Opinion ID: 2824994
Heading Depth: 2
Heading Rank: 1

Heading: insufficient explanation of ppd calculation

Text: We first consider whether the ALJ’s 10% PPD calculation was supported by substantial evidence. The ALJ explained Bowles’s disability level as follows: In sum, it is concluded that based on a complex of factors, taking into account the amount of physical impairment caused by the surgical procedure and zero potential for future wage loss, claimant has sustained some permanent partial impairment of the right leg based on her pain and atrophy and is entitle to a 10% permanent partial disability rating to the right leg. Unfortunately this court cannot discern which values the ALJ assigned to each factor (impairment, pain, atrophy, etc.) to reach the 10% PPD level and therefore cannot say whether substantial evidence supports the ALJ’s determination. 1 Given this court’s disposition of the case, we need not evaluate Bowles’s two other claims of error—whether substantial evidence supported the ALJ’s decision to discredit Dr. Phillips’s medical report and whether the ALJ failed to take into account the differences in the physical requirements of the claimant’s preand post-injury employment when assessing wage loss. 11 We review the CRB’s Decision and Order which affirmed the ALJ’s Compensation Order—we do not directly review the ALJ’s determination on appeal. Jones v. District of Columbia Dep’t of Emp’t Servs., 41 A.3d 1219, 1221 (D.C. 2012). “Under the Administrative Procedure Act, this court may overturn a decision of the CRB only if it is arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law.” McNeal v. District of Columbia Dep’t of Emp’t Servs., 917 A.2d 652, 656 (D.C. 2007) (citing D.C. Code § 2-510 (a)(3) (2001)). “We affirm an administrative agency decision when (1) the agency made findings of fact on each contested material factual issue, (2) substantial evidence supports each finding, and (3) the agency’s conclusions of law flow rationally from its findings of fact.” Georgetown Univ. v. District of Columbia Dep’t of Emp’t Servs., 971 A.2d 909, 915 (D.C. 2009). “An administrative order can only be sustained on the ground relied on by the agency.” Walsh v. District of Columbia Bd. of Appeals & Review, 826 A.2d 375, 380 (D.C. 2003) (citation and internal quotation marks omitted). When the ALJ fails to “explain [its] reasoning in arriving at a disability award” such that “we are unable to meaningfully review the decision to determine whether it is based on substantial evidence,” we must remand the case back to the CRB. Jones, supra, 41 A.3d at 1225. This court in Jones addressed a very similar analysis in an ALJ’s 12 Compensation Order. Jones, supra, 41 A.3d at 1219. The Jones opinion described the ALJ Compensation Order as containing the following explanation for its PPD calculation: In consideration of the evidence in the record as detailed above, and setting aside any consideration of wage loss but presuming an effect on claimant’s earning capacity, claimant qualifies for a 7% permanent partial disability award for her left leg disability. Id. at 1226 (internal quotation marks and emphasis omitted). This court ultimately found that “because the ALJ did not explain her reasoning in arriving at a disability award of 7%, we are unable to meaningfully review the decision to determine whether it is based on substantial evidence, applying proper legal principles.” Id. at 1225. “How the ALJ determined that the disability award should be 7%—and not, for example, 1%, 10% or 30%—is a complete mystery, however.” Id. at 1226. This court remanded the case for the agency to essentially show its work and explain how exactly it calculated the 7% PPD. The ALJ in this case put forth an analysis very similar to the ALJ in Jones. The ALJ in this case found that Bowles suffered an impairment of the right leg and suffered both pain and atrophy. The ALJ considered the “amount of physical 13 impairment caused by the surgical procedure,” “zero potential for future wage loss,” pain, and atrophy and ultimately determined that Bowles suffered a 10% PPD in her right leg. How the ALJ reached this conclusion is a mystery; this court cannot discern which values were assigned to each factor that add up to 10%. When the ALJ evaluated the “amount of physical impairment caused by the surgical procedure,” it discredited Dr. Phillips assignment of 17% disability for antalgic gait because a “[r]eview of Table 17.5 reveals that [the Fifth Edition of] the [AMA] Guides suggest a maximum of 7% for mild antalgic gait.” The ALJ also notes that “Dr. Meyer found only a very mild effusion and a mildly right antalgic gait.” The ALJ uses Table 17.5 and Dr. Meyer to discredit Dr. Phillips’ medical report, but does not decide a level of impairment suffered by Bowles as a result of the surgical procedure, although this number is apparently incorporated into the 10% disability level. In addition, Dr. Phillips opined that Bowles suffered 8% disability for atrophy and 5% for pain. The ALJ then goes on to state that “claimant still has pain in her knee while climbing or descending stairs and cannot question Dr. Phillips’ minor atrophy finding.” No combination of 7%, 8%, and 5% add up to just 10%. On this record we are unable to affirm the CRB’s conclusion that the ALJ’s 14 determination was supported by substantial evidence.