Medina: Work Restrictions Supported a Limited Temporary-Disability Award

If your job has ended and a doctor says you can work only with restrictions, the loss of income can be frightening. Being capable of some tasks does not put a suitable job in your hands. A temporary-disability claim needs medical support for the restrictions and a careful look at whether appropriate work was actually available and offered.

In Medina v. Foster Dairy Farms, No. ADJ17875984 (WCAB Nov. 7, 2024), the Workers’ Compensation Appeals Board awarded temporary total disability after a QME supported modified-duty restrictions and the employer supplied no evidence of an available offer. The award covered 45 days beginning December 21, 2023. The medical record supported that limited period, rather than the entire period the worker claimed.

The two QME reports supported different conclusions

Jose Medina injured his right wrist in August 2022 while working at a dairy. He lost his footing while climbing over a fence, fell backward and struck the wrist. His treating physician initially permitted modified duties, then declared him permanent and stationary and released him to full duty. The doctor again released him without restrictions or a need for future treatment in December 2022.

Medina continued working until the dairy closed in April 2023. He later sought temporary disability from October 19, 2023, through April 15, 2024, relying on reports from orthopedic QME Dr. Ogoegbunam Agubuzu.

The first-evaluation discussion in Medina explains an important limitation in the October report. The QME took a history and examined the wrist, finding limited motion, tenderness and reduced grip strength. But he had received no medical records. He deferred a formal disability and work-restriction opinion while stating that he suspected Medina could perform modified duties involving no use of the right arm.

The December 21 supplemental report followed review of the medical records. The QME identified residual pain, impaired wrist motion and grip strength, found Medina was not yet permanent and stationary, and supported an orthopedic consultation and interim treatment. He stated that Medina could work with a restriction against using the right upper extremity.

The Board’s disability finding in Medina began with that second report. It found the medical evidence sufficiently established modified-duty capacity as of December 21. The distinction between a preliminary suspicion and a supported opinion affected the start of the benefits awarded.

The reporting gap had to be read in context

The trial judge had denied the claim, finding the QME reports insufficient and Medina’s testimony not credible. The reasons included the absence of contemporaneous treating reports and an explanation of worsening symptoms during the period after the earlier release.

The Board examined why Medina had pursued a QME. His treating physician had discharged him, released him to unrestricted work and found no need for future treatment. Disputing that determination required following the applicable medical-dispute process.

In the discharge-and-dispute analysis in Medina, the Board applied Rule 9785 and Tenet/Centinela Hospital Medical Center v. Workers’ Compensation Appeals Board (Rushing), 80 Cal.App.4th 1041, 1048 (2000). On this record, the QME process under Labor Code sections 4061 and 4062 was the route for challenging the release before obtaining a new primary treating physician.

That context mattered to both credibility and medical proof. The Board found that the lack of interim treating reports was an unreasonable basis for rejecting Medina’s testimony in these circumstances. It also found the QME’s reviewed medical history, current examination findings and supported restrictions sufficient for the period beginning with the supplemental report.

The current treating-physician rule identifies procedures for disputes over release from care, while Rule 10682(b)(8) identifies disability duration and work limitations as subjects for medical reports. For a worker facing a similar gap, counsel should compare the actual release, the dispute steps and the later report. A missing series of visits needs to be understood alongside the medical and procedural record.

Modified-duty capacity shifted the work-availability question

The worker first needed to establish disability. The Board explained that temporary disability replaces wages lost during a temporary inability to perform employment; the medical condition and wage loss must be connected.

The burden analysis in Medina applied Huston v. Workers’ Compensation Appeals Board, 95 Cal.App.3d 856, 868 (1979). Once the worker established temporary disability, including capacity for modified work, the employer needed to show that suitable work was available and offered. Without that showing, the resulting wage loss could be treated as total.

Here, the QME’s December report supplied the medical restrictions, and the record contained no evidence establishing an available modified-duty offer. The Board therefore found entitlement to temporary total disability for the supported period. The ability to perform some restricted tasks was considered together with the actual availability of work.

For another claim, preserve the offer itself, the duties, schedule, pay and medical restrictions. Identify what was genuinely available during the weeks claimed. A general statement that a worker could do something is different from evidence of a suitable assignment that was offered.

The award covered 45 days supported by this record

The evidence also needed to support duration. The Board found no designated primary treating physician and no treating-physician reporting during the claimed period. It concluded that Medina had established an initial 45-day period beginning December 21, but had not carried the burden for the longer period requested.

The duration discussion in Medina referred to Rule 9785(f)(8), which calls for progress reporting no later than 45 days after the last report when continuing treatment is provided. The Board applied that reporting context to the evidentiary gap in this case. The award’s length followed the proof in Medina’s record; the rule’s reporting interval should not be treated as an automatic benefit cutoff for every injured worker.

The Board also criticized the trial judge’s statement that developing the record was outside the judge’s duty when a party failed to present competent evidence. It discussed Kuykendall v. Workers’ Compensation Appeals Board, 79 Cal.App.4th 396 (2000), and Tyler v. Workers’ Compensation Appeals Board, 56 Cal.App.4th 389, 394 (1997), on a developed record and due process. It then decided the benefits supported by the record before it.

The substituted findings in Medina granted reconsideration and rescinded the earlier decision. The resulting award was 45 days of temporary total disability commencing December 21, 2023, at $545.31 a week, less the specified 15-percent attorney’s fee. The fee, payable from the total unpaid, accrued indemnity, was to be calculated by the parties, with the judge retaining jurisdiction over a dispute.

Match medical support and work offers to each claimed period

Start with the treating physician’s release and the QME reports. Identify when records were reviewed, when the evaluator expressed a firm disability opinion, what restrictions applied and what later reports support continuing disability. Those dates can distinguish the beginning of a supported period from an earlier request for benefits.

Place the medical timeline beside the employer’s modified-work communications, actual work history and closure or separation records. The relevant question is how the work-related restrictions affected the ability to earn during the specific period claimed.

Keep obtaining appropriate medical and legal guidance about continuing treatment and work status. Medina’s outcome shows why a report establishing restrictions and proof supporting their duration both matter. Our Hillmon analysis considers a different wage-loss record involving injury-driven retirement and a longer medically supported period.