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.
PTPRejected
Stated applicant was temporarily disabled based on patient reports but did not clearly state it was his medical opinion; reports lacked explanation and substantial evidence for disability status.
Reports did not explain basis for statements and did not clearly state medical opinion of temporary disability.
From the decision · page 4It has long been the law that in order to constitute substantial evidence, a medical opinion
must be based on pertinent facts and it must set forth the reasoning behind the physician's opinion,
not merely his or her conclusions; a mere legal conclusion does not furnish a basis for a finding.
(Granado v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 399 [33 Cal.Comp.Cases 647];
McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408 [33 Cal.Comp.Cases 660].) As
noted above, Dr. Dahi is applicant's pain management treating physician, but in neither of his
reports does the doctor explain the basis for his statements that "Per patient reports the patient is
currently not working and is temporarily disabled." (App. Exh. 1, January 27, 2022, p. 3; App.
Exh. 1, Dr. Dahi, February 16, 2022, p. 3.) Also, as noted by the WCJ, Dr. Dahi did not clearly
state that it was his medical opinion that applicant was currently temporarily disabled. (Findings,
p. 3, Opinion on Decision.) Thus, we agree that the reports from Dr. Dahi are not substantial
evidence regarding applicant's disability status.
QMERejected · neurology
Considered applicant's neurological condition permanent and stationary as of 2/11/22; deferred to specialists for orthopedic and psychological symptoms; did not address overall disability status.
Opinion limited to neurological symptoms and deferred other symptoms to specialists, thus not substantial evidence for disability status.
From the decision · page 4Our review of the trial record indicates that applicant's "head injury" was a traumatic brain
injury caused by a temporal fracture, a skull fracture, swelling of the brain and bleeding in and
around the brain resulting in numerous conditions and/or symptoms. QME Dr. Verpukhovskiy and
Dr. Lin both stated that from a "neurological perspective," applicant's condition is permanent and
stationary. (Def. Exh. A, p. 34; Def. Exh. B, p. 2 [EAMS p. 5].) However, Dr. Verpukhovskiy
also deferred to a "specialist in the field of orthopedic surgery" and "a QME in the field of
psychology" (Def. Exh. A, p. 33) and Dr. Lin stated he would defer applicant's "official" work
status to "his primary treating doctor, who is the pain management specialist." (Def. Exh. B, p. 2
[EAMS p. 5].) The opinions stated by Dr. Verpukhovskiy and Dr. Lin pertain only to applicant's
neurological symptoms and they do not address any other symptoms or conditions that could affect
applicant's disability status. Based thereon, the reports from Dr. Verpukhovskiy and Dr. Lin do
not constitute substantial evidence as to the issue of applicant's disability status.
QMERejected · neurology
Diagnosed traumatic brain injury and considered neurological condition permanent and stationary; deferred official work status to treating pain management physician; did not address overall disability status.
Opinion limited to neurological perspective and deferred work status to treating physician, thus not substantial evidence for disability status.
From the decision · page 4Our review of the trial record indicates that applicant's "head injury" was a traumatic brain
injury caused by a temporal fracture, a skull fracture, swelling of the brain and bleeding in and
around the brain resulting in numerous conditions and/or symptoms. QME Dr. Verpukhovskiy and
Dr. Lin both stated that from a "neurological perspective," applicant's condition is permanent and
stationary. (Def. Exh. A, p. 34; Def. Exh. B, p. 2 [EAMS p. 5].) However, Dr. Verpukhovskiy
also deferred to a "specialist in the field of orthopedic surgery" and "a QME in the field of
psychology" (Def. Exh. A, p. 33) and Dr. Lin stated he would defer applicant's "official" work
status to "his primary treating doctor, who is the pain management specialist." (Def. Exh. B, p. 2
[EAMS p. 5].) The opinions stated by Dr. Verpukhovskiy and Dr. Lin pertain only to applicant's
neurological symptoms and they do not address any other symptoms or conditions that could affect
applicant's disability status. Based thereon, the reports from Dr. Verpukhovskiy and Dr. Lin do
not constitute substantial evidence as to the issue of applicant's disability status.
PTPRelied upon · otolaryngology
Diagnosed anosmia and post-concussion syndrome; discharged applicant as permanent and stationary from his perspective.
From the decision · page 3In otolaryngologist Pierre F. Giammanco, M.D.'s February 24, 2022 PR-2, the doctor
diagnosed applicant as having anosmia [loss of sense of smell], and post-concussion syndrome.
The PR-2 also states that, "per ptp [primary treating physician] discharged MMI." (Def. Exh. C,
Dr. Giammanco, February 24, 2022, p. 1.)