ADJ8760173 · October 8, 2026

The WCAB rejected the medical apportionment determinations by QMEs as legally invalid and lacking substantial medical evidence. The vocational expert's alternative analysis based on purely industrial factors, including psychiatric injury and medication side effects, was accepted, supporting the 100% permanent disability award without apportionment.

From the decision · page 1The WCJ found, in pertinent part, that applicant, while employed on December 27, 2012, as an electrician, sustained an industrial injury to his back, left shoulder, right knee, left ankle, psyche, urologic system, internal system, and in the form of sexual dysfunction, resulting in 100% permanent disability without apportionment. Defendant contends that the WCJ erred in awarding 100% permanent disability without apportionment, arguing that the award incorrectly assigns liability for permanent disability not caused by the industrial injury and fails to apply the non-industrial apportionment established by the Qualified Medical Evaluators (QMEs). Specifically, defendant argues that the reporting of applicant’s vocational expert, Ray Largo, M.A., does not constitute substantial evidence because he disregarded the medical apportionment determinations provided by the QMEs. Furthermore, defendant asserts that the WCJ erred by admitting and relying on the medical reporting of Mohammed Zain Vally, M.D., contending Dr. Vally’s reports are inadmissible and do

Applicant sustained industrial injury on December 27, 2012, causing multiple physical and psychiatric conditions resulting in permanent disability.

Favours Applicant prevailed

This established the basis for the permanent disability claim and the scope of injuries considered.

The medical apportionment determinations by QMEs were legally invalid and lacked substantial medical evidence.

Favours Applicant prevailed

This justified rejecting the apportionment and accepting the vocational expert's alternative analysis for 100% industrial disability.

The vocational expert's alternative analysis based on purely industrial factors, including psychiatric injury and medication side effects, independently supported total permanent disability.

Favours Applicant prevailed

This provided a legally valid basis for the unapportioned 100% permanent disability award.

From the decision · page 27Largo properly offered an alternative analysis grounded exclusively in the purely industrial factors. He did not evaluate the clinical significance of the medical apportionment. Rather, he concluded that the 100% industrial components, specifically, the severe cognitive side effects of the industrially necessitated opioid medications and the entirely industrial psychiatric injury established by Dr. Friedman, independently render applicant permanently totally disabled. The law permits a finding of permanent total disability when the vocational and medical evidence establishes that the purely industrial conditions autonomously cause the total loss of earning capacity. The WCJ correctly determined that applicant’s industrial medication side effects and psychiatric decline pushed his vocational non-feasibility over the top, independently justifying the unapportioned 100% award based on a proper alternative vocational analysis. Accordingly, as our Decision After Reconsideration, we will affirm the FA&O.

Diagnosed left shoulder tendinitis, lumbosacral strain, right knee strain, and left calcaneus fracture complicated by osteomyelitis; attempted apportionment of 10% to non-industrial activities of daily living, which was rejected as legally invalid.

Apportionment attempt lacked specific 'how and why' analysis connecting activities to disability, thus legally invalid.

From the decision · page 26Code, § 11425.60(b).) Accordingly, to constitute substantial evidence, the opinions of both the evaluating physician and the vocational expert must set forth the history and evidentiary basis for their conclusions, including an explanation of “how and why” a condition or factor results in permanent disability. (Nunes I, supra, at p. 896.) In this case, we must reject the medical apportionment determinations provided by three evaluating QMEs, as none rise to the level of substantial medical evidence required by section 4663 and Escobedo. QME Dr. Luciano attempted to apportion 10% of applicant’s left shoulder, lumbar spine, and right knee disability to non-industrial “activities associated with daily living.” This formulation is legally invalid. Unspecified ADLs do not inherently constitute a pathology, disease, or prior condition under the expanded “other factors” contemplated by section 4663. QME Dr. Luciano failed to identify which specific activities caused distinct anatomical conditions and entirely omitted the mandatory “how and why” analysis connecting these routine activities to applicant’s permanent disability. Similarly, QMEs Dr. Lineback and Dr. Agatstein failed to provide legally sufficient apportionment. Dr. Lineback apportioned 10% of applicant’s hypertension and coronary artery

Apportioned 10% of hypertension and coronary artery disease to non-industrial obesity risk factor; rejected as legally insufficient due to lack of clinical mechanism explaining causation of disability.

Generalized risk factor without clinical mechanism conflates injury causation with disability causation; legally insufficient.

Attempted to apportion 40% of erectile dysfunction to hypertension, obesity, cholesterol, and coronary artery disease but deferred industrial/non-industrial breakdown to an internist; rejected as incomplete and legally defective.

Deferred apportionment to internist is incomplete and cannot serve as substantial evidence.

Provided medical reports supporting applicant's total disability; reports challenged for lack of physical exam and primary treating physician reporting but considered in totality and given weight.

Despite procedural challenges, the opinion was evaluated in totality and contributed to the vocational analysis supporting total disability.

Lab. Code, §§ 4663(a) and 4664(a); Brodie, 40 Cal.4th at p. 1321; Marsh v. Workers’ Comp. Appeals Bd. (2005) 130 Cal.App.4th 906, 911; Escobedo, 70 Cal.Comp.Cases at p. 611; E.L. Yeager Construction v. Workers’ Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 927-928

Apportionment must be based on causation of permanent disability, not just injury, and must include a 'how and why' analysis.

The WCAB rejected QME apportionment opinions for lacking substantial medical evidence and proper causation analysis, requiring vocational expert alternative analysis under Nunes II.

Sub rosa videos of applicant supporting light work capacity

Applicant's testimony regarding persistent pain and restricted physical endurance

From the decision · page 3Tang concluded that applicant’s subjective pain complaints and ratings were not credible, he disputed this assessment, maintaining that he answered all the questions honestly despite feeling anger over delayed prescription medications during the psychiatric evaluation. (MOH/SOE, 03/03/2022, 4:7-15.) Regarding his activities of daily living (ADLs), he reported persistent pain in his low back, left shoulder, right knee, and left foot, which restricts his physical endurance. (MOH/SOE, 06/23/2021, 9:14-20.) He wears a medical boot constantly, except when sleeping, and experiences instability when walking without it.