Susan Toste vs. Kerman Unified Scholl

This case is about Susan Toste, a kindergarten teacher who slipped and fell at work and injured her right shoulder. The parties used Dr. Mandell as an agreed medical evaluator (AME) who opined that the applicant had 3% whole person impairment under a strict application of the AMA guides. The Appeals Board granted reconsideration of the May 11, 2010 Findings and Award and rescinded the Findings and Award, returning the matter to the trial level for further development of the medical record. The Appeals Board held that the burden of rebutting a scheduled permanent disability rating rests with the party disputing that rating and one method of rebutting a scheduled permanent disability rating is to successfully challenge one of the component elements of that rating

Kerman Unified Scholl Susan Toste WORKERS’ COMPENSATION APPEALS BOARD STATE OF CALIFORNIA SUSAN TOSTE,Applicant,vs. KERMAN UNIFIED SCHOOL DISTRICT; TRISTAR RISK MANAGEMENT,Defendant(s).Case No. ADJ6598413OPINION AND ORDERGRANTING RECONSIDERATIONAND DECISION AFTERRECONSIDERATION Defendant seeks reconsideration of the May 11, 2010 Findings and Award, wherein theworkers’ compensation administrative law judge (WCJ) found that the applicant sustained anindustrial injury to her right shoulder on May 17, 2007 that caused 130% permanent disability. Defendant contends that the WCJ erred in finding that the applicant sustained 13%permanent disability, arguing that the WCJ’s decision is not supported by substantial medical evidence. For the reasons set forth below, we will grant reconsideration, rescind the Findings andAward, and return this matter to the trial level for further development of the medical record. The relevant facts are not in dispute. On May 17, 2007, the applicant was working as akindergarten teacher. She slipped and fell injuring her right shoulder. The parties used Dr.Mandell as an agreed medical evaluator (AME). Dr. Mandell examined applicant on April 2, 2009. He opined that the applicant had 3% whole person impairment under a strict application of the AMA guides. Dr. Mandell also stated that: “Under Almaraz, it is my opinion, based upon her clinical examination and my experience and expertise, that the above-noted rating undershoots her true impairment in the RIGHT shoulder. It therefore would be inequitable, disproportionate, inaccurate, and thus not fair.” (Exhibit 1, p. 6.) Dr. Mandell opined that, by analogy to another section of the AMA Guides, the applicant probably has a 9% whole person impairment rating. ,  In reviewing the -issues -presented here, we begin by presuming that the AME has beenchosen by the parties because of his expertise and neutrality. Therefore his opinion should ordinarily be followed unless there is good reason to find that

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