What the panel treated as outcome-determinative, and which side it favoured.
Applicant's credible testimony and polysomnogram evidence showed sleep disorder symptoms.
Favours Applicant prevailed
Supported finding of compensable sleep disorder injury.
From the decision · page 4To find a sleep disorder and arousal disorder injury occurred, the WCJ relied upon
applicant's credible testimony about her sleep disorder injury. (Opinion on Decision, at p. 4;
Report, at p. 4.) Additionally, on October 30, 2014, applicant underwent an overnight
polysomnogram which revealed she had difficulty initiating sleep, repositioning, arousals were
observed and the ECG revealed an irregular sinus rhythm throughout the night with some artifact.
(Exhibit J1, at p. 5.) As the WCJ noted, applicant reported that she has sleep difficulties to many
doctors. (Report, at p. 4.) Finally, agreed medical evaluator (AME) Seymour Levine, M.D.,
determined that applicant's accepted and industrially related fibromyalgia caused applicant
nonrestorative sleep. (Exhibit J5, at p. 29, MOH/SOE, at p. 2:12-13.)
AME Dr. Levine's opinion linked sleep disorder to industrial fibromyalgia injury.
Favours Applicant prevailed
Provided substantial medical evidence supporting compensability of sleep disorder.
From the decision · page 4To find a sleep disorder and arousal disorder injury occurred, the WCJ relied upon
applicant's credible testimony about her sleep disorder injury. (Opinion on Decision, at p. 4;
Report, at p. 4.) Additionally, on October 30, 2014, applicant underwent an overnight
polysomnogram which revealed she had difficulty initiating sleep, repositioning, arousals were
observed and the ECG revealed an irregular sinus rhythm throughout the night with some artifact.
(Exhibit J1, at p. 5.) As the WCJ noted, applicant reported that she has sleep difficulties to many
doctors. (Report, at p. 4.) Finally, agreed medical evaluator (AME) Seymour Levine, M.D.,
determined that applicant's accepted and industrially related fibromyalgia caused applicant
nonrestorative sleep. (Exhibit J5, at p. 29, MOH/SOE, at p. 2:12-13.)
Dr. Flores' predominant causation analysis showed psychiatric injury was primarily caused by work events.
Favours Applicant prevailed
Met statutory requirement for compensability of psychiatric injury.
From the decision · page 10Defendant claims secondary treating physician, Nelson Flores, Ph.D. does not discuss
predominant causes. This is incorrect. Dr. Flores, in his initial report dated 10/28/2014, indicated
that more than 51% of all combined factors contributed to the applicant's mental disorder and
current level of psychiatric disability were directly related to cumulative trauma injuries (CT
QME Dr. Kim's review of entire medical record supported extended temporary disability period through 08/25/2022.
Favours Applicant prevailed
Supported WCJ's finding of temporary disability period beyond PTP's MMI date.
From the decision · page 12The orthopedic QME, Dr. Donald Kim in his report dated 10/04/2022, declared the
applicant MMI on 08/25/2022, the date of her last evaluation. (Exhibit #8, page 11) Dr. Kim
provided this date after he reviewed records and evaluated the applicant numerous times. Dr. Kim's
report was more substantial medical evidence than PTP, Dr. Brent Prately's report dated
01/29/2014. (Exhibit #A) Dr. Kim reviewed several reports, including the rheumatology and
psychology reports. Dr. Prately did not appear to review any report after 01/29/2014, the date of
his last report. Dr. Pratley did not address the applicant's increased symptoms as documented in
QME, Dr. Kim's reports, dated 05/29/2018 and dated 08/29/2022. (Exhibits J4, page 1-2 and #J6,
page 1-2). Her orthopedic injuries were complicated by her fibromyalgia. Dr. Kim's report was
found to be substantial medical evidence and more persuasive on the issue of MMI status.