwin
Haronian, MD admitted as Lien Claimant Edwin Haronian's 15, 16, 17, and 18,
were found to provide sufficiently substantial medical evidence of cumulative
trauma injury to the upper extremities, neck, back, and right lower extremity and
foot, on which basis cumulative injury arising out of and in the course of
secondary_treaterRelied upon · orthopedics
Provided substantial medical evidence supporting cumulative trauma injury to multiple body parts, considered job duties as mechanism for injury.
Reports expressly considered job duties and affirmed mechanism for cumulative injury; not effectively rebutted by QME opinion.
From the decision · page 7The reports of Albert Kandkhorov, DC and Kiet Nguyen, DC of North Valley
Health Center admitted as Lien Claimant Edwin Haronian's 3, 4, and 5, and Lien
Claimant North Valley Health Center's 9, and 11, as well as the reports of Edwin
Haronian, MD admitted as Lien Claimant Edwin Haronian's 15, 16, 17, and 18,
were found to provide sufficiently substantial medical evidence of cumulative
trauma injury to the upper extremities, neck, back, and right lower extremity and
foot, on which basis cumulative injury arising out of and in the course of