Juan Alegria — ADJ8760173

Applicant, an electrician, fell 12-15 feet in December 2012, sustaining industrial injuries to his back, left shoulder, right knee, left ankle, psyche, urologic system, internal system, and sexual dysfunction, including a severely comminuted calcaneus fracture with osteomyelitis, complex regional pain syndrome, and a subsequent industrial heart attack. The WCJ awarded 100% permanent disability without apportionment, relying on vocational expert Ray Largo and treating pain physician Dr. Vally. Defendant sought reconsideration, arguing Largo disregarded QME medical apportionment and that Dr. Vally's reporting was inadmissible and not substantial evidence. The WCAB majority affirmed, holding that the QMEs' apportionment opinions (to ADLs, obesity, and deferred breakdowns) were not substantial medical evidence, so Largo properly offered an alternative analysis under Nunes II based solely on purely industrial factors—the opioid-induced cognitive deficits and the psychiatric injury—that independently rendered applicant permanently totally disabled. Commissioner Razo dissented, arguing the QME apportionment was valid and that Largo and Dr. Vally's reports were procedurally and evidentiarily deficient.