Vocational Evidence and LC 4660.1(c)
For injuries on or after Jan. 1, 2013, Labor Code 4660.1(c)(1) states that “the impairment ratings for sleep dysfunction, sexual dysfunction, or psychiatric disorder, or any combination thereof, arising out of a compensable physical injury shall not increase.” LC 4660.1(c)(2)(A)(B), however, specifies two exceptions allowing an increased impairment rating for a psychiatric disorder. An employee may receive such a rating by proving that the injury resulted from either: (1) being a victim of a violent act or direct exposure to a significant violent act; or (2) a catastrophic injury. Moreover, the WCAB continues to hold that the permanent disability schedule under LC 4660.1 can be rebutted by vocational evidence.
How should LC 4660.1(c)(1) be applied if the employee is unable to return to the open labor market as a result of his or her physical injury in addition to a compensable consequence psychological disorder? The issue was addressed recently in the case of Schaan v. Jerry Thompson & Sons, 2022 Cal. Wrk. Comp. P.D. LEXIS 264.
In Schaan, the applicant claimed a cumulative trauma injury through 2015, alleging an internal injury and injuries to his shoulders and psyche, among other body parts. He had seven surgeries on his shoulders, four on the left shoulder and three on the right. He was evaluated by QMEs in orthopedics, internal medicine and psychiatry, who assigned various whole person impairments. The applicant also was evaluated by vocational experts, and his vocational expert reported that he very depressed and angry about the devastating impact of his bilateral upper-extremity impairment, and that he was unable to compete in the open labor market due to the effects of the psychiatric and orthopedic impairments.
The appeals board first noted that the psychiatric QME reported that the psychiatric injury was a consequence of the physical injury, and, therefore, LC 4660.1(c) applied and barred adding on impairment for the psychiatric disorder unless an exception applied. It noted that in Wilson v. State of CA Cal Fire (2019) 84 CCC 393, the appeals board en banc held that determining whether an injury is catastrophic per LC 4660.1(c)(2)(B) is limited to looking solely at the physical injury, without consideration for the psychiatric injury.
The board considered the factors for a catastrophic injury outlined in Wilson and found that although the applicant had seven shoulder surgeries, he did not require treatment for a serious or life-threatening condition. It also found that he could perform physical activities including walking, lifting, chores around the house and yard work. So, the board concluded that the record did not support a catastrophic injury.
The appeals board then held that the evidence could not support a finding that the applicant was permanently totally disabled. It found that none of the physicians reported that he was completely unable to return to work due to his industrial injury. It also declined to follow the analysis of the vocational experts, because they considered the applicant’s psychological issues in determining his amenability to vocational rehabilitation. The applicant’s permanent disability rating could not be increased for his compensable consequence psychiatric condition because his injury was not catastrophic, so the board concluded that his psychiatric condition was improperly considered in evaluating his amenability to vocational rehabilitation.
So, pursuant to Schaan, under LC 4660.1(c)(1) the bar against adding on psychiatric impairment, as well as impairment for sleep dysfunction and sexual dysfunction, also applies to vocational evidence. If a psychiatric injury is a compensable consequence of a physical injury, the psychiatric impairment may be considered in the analysis as to whether the applicant is amenable to vocational rehabilitation or unable to return to the open labor market only if an exception applies. Otherwise, any vocational evidence that considers a psychiatric impairment will not be considered substantial evidence.
About the Author
Sure Log, of Counsel, is a specialist in workers’ compensation defense and related labor law issues. He analyzes files for litigation and settlement, conducts research, reviews records to facilitate completion of discovery and drafts a variety of documents, including trial and appellate briefs. He was instrumental in a 2009 case that ended vocational rehabilitation in California.
IEA traces its history to our predecessor organization, “The Fire Underwriters Association of the Pacific” (FUAP) created in 1876 in San Francisco, CA after the post Gold Rush building boom. Its stated purpose was the promotion of harmony and good practice among the claims adjusting profession. Over time, we became an all industry, all-lines organization with national outreach across the United States.
Today, we are committed to providing professional development to a changing workforce with changing needs. IEA offers myriad courses, seminars, and on-demand training to meet our students where they are and help them reach their goals. We are proud of our contribution to better risk analysis and high operating standards in the industry.
Attorney of Counsel Michael Sullivan & Associates, LLP.
Mr. Log is a specialist in workers’ compensation defense and related labor law issues. He analyzes files for litigation and settlement, conducts research, reviews records to facilitate completion of discovery and drafts a variety of documents, including trial and appellate briefs. He was instrumental in a 2009 case that ended vocational rehabilitation in California.
Mr. Log prepares seminar material and co-authors white papers on significant topics in workers’ comp law, including “An Analysis of the New Regulations Regarding Disputes Over Medical-Legal Expense and Medical Treatment,” “Special Report: A First Look at SB 863,” about the 2012 legislation’s wide-ranging changes to the state’s workers’ compensation system, and “SB 863: Five Years Later.”
Mr. Log is also Co-Author of “Sullivan on Comp,” a 16-chapter objective analysis of California workers’ compensation law, updated monthly.