Ramirez v. Quality Scales Unlimited: DEU Ratings and Unsupported Disability Findings

The Workers’ Compensation Appeals Board (WCAB) panel in Ramirez v. Quality Scales Unlimited set aside a permanent disability determination built partly on an inadmissible DEU consultative rating and insufficiently explained medical and psychiatric findings. Its practical lesson is to trace the percentage back to admissible evidence and reasoned findings. It did not select a higher rating or decide that the injury was catastrophic.

The 40% award and the competing figures

Jose Ramirez sustained an industrial injury while working as a scale technician for Quality Scales Unlimited on April 20, 2016. The December 17, 2024 findings and award identified injuries to several orthopedic body parts and the psyche, characterized the physical injury as noncatastrophic, and awarded 40% permanent disability excluding a psychiatric component. The judge relied on PQME reports and depositions and a February 8, 2022 consultative rating. Ramirez, slip op. at 1, 8.

The worker, representing himself, challenged the percentage, the treatment of surgical scars and psychiatric impairment, and the handling of other evidence. His contentions included higher percentages appearing in notices and a claimed catastrophic or violent injury. These were issues raised by the worker, not facts the panel accepted merely because he raised them. Id. at 1–2.

The panel’s footnote exposed a significant record problem. A December 2021 notice calculated 58% using an October 2021 report. The February 2022 DEU consultative rating calculated 40% using July 2020 and June 2021 reports. An August 2023 notice calculated 65%, again referring to the October 2021 report. The judge did not explain why the 40% calculation should control. Id. at 5 n.4. Comparing the numbers without their source reports would miss the central evidentiary issue.

Why lack of an objection did not cure inadmissibility

The WCJ described the consultative rating as admitted without objection and used it as a basis for the award. The panel rejected that reliance. Title 8, section 10166(b) makes consultative rating determinations inadmissible in judicial proceedings. The absence of an objection did not make this particular rating a permissible foundation for the 40% finding. Id. at 4–5.

This is a narrow but important distinction. The ruling does not say that every DEU rating is inadmissible. It concerns the consultative rating described in the record. The regulatory category controls; the document’s official origin does not override the restriction. Our guide to consultative ratings and trial evidence explains how to identify the category before deciding what procedural steps to take.

The judge had to explain the medical and rating analysis

Labor Code section 5313 requires the judge to state the evidence relied on and the reasons for the determination. Here, neither the opinion on decision nor the reconsideration report adequately identified the reports, impairment findings, rating strings, or legal basis supporting the disputed conclusions. Without that explanation, the Board and the parties could not meaningfully review the result. Ramirez, slip op. at 3–5.

The panel also distinguished expert rating assistance from judicial responsibility. A WCJ uncertain about the calculation could submit formal rating instructions to the DEU. But the judge first had to review the physician’s reports with the AMA Guides and describe the impairment to be rated. The rater’s assistance could not replace the judge’s assessment of the medical evidence. Id. at 5; see our Blackledge analysis.

The medical record itself required scrutiny. The panel noted apparent inconsistencies in the PQME’s serial permanent and stationary reports and an insufficiently explained conclusion about low back impairment compared with a prior award. A precise rating does not transform a conclusory medical premise into substantial evidence. Ramirez, slip op. at 7–8.

Psychiatric injury and psychiatric impairment were separate questions

The parties had stipulated to psychiatric injury, but that did not resolve whether the psyche injury arose directly from the events of employment or was a compensable consequence of the physical injuries. The distinction matters under Labor Code section 4660.1(c). The panel required findings and an explanation rather than an implicit assumption. Id. at 5–6.

The WCJ’s conclusion that there was no catastrophic injury relied on the absence of limb loss or paralysis and an unexplained reference to other factors. The panel said the statutory examples were not exhaustive and required a fact-specific analysis. It also identified the absence of findings about the claimed violent mechanism. The panel expressly declined to decide whether this worker’s injury was catastrophic. Id. at 6–7.

Thus, the decision should not be read as automatically adding psychiatric impairment whenever a worker suffers a serious physical injury. It calls for evidence establishing the applicable route and findings explaining why the record satisfies—or fails to satisfy—that route.

What the Board actually ordered

The Board granted reconsideration and amended the findings and award. It deferred permanent and stationary status, the permanent disability impairment rating, all issues under section 4660.1(c), and attorney’s fees, while otherwise affirming the decision. Id. at 8–9. It did not award 58% or 65%, conclusively accept new MRI evidence, or decide every issue in the worker’s petition.

For a comparable record, the next useful step is to organize each medical opinion, calculation, and disputed finding. Identify the specific report inputs and explain the requested legal result. That makes an evidentiary challenge more useful than an assertion that another document contains a larger number. The applicable challenge and filing deadline still depend on the actual decision and procedural stage.

Frequently asked questions

Did the panel prohibit all settlement use of a consultative rating? No. The rule permits consultative ratings for identified advisory purposes. The error was reliance on that type of rating as judicial evidence.

Did the worker win a higher permanent disability award? No. The disputed rating issues were deferred for a legally supported determination.

Does this replace the summary rating review process? No. A summary rating and its review procedure are distinct from the consultative evidence problem addressed here.