Your Psychiatric Report Has an Impairment Score but No Work Restrictions

A vocational expert may conclude that an injured worker cannot return to employment, yet the psychiatric report may leave a crucial question unanswered: What work has that physician actually restricted? A psychiatric impairment percentage, a description of difficulty functioning, and a medical restriction are different pieces of evidence. A vocational conclusion does not automatically supply the missing medical opinion.

Before relying on a total-disability analysis, compare the restrictions the expert used with the signed medical reports. The immediate task is to identify the missing answer and the physician responsible for it, rather than ask the vocational expert to diagnose a condition or create a restriction.

Find the actual restriction behind each vocational assumption

Look for a physician’s statement about an activity, tolerance, frequency, or work condition. Then locate the passage in which the vocational expert applies that statement to jobs or retraining. A reference to pain, a whole-person impairment score, or a general reduction in function does not necessarily answer the same question.

A useful comparison has four columns: The task or tolerance at issue; the medical report and page; the vocational assumption; and the unresolved question. For example, a hypothetical vocational report might assume that a worker cannot maintain attendance, while the psychiatric report gives an impairment score without addressing attendance. Mark that as a question for appropriate medical clarification, not an established restriction.

Do not let a referral between specialists become an unanswered loop

In Cosentino v. Ehlen, Spiess & Haight, Inc., a September 24, 2026 WCAB panel decision, the psychiatric evaluator had not assigned psychiatric work restrictions, although orthopedic restrictions were already in the record. Final neurological reporting was still needed for headaches and memory complaints. Separately, questions about adding or combining impairments remained unanswered as evaluators deferred to one another. The applicant’s vocational expert nevertheless supplied conclusions on an incomplete medical foundation. The panel deferred permanent disability and returned the matter for additional development; it did not decide that the worker could work or fix a final disability percentage. Slip opinion at 7–8, 12, 15–19.

For each deferred issue, identify who was asked to answer it, whether that physician responded, and whether the vocational expert saw the response. A report can be extensive without resolving the particular medical question on which the vocational conclusion depends.

Keep medical clarification separate from vocational analysis

The medical evaluator addresses medical findings, restrictions, and medical causation or apportionment within the evaluator’s competence. The vocational expert can analyze how the established restrictions affect rehabilitation and employment. The distinction does not mean that every observation during vocational testing is improper; it means that the report must explain the foundation for its conclusions.

Our analysis of Valencia discusses a different record in which the panel accepted vocational testing tied to medical restrictions. Comparing the two outcomes is more useful than assuming that the presence of a vocational report guarantees either acceptance or rejection.

Prepare a focused review of the missing evidence

Bring the final and supplemental medical reports, relevant deposition testimony, both sides’ vocational reports, the proposed rating, and any order identifying unresolved issues. Note whether the expert relied on an earlier report later supplemented or changed. Preserve the original wording; do not rewrite a physician’s statement to match the desired vocational conclusion.

Ask counsel which issue requires clarification, which procedure is available, and what discovery or hearing dates matter. There is no automatic entitlement to reopen a record whenever a report is unfavorable. Nor does a missing restriction alone establish a final benefit result. A workers’ compensation review should connect the actual medical foundation to the vocational question before the next hearing or settlement decision.