Carrasco: A Stale Kidney Report Could Not Support a Permanent Disability Rating

A workers’ comp judge should not rate permanent disability from an old medical report when the newer reports, including the old report’s author, say the condition has returned to normal. In Carrasco v. University of California Davis Police Department, Nos. ADJ10287483 and ADJ10137345 (WCAB Oct. 26, 2026), the Appeals Board removed a kidney rating based on 2017 reporting and cut the award from 79 to 65 percent; the finding that the kidneys had been injured stayed in place.

The decision comes from a three-member panel of the Board. Its value lies in how it treated two reasoned medical opinions written years apart about a condition that changed.

Heart treatment led to a kidney claim

Michael Carrasco was a police officer, first for the City of Sacramento and then for UC Davis. He claimed a cumulative injury ending in 2013 and a specific injury on September 10, 2015, both to his circulatory system. The cases were consolidated, and the trial judge’s May 2022 findings established industrial injury to his heart and circulatory system with both employers.

The kidney question grew out of his treatment. In a 2017 deposition, panel qualified medical evaluator (QME) Dr. Bellinger said one heart medication, a diuretic, “creates havoc in the kidneys” and can cause them to fail. A second QME, Dr. Levy, examined Carrasco in May 2017 and, in reports that year and a 2020 deposition, tied chronic kidney disease to low cardiac output, heart medications, weight and anti-inflammatory pain medicine taken for an earlier injury. Dr. Bellinger’s 2021 reports repeated that Carrasco had stage III chronic kidney disease, according to Dr. Levy, from his cardiac condition and the anti-inflammatory drugs.

Later tests showed normal kidney function

The picture changed after 2022. In a December 2022 reevaluation, Dr. Bellinger wrote that the kidney problem “needs more development with current laboratory testing” before he could address impairment. In February 2023 he noted normal October 2022 laboratory results and concluded that no kidney rating was needed. His August 2024 reevaluation described the earlier kidney insufficiency as now normal.

Dr. Levy had already agreed. In a January 2024 supplemental report reviewing Dr. Bellinger’s 2022 and 2023 reports, he noted that he had last examined Carrasco in 2017, that Dr. Bellinger was now seeing normal kidney function five years later, and that the improvement likely followed stopping the anti-inflammatory drugs and treating the heart failure. He said he agreed with Dr. Bellinger’s analysis. Then, in January 2025, Dr. Bellinger reviewed a table of laboratory results from December 2019 through November 2024 and concluded that there was “no injury in the form of kidney disease.”

The judge rated the kidneys from the 2017 reporting

When the case was tried again in 2026, the judge noticed that the reports discussed kidney and thyroid conditions that had never been claimed, and Carrasco amended his application to add them. The July 14, 2026 Findings and Award found industrial injury to the kidneys and thyroid as compensable consequences of the heart injury, meaning conditions caused by treatment for that injury.

For the heart and thyroid, the judge relied on Dr. Bellinger’s ratings; she found his opinion on the heart better reasoned, noting that he had examined Carrasco four times. For the kidneys, she used Dr. Levy’s 20 percent whole person impairment, writing that Dr. Bellinger had provided none. She also rejected Dr. Levy’s 60 percent apportionment to nonindustrial causes as unexplained, so the kidneys added a full rating to the combined 79 percent permanent disability, awarded against both employers jointly and severally. UC Davis petitioned for reconsideration. It argued that the kidney injury finding lacked substantial evidence and that the kidney rating rested on a stale, outdated report. The judge recommended denying the petition.

A reasoned report can still be out of date

A Board decision must rest on substantial evidence, and the worker carries the burden of proving the injury. Quoting the California Supreme Court’s decision in Hegglin, the Board explained that medical opinions are not substantial evidence if they rest “on facts no longer germane” or on inadequate histories, examinations or speculation. Citing Turner, it added that an expert’s opinion is no better than the facts behind it.

The Board found that both doctors’ opinions rested on reasonable medical probability, adequate examination and stated reasoning. The difference was time: Dr. Levy last examined Carrasco in 2017, while Dr. Bellinger’s later reports addressed current test results. The Board also pointed to an inconsistency. The judge accepted Dr. Bellinger’s later reporting as substantial evidence for the heart and thyroid, yet set aside his conclusion that there was currently no kidney disease and rated the kidneys from Dr. Levy’s 2017 work.

The Board’s conclusion separated two questions. Both evaluators agreed that Carrasco had earlier suffered an industrial kidney injury as a compensable consequence. But “the most recent opinions do not support a finding of impairment to the kidneys.” An injury that happened was not the same as a permanent impairment that remained.

The award fell from 79 to 65 percent

The Board granted reconsideration and rerated the case without the kidneys. The cardiomyopathy, arrhythmia and hypothyroidism ratings stayed exactly as the judge had calculated them and now combine to 65 percent. Rather than send the case back for more evidence, the Board amended the permanent-disability finding itself and otherwise affirmed the Findings and Award, leaving the injury findings, including the kidneys, in place.

The amended award gives Carrasco 65 percent permanent disability against both employers jointly and severally: 391.25 weeks at $290 a week, totaling $113,462.50, less credit for amounts already paid and a 15 percent attorney fee. The parties are to adjust payment, and jurisdiction remains reserved over their rights of contribution and reimbursement.

What the decision means for a condition that improves

In our reading, Carrasco matters most where a condition changes during a long claim. A rating needs medical evidence of the impairment as it now stands, and the Board looked to the most recent reasoned opinions to find it. A well-written older report can lose its force when later tests and the same doctor’s own update overtake it.

For a worker, that means checking whether the report behind each rated body part still describes your current condition. If a condition has improved, worsened or been retested, ask whether the evaluators have reviewed the newer results. For an employer, the decision shows the value of putting updated testing and the evaluators’ responses in evidence. Our Rogers analysis shows a different outcome, where an incomplete medical record led the Board to defer disability for further development rather than rerate it.