What the panel ordered
Findings and Order issued on December 23, 2021, affirmed; applicant takes nothing further on petition to reopen
Petitions for Reconsideration granted to further study factual and legal issues; WCJ Report recommending denial of reconsideration; WCAB Decision After Reconsideration affirming December 23, 2021 Findings and Order
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.
Applicant's psychiatric permanent disability is barred from add-on disability under Labor Code section 4660.1(c) as the injury was not catastrophic or due to a violent act; prior final finding on this issue is binding and applicant did not appeal it.
From the decision · page 5A. There was No Timely Appeal of the Findings and Award of 03-30- 2020 Barring Additional Permanent Disability for Psychiatric Injury under Labor Code section 4660.1
Vocational expert's opinion is not substantial evidence because it relies on psychiatric limitations barred by Labor Code section 4660.1(c) and fails to adequately address apportionment to non-industrial factors.
From the decision · page 5B. Applicant's Vocational Evidence Is Insufficient to Rebut the PDRS on an Industrial Basis
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant's psychiatric permanent disability is barred from add-on disability under Labor Code section 4660.1(c) as the injury was not catastrophic or due to a violent act
Favours Defendant prevailed
This legal bar prevents applicant from receiving additional disability for psychiatric injury, leading to denial of petition to reopen
From the decision · page 5A. There was No Timely Appeal of the Findings and Award of 03-30- 2020 Barring Additional Permanent Disability for Psychiatric Injury under Labor Code section 4660.1
Vocational expert's opinion relies primarily on psychiatric limitations barred by Labor Code section 4660.1(c) and fails to adequately address apportionment to non-industrial factors
Favours Defendant prevailed
Lack of substantial vocational evidence to rebut scheduled rating supports denial of additional permanent disability
From the decision · page 5B. Applicant's Vocational Evidence Is Insufficient to Rebut the PDRS on an Industrial Basis
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.
Assigned work restrictions including no lifting over 10 pounds, no repetitive bending or twisting, and frequent position changes; patient unable to return to usual work as counselor.
From the decision · page 3Applicant was evaluated by orthopedic qualified medical evaluator (QME) William
Assigned psychiatric work restrictions but did not complete apportionment reporting; found 15% nonindustrial apportionment for traumatic exposure and 50% apportionment for addiction tendencies, totaling at least 17.5% non-industrial apportionment of psychiatric disability.
Apportionment to non-industrial factors accepted as undisputed medical evidence; vocational expert failed to address this adequately.
From the decision · page 2applicant was employed as a substance abuse counselor for defendant Health Net Inc. when she sustained injury on 04-01-2013 to her right hip, back, and psyche as the result of a slip and fall accident. Originally, applicant settled her case by way of Stipulations with Award on 01-08-2018 for 27% permanent disability after apportionment based on orthopedic body parts based on the reports of QME Dr. William Campbell. The settlement of 01-18-2018 also included psychiatric injury and the QME for psychiatric issues is Dr. John Parke. The settlement of 01-18-2018 did not include any permanent disability rating attributed to psychiatric injury.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 4660.1(c)
Labor Code section 4660.1(c) bars add-on disability for psychiatric injury unless injury is catastrophic or due to violent act
Applicant's psychiatric injury is barred from add-on disability under this section as injury was not catastrophic or due to violent act; prior final finding is binding
From the decision · page 5A. There was No Timely Appeal of the Findings and Award of 03-30- 2020 Barring Additional Permanent Disability for Psychiatric Injury under Labor Code section 4660.1
Nunes v. State of California, Dept. of Motor Vehicles (2023) 88 Cal.Comp.Cases 741 (en banc)
Vocational evidence must address apportionment and cannot substitute for medical apportionment
Vocational expert's opinion is not substantial evidence because it relies on barred psychiatric limitations and fails to address apportionment
From the decision · page 5B. Applicant's Vocational Evidence Is Insufficient to Rebut the PDRS on an Industrial Basis
What proof carried it
The evidence the panel weighed, by kind.
Applicant's psychiatric permanent disability is barred from add-on disability under Labor Code section 4660.1(c) as the injury was not catastrophic or due to a violent act
From the decision · page 5A. There was No Timely Appeal of the Findings and Award of 03-30- 2020 Barring Additional Permanent Disability for Psychiatric Injury under Labor Code section 4660.1
Vocational expert's opinion is not substantial evidence because it relies on psychiatric limitations barred by Labor Code section 4660.1(c) and fails to adequately address apportionment to non-industrial factors
From the decision · page 5B. Applicant's Vocational Evidence Is Insufficient to Rebut the PDRS on an Industrial Basis
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
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