Sometimes industrial disabilities require medical or psychiatric intervention. Where surgical intervention is indicated and accomplished, the results achieved as a consequence of this modality of care can generate the true extent of compensable permanent partial or permanent total disability. Phrased another way, sometimes permanent disability is tied solely to the treatment to cure or relieve the effects of injury of the industrial injury rather than to the injury itself.
The courts have confirmed the concept that if permanent partial or permanent total disability is solely attributable to the effects of the care provided (i.e., surgical intervention), the QME/AME apportionment as to the injury itself may not be relevant to what has caused the actual permanent disability.
If the permanent disability is solely tied to the treatment for the industrial injury, the courts have decided that this becomes the compensable consequence of the underlying work-related injury, and it must be separately analyzed by the AME/QME in determining apportionment.
Suppose the apportionment is 100% tied to the treatment. In that case, that outcome is applicable to the compensable consequence of the entire injury even relating back ab initio to the industrial event that gave rise to the need for surgical intervention (Hikida v. WCAB (2017) 12 Cal. App. 5th 1249, 82 Cal. Comp. Cases 679). “Hikida precludes apportionment only where the industrial medical treatment is the sole case of the permanent disability” (12 Cal. App. 5th at 1263).