Taulona Williams Applicant v. Kaiser Permanente, Permissibly Self-Insured, Administered by Sedgwick Claims Management Services, Defendants

Full title: TAULONA WILLIAMS Applicant v. KAISER PERMANENTE, Permissibly Self-Insured…

Court: California Workers Compensation Decisions

Date published: Dec 14, 2021

No. ADJ13042596 (Cal. W.C.A.B. Dec. 14, 2021)

Opinion

TAULONA WILLIAMS Applicant v. KAISER PERMANENTE, Permissibly Self-Insured, Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants No. ADJ13042596 California Workers Compensation Decisions Workers’ Compensation Appeals Board State of California December 14, 2021

Oakland District Office

OPINION AND ORDER DENYING PETITION FOR RECONSIDERATION

KATHERINE A. ZALEWSKI, CHAIR

We have considered the allegations of the Petition for Reconsideration, the contents of the Report and the Opinion on Decision of the workers’ compensation administrative law judge (WCJ) with respect thereto. Based on our review of the record, and for the reasons stated in the WCJ’s Report and Opinion, which are both adopted and incorporated herein, we will deny reconsideration.

For the reasons stated in the WCJ’s Report and Opinion, we agree that the opinion of panel qualified medical examiner (QME) Michael Fujinaka, M.D., is substantial medical evidence upon which the WCJ properly relied. To be considered substantial evidence, a medical opinion “must be predicated on reasonable medical probability.” (E.L. Yeager Construction v. Workers’ Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 928 [71 Cal.Comp.Cases 1687]; McAllister v. Workmen’s Comp. Appeals Bd. (1968) 69 Cal.2d 408, 413, 416–17, 419 [33 Cal.Comp.Cases 660].) A physician’s report must also be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions. (Yeager Construction v. Workers’ Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 928 [71 Cal.Comp.Cases 1687]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 612 (Appeals Board en banc), 70 Cal.Comp.Cases 1506 (writ den.).)

We have given the WCJ’s credibility determination great weight because the WCJ had the opportunity to observe the demeanor of the witness. (Garza v. Workmen’s Comp. Appeals Bd. (1970) 3 Cal.3d 312, 318-319 [35 Cal.Comp.Cases 500].) Furthermore, we conclude there is no evidence of considerable substantiality that would warrant rejecting the WCJ’s credibility determination. (Id.)

We observe, moreover, it is well-established that the relevant and considered opinion of one physician may constitute substantial evidence, even if inconsistent with other medical opinions. (Place v. Workmen’s Comp. Appeals Bd. (1970) 3 Cal.3d 372, 378-379 [35 Cal.Comp.Cases 525].)

For the foregoing reasons,

IT IS ORDERED that the Petition for Reconsideration is DENIED.

JOSé H. RAZO, COMMISSIONER I CONCUR, DEIDRA E. LOWE, COMMISSIONER