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.
AMERelied upon · neurologist
Concluded injuries are permanent and stationary with intertwined specific injury and cumulative trauma causing permanent partial disabilities, making exact apportionment difficult.
The AME's report states the examinee's specific injury and cumulative trauma are intertwined, making exact apportionment difficult, supporting permanent disability due to both.
From the decision · page 4The most recent report by the AME is dated January 28,
2020 (Exh. H).2 There, she concludes, as she had in previous reports,
that these injuries have become permanent and stationary, with
residual impairment in several areas of the body, some of which she
apportions between the two injuries. However, after outlining that
apportionment (10% of some impairments to the cumulative claim),
Dr. Gupta states:
QMERelied upon · psychiatrist
Found psychological condition permanent and stationary with 8% impairment, 90% due to physical injury, 10% to marijuana use related to pain.
The QME apportioned psychological impairment mostly to physical injury, supporting the permanent disability finding.
From the decision · page 5Dr. Punia, in his comprehensive evaluation of February 14,
2016, finds applicant's psychological condition permanent and
stationary, with a GAF3 score of 65,4 equating to permanent
impairment of 8%. Of this he apportions 90% to "physical claimed
injury," 10% to "the continued Marijuana use." (Capitalization in
the original) Dr. Punia does not appear to account for the fact that
the marijuana use in this case was occasioned by the pain
engendered by applicant's injuries. Two supplemental reports do
not change those conclusions. (This QME's opinion that the applicant
has mild psychological impairment is contradicted by two treating
physicians, Drs. David Green and Robert Boyd, who found her
impairment moderate and moderate to severe, respectively.) (Exhs.
2, 3)
QMERelied upon · internal medicine
Provided impairment ratings for internal medicine conditions and discussed cumulative trauma as related to pain, medications, and psychological ailments.
The QME's testimony and reports supported the intertwined nature of injuries and cumulative trauma.
From the decision · page 5Dr. Levy's second comprehensive evaluation, dated May 4,
2018 (Exh. J), concludes with an impairment rating for headaches
but defers on other internal-medicine impairments pending review
of records generated since his first evaluation in 2015. In his
supplemental report of October 21, 2018, he provides impairment
ratings for heartburn, reduced sexual function and reduced sleep. (In
some respects, this QME refers back to the conclusions outlined in
his initial evaluation of October 23, 2015 (Exh. I). In some, the
impairment rating rose slightly between the two examinations.) In
terms of apportionment, Dr. Levy ascribes percentages of some
impairments to pain, to "psychiatric aspects of the case" and to "the
vocational_expertRejected
Concluded applicant is employable with 11-15% loss of earning capacity, contrasting with applicant's vocational expert who found total disability.
The WCJ found the opposing vocational expert less credible and relied on the applicant's vocational expert's opinion of total disability.
From the decision · page 6Dr. Van de Bittner, on the other hand, believes the applicant to
be employable, giving such examples of available positions as
cashiering and reception. In fact, he concludes that she has lost only
11% of her pre-injury earning capacity, or 15% if one considers the
costs involved in searching for jobs. For this conclusion, this
vocational expert employs a mathematical formula based on pre-
injury earnings and those likely from the jobs he feels applicant can
perform, aggregated over her projected working life. (Exh. O)
vocational_expertRelied upon
Concluded applicant is not employable and not amenable to vocational rehabilitation due to injuries, supporting permanent total disability.
The WCJ credited this vocational expert's opinion as more consistent with medical evidence and applicant's credible testimony.