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William Valdez, while employed as a firefighter for the Orange County Fire Authority, sustained a continuous trauma industrial injury in the form of hypertension, coronary artery disease, hands including thumbs, shoulders, feet including toes, and to the upper digestive tract in the form of a hiatal hernia.

In finding permanent disability of 89%, his right and left thumb disabilities were added together rather than combined utilizing the Combined Values Chart in the 2005 Schedule for Rating Permanent Disabilities, as were his right and left foot disabilities. The disabilities were otherwise combined utilizing the Combined Values Chart. (2005 Schedule at pp. 8-1 – 8-4.)

Valdez contended on reconsideration that the WCJ erred in combining applicant’s orthopedic disabilities with his internal medicine disabilities by way of the CVC rather than adding the percentages of permanent disability. Reconsideration was denied in the panel decision of Valdez v Orange County Fire Authority ADJ11323413 (March 2022).

Valdez argues that the orthopedic disabilities should be added to the internal medicine disabilities based on the June 23, 2021 deposition testimony of orthopedist Mitchel Silverman, M.D. Dr. Silverman opined that applicant’s orthopedic impairments did not “overlap” with the internal medicine impairments.He opined that the impairments affected different activities of daily living and work restrictions, although the activities of daily living and work restrictions were not specified.

Explaining why the orthopedic disability should be added to the internal medicine disability, Dr. Silverman testified, “I understand the CVC, but the courts have decided. I haven’t decided, the courts have decided, that there’s a way to look at this in terms of adding them, and I agree in this particular case.”

However the panel concluded that “Dr. Silverman’s report is not substantial medical evidence sufficient to rebut the use of the Combined Values Chart.

In Athens Administrators v. Workers’ Comp. Appeals Bd. (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.), the evaluator explained why the disparate impairments were not actually disparate, and the impairments in question were all under the physician’s expertise.

In contrast, here one specialist is suggesting that we add impairments found by him in his own specialty to impairments in completely different body systems found by a different specialist. As an orthopedist, it was Dr. Silverman’s role to describe and give a whole person impairment with regard to the orthopedic impairment.”

“Dr. Silverman did not give any compelling reason why the orthopedic and internal medicine impairments should be added, and questions beyond applicant’s orthopedic impairment, including applicant’s overall impairment or the operation of the CVC, are beyond Dr. Silverman’s expertise.” (Applied Materials v. Workers’ Comp. Appeals Bd. (D.C.) (2021) 64 Cal.App.5th 1042, 1097 [86 Cal.Comp.Cases 331].)