ADJ18309914 · April 20, 2026

The applicant's credible testimony, supported by medical opinions including QME Dr. the applicant's, established a compensable injury to the left calf and lumbar spine as a compensable consequence of the industrial injury, despite some medical reports lacking specific lumbar spine documentation.

From the decision · page 5As summarized in the Opinion on Decision, applicant testified that on 4/06/2023, he was pulling a hose to get ready for an inspection when he stepped on a plastic pipe, slipped, and fell backwards landing on the ground. He testified he injured his leg, calf, and back. He testified he was carrying the hose on his left side, and that when he landed, it was in a twisted position on his left side. He testified he received treatment for his injury that same day with a doctor from Kaiser.

Applicant's credible testimony of injury mechanism and symptoms

Favours Applicant prevailed

Supported finding of compensable injury to left calf and lumbar spine

From the decision · page 5As summarized in the Opinion on Decision, applicant testified that on 4/06/2023, he was pulling a hose to get ready for an inspection when he stepped on a plastic pipe, slipped, and fell backwards landing on the ground. He testified he injured his leg, calf, and back. He testified he was carrying the hose on his left side, and that when he landed, it was in a twisted position on his left side. He testified he received treatment for his injury that same day with a doctor from Kaiser.

QME Dr. the applicant's medical opinion linking lumbar spine injury to industrial accident

Favours Applicant prevailed

Provided substantial evidence supporting compensability and causation

From the decision · page 8On 3/04/2024, Orthopaedic Surgeon QME, Ramon the applicant, M.D. evaluated applicant and reviewed 266 pages of medical records, including applicant's deposition transcript. He diagnosed applicant with left calf (gastrocnemius) muscle strain, and left lumbago and sciatica. Dr. the applicant opined applicant had reached maximum medical improvement as of the date of the examination, 3/04/2024. He found applicant's diagnosis and disability were caused by the 4/06/23 injury, with signs and symptoms of lumbago and sciatica at the left lower extremity related by compensable consequence. He indicated there was no basis for apportionment, and assigned work preclusions of no lifting greater than 25 pounds, no push/pulling greater than 25 pounds, no repetitive bending, and no ladder climbing. Dr. the applicant refrained from providing an impairment rating until he was able to review the results of an MRI scan of applicant's lumbar spine. (Exhibit 8)

MRI evidence showing left foraminal disc protrusion impinging on left L5 nerve root

Favours Applicant prevailed

Supported medical causation and compensability of lumbar spine injury

From the decision · page 11Further, in his deposition, Dr. the applicant testified that although applicant did not fall, "it was the twisting component, the violent torquing component to his lumbar spine, that could reasonably have caused the lumbar spine injury. (Exhibit 7, p. 36: 20-25) Dr. the applicant also opined, to a reasonable degree of medical probability, that the signs and symptoms of lumbago and sciatica of the left lower extremity are related by compensable consequence. (Exhibit 8, p. 21) Dr. the applicant also opined that the 6/25/2024 MRI of the lumbar spine point to the possibility that applicant's left calf pain and injury may be indicative of a radicular nature or a radiculopathy from the lumbar disc. (Exhibit 10)

Diagnosed left gastrocnemius strain, left knee sprain, and left thigh muscle strain; prescribed treatment and work restrictions; discharged applicant from care with no restrictions and no need for future medical care as of 9/18/2023.

Dr. Chen's reports document applicant's complaints and unresolved symptoms but ultimately found applicant P&S with no need for future care.

From the decision · page 6On 4/06/2023, applicant was examined by Fulton Chen, M.D. Under mechanism of injury, Dr. Chen noted applicant was in the process of pulling a hose and stepped on a tube, causing him to slip and twist his left leg without a fall. He diagnosed applicant with left gastrocnemius strain, left knee sprain, and left thigh muscle strain. He noted that the primary concern would be left calf strain, and prescribed Motrin and ice. Applicant was placed off work from 4/06/2023 through 4/10/2023, with work restrictions of occasionally standing, walking, and bending at the waist, no torso/spine twist, no climbing ladders, no use of scaffolds, lifting/carry/push/pull limited to no more than 10 pounds, and sit down job only. (Exhibit K)

Diagnosed radiculopathy in the lumbar region; specified work restrictions and opined applicant unable to perform usual work.

His evaluation supported the finding of ongoing lumbar issues and work restrictions.

From the decision · page 8lumbar manipulation and myofascial release of left calf and hamstring. Dr. Pedreiro opined applicant was unable to perform his usual work and specified work restrictions of "no repetitive bending, lifting, and squatting more than 20 lbs, no repetitive stairs." (Exhibit 1)

Diagnosed left calf muscle strain and left lumbago and sciatica; opined injury caused by industrial accident; found no basis for apportionment; deferred permanent disability rating pending MRI review; ultimately found MMI as of 3/04/2024.

His thorough evaluation and deposition testimony provided substantial evidence supporting compensability and causation of lumbar spine injury as a compensable consequence.

From the decision · page 8On 3/04/2024, Orthopaedic Surgeon QME, Ramon the applicant, M.D. evaluated applicant and reviewed 266 pages of medical records, including applicant's deposition transcript. He diagnosed applicant with left calf (gastrocnemius) muscle strain, and left lumbago and sciatica. Dr. the applicant opined applicant had reached maximum medical improvement as of the date of the examination, 3/04/2024. He found applicant's diagnosis and disability were caused by the 4/06/23 injury, with signs and symptoms of lumbago and sciatica at the left lower extremity related by compensable consequence. He indicated there was no basis for apportionment, and assigned work preclusions of no lifting greater than 25 pounds, no push/pulling greater than 25 pounds, no repetitive bending, and no ladder climbing. Dr. the applicant refrained from providing an impairment rating until he was able to review the results of an MRI scan of applicant's lumbar spine. (Exhibit 8)

Reviewed QME report; returned applicant to modified work with restrictions; opined applicant not permanent and stationary as of 10/22/2024.

Her opinion supported ongoing treatment and non-P&S status.

From the decision · page 10On 10/22/2024, primary treating physician Sova Khuong, D.C., noted she had reviewed the 7/25/2024 report of QME Ramon the applicant, M.D., who found industrial causation of the left calf and a compensable consequence injury with lumbago and left sciatica. Dr. Khuong returned applicant to modified work on 10/22/2024 with restrictions of no lift, push, pull to 25 pounds, no repeated squatting and no climbing ladders, and opined applicant was not permanent and stationary. (Exhibit 2)

LaTourette v. Workers' Comp. Appeals Bd. (1998) 17 Cal.4th 644; McAllister v. Workers' Comp. Appeals Bd. (1968) 69 Cal. 2d 408; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291

Applicant has the burden of proving reasonable probability of industrial causation based on substantial evidence; a reasonable or probable causal connection will suffice; work need only be a contributing cause of injury.

Applied to determine compensability of lumbar spine injury as compensable consequence.

From the decision · page 11Applicant has the burden of proving reasonable probability of industrial causation based on substantial evidence. (LaTourette v. Workers' Comp. Appeals Bd. (1998) 17 Cal.4th 644, 651 [72 Cal.Rptr.2d 217, 951 P.2d 1184] An applicant need not prove causation to a scientific certainty. A "reasonable" or "probable" causal connection will suffice. (McAllister v. Workers' Comp. Appeals Bd., (1968) 69 Cal. 2d 408, [33 Cal. Comp. Cases 660].) For purposes of meeting the causation requirement in workers' compensation cases, it is sufficient if the work is a contributing cause of the injury. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, [80 Cal.Comp.Cases 489]).

E.L. Yeager v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922

Expert medical opinion must be framed in terms of reasonable medical probability, based on accurate history and examination, and supported by reasoning to be substantial evidence.

Applied to evaluate medical opinions on causation and compensability.

Ponce v. Barrett Business Servs. (2017)

An injury is a compensable consequence when it is the direct and natural consequence of an original industrial injury, relating back to the original injury.

Applied to determine compensability of lumbar spine injury as compensable consequence.

MRI evidence showing left foraminal disc protrusion impinging on left L5 nerve root

From the decision · page 11Further, in his deposition, Dr. the applicant testified that although applicant did not fall, "it was the twisting component, the violent torquing component to his lumbar spine, that could reasonably have caused the lumbar spine injury. (Exhibit 7, p. 36: 20-25) Dr. the applicant also opined, to a reasonable degree of medical probability, that the signs and symptoms of lumbago and sciatica of the left lower extremity are related by compensable consequence. (Exhibit 8, p. 21) Dr. the applicant also opined that the 6/25/2024 MRI of the lumbar spine point to the possibility that applicant's left calf pain and injury may be indicative of a radicular nature or a radiculopathy from the lumbar disc. (Exhibit 10)

Applicant's credible testimony about injury mechanism and symptoms

From the decision · page 5As summarized in the Opinion on Decision, applicant testified that on 4/06/2023, he was pulling a hose to get ready for an inspection when he stepped on a plastic pipe, slipped, and fell backwards landing on the ground. He testified he injured his leg, calf, and back. He testified he was carrying the hose on his left side, and that when he landed, it was in a twisted position on his left side. He testified he received treatment for his injury that same day with a doctor from Kaiser.