What the panel ordered
Petition for reconsideration granted; WCJ's Findings rescinded; matter remanded for further proceedings and new decision.
Applicant sought reconsideration of the WCJ's August 23, 2023 Findings of Fact denying surgery; WCAB granted reconsideration, rescinded the Findings, and remanded for further proceedings.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.
The medical reports from Dr. Taher and Dr. Sollaccio did not constitute substantial evidence as to whether the requested surgery was reasonable and necessary, but referenced diagnostics indicated possible need. The record was insufficiently developed, so remand for further development was required.
From the decision · page 4Having reviewed the trial record, we agree with the WCJ that the treatment notes/reports
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Medical reports from Dr. Taher and Dr. Sollaccio did not provide sufficient reasoning or explanation for the necessity of surgery.
Favours neutral
Lack of substantial evidence required remand for further development of the record.
From the decision · page 4Having reviewed the trial record, we agree with the WCJ that the treatment notes/reports
Diagnostics referenced in the reports (March 31, 2023 NCV; January 26 cervical MRI) indicated possible neurologic conditions that may warrant surgery.
Favours neutral
Suggested that further development of the record could clarify medical necessity.
From the decision · page 4industrial injury. However, the reports do include references to diagnostics (e.g., the March 31,
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.
Requested right carpal tunnel release and right elbow ulnar nerve decompression surgery, but did not provide analysis or explanation for the recommendation; report not substantial evidence.
Tribunal found Dr. Taher's report lacked reasoning and explanation for surgery recommendation.
From the decision · page 4Dr. Taher did not provide an analysis as to why he was recommending the surgery for the applicant. The analysis should have included a summary of treatment rendered to the applicant for said body part, if further conservative care was needed, and why the applicant required the specific surgery recommended. Dr. Taher simply requested the surgery with no explanation. This does not constitute substantial medical evidence. Dr. Sollaccio's May 31, 2023 report was also considered in determining if there was substantial medical evidence for the requested surgery. Specifically, on page 7 of his report, Dr. Sollaccio indicates that he "discussed at length with the patient the diagnosis and treatment options." Dr. Sollaccio reports that the "treatment options include activity modifications, hand therapy exercises, night splinting, anti- inflammatory medications, possible corticosteroid injections, potential and surgery (carpal tunnel release, elbow ulnar nerve decompression)." Id. at page 7. Dr. Sollaccio then indicates that the "patient elects for surgery, beginning with right side." Id. at page 7. However, Dr. Sollaccio did not provide an explanation as to why the applicant was not going to undergo further conservative care, nor why he recommended the applicant undergo surgery. (Report, p. 3; citations to doctors' reports in original.)
Reviewed NCV study, discussed treatment options including surgery, but did not explain why further conservative care was not pursued or why surgery was recommended; report not substantial evidence.
Tribunal found Dr. Sollaccio's report lacked explanation for not pursuing further conservative care or for recommending surgery.
From the decision · page 4Dr. Taher did not provide an analysis as to why he was recommending the surgery for the applicant. The analysis should have included a summary of treatment rendered to the applicant for said body part, if further conservative care was needed, and why the applicant required the specific surgery recommended. Dr. Taher simply requested the surgery with no explanation. This does not constitute substantial medical evidence. Dr. Sollaccio's May 31, 2023 report was also considered in determining if there was substantial medical evidence for the requested surgery. Specifically, on page 7 of his report, Dr. Sollaccio indicates that he "discussed at length with the patient the diagnosis and treatment options." Dr. Sollaccio reports that the "treatment options include activity modifications, hand therapy exercises, night splinting, anti- inflammatory medications, possible corticosteroid injections, potential and surgery (carpal tunnel release, elbow ulnar nerve decompression)." Id. at page 7. Dr. Sollaccio then indicates that the "patient elects for surgery, beginning with right side." Id. at page 7. However, Dr. Sollaccio did not provide an explanation as to why the applicant was not going to undergo further conservative care, nor why he recommended the applicant undergo surgery. (Report, p. 3; citations to doctors' reports in original.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Granado v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 399; McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (en banc)
A physician's report constitutes substantial evidence when it is well-reasoned, not speculative, based on adequate history and examination, and sets forth the reasoning behind the opinion.
Applied to determine that the medical reports did not constitute substantial evidence for the requested surgery.
From the decision · page 4his or her conclusions; the report constitutes substantial evidence. (Granado v. Workmen's Comp.
Lab. Code §§ 5701, 5906; Kuykendall v. Workers' Comp. Appeals Bd., (2000) 79 Cal.App.4th 396; McDuffie v. Los Angeles County Metropolitan Transit Authority (2003) 67 Cal.Comp.Cases 138 (en banc)
The Appeals Board has discretionary authority to develop the record when it does not contain substantial evidence pertaining to a threshold issue or when necessary to fully adjudicate the issues.
Applied to remand the case for further development of the medical record regarding the necessity of surgery.
From the decision · page 4threshold issue, or when it is necessary in order to fully adjudicate the issues. (Lab. Code § 5701,
What proof carried it
The evidence the panel weighed, by kind.
References to diagnostics (March 31, 2023 NCV; January 26 cervical MRI) indicated possible neurologic conditions warranting surgery.
From the decision · page 4industrial injury. However, the reports do include references to diagnostics (e.g., the March 31,
Dr. Taher's report lacked analysis and explanation for surgery recommendation; Dr. Sollaccio's report lacked explanation for not pursuing further conservative care or for recommending surgery.
From the decision · page 4Dr. Taher did not provide an analysis as to why he was recommending the surgery for the applicant. The analysis should have included a summary of treatment rendered to the applicant for said body part, if further conservative care was needed, and why the applicant required the specific surgery recommended. Dr. Taher simply requested the surgery with no explanation. This does not constitute substantial medical evidence. Dr. Sollaccio's May 31, 2023 report was also considered in determining if there was substantial medical evidence for the requested surgery. Specifically, on page 7 of his report, Dr. Sollaccio indicates that he "discussed at length with the patient the diagnosis and treatment options." Dr. Sollaccio reports that the "treatment options include activity modifications, hand therapy exercises, night splinting, anti- inflammatory medications, possible corticosteroid injections, potential and surgery (carpal tunnel release, elbow ulnar nerve decompression)." Id. at page 7. Dr. Sollaccio then indicates that the "patient elects for surgery, beginning with right side." Id. at page 7. However, Dr. Sollaccio did not provide an explanation as to why the applicant was not going to undergo further conservative care, nor why he recommended the applicant undergo surgery. (Report, p. 3; citations to doctors' reports in original.)
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
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