ADJ10287483 · August 5, 2022

The defendant City of Sacramento failed to overcome the presumption of industrial injury because they did not prove the cause of the sarcoidosis was non-industrial, and the cause of sarcoidosis is unknown to science, so the presumption stands.

From the decision · page 9Applicant alleged a presumptive heart injury against City of Sacramento. By stipulation of the parties, applicant qualifies for a presumption of compensability per Labor Code, section 3212.5, and it is City of Sacramento's burden to overcome the presumption.

Applicant sustained an industrial injury to his heart and circulatory system through cumulative trauma with City of Sacramento ending October 4, 2013, and a date of injury with UC Davis on September 10, 2015.

Favours Applicant prevailed

This established the presumption of industrial injury against City of Sacramento.

From the decision · page 3Defendant, City of Sacramento, filed a timely and verified Petition for Reconsideration from the Joint Findings of Fact and Order with Opinion on Decision, issued on May 23, 2022, which found, in pertinent part, that applicant sustained an industrial injury to his heart and circulatory system with City of Sacramento through the cumulative period ending on October 4, 2013, and for a date of injury per Labor Code1, section 54122 of September 10, 2015.

Defendant City of Sacramento did not prove the cause of sarcoidosis was non-industrial and failed to rebut the presumption of industrial injury.

Favours Applicant prevailed

Because the cause of sarcoidosis is unknown to science, the defendant could not meet the burden to show a non-industrial cause.

From the decision · page 10Defendant's petition cherry picks the factual record multiple times in falsely asserting that applicant's sarcoidosis was proven non-industrial. Both QMEs in this case are essentially in agreement. The cause of applicant's sarcoidosis is presently unknown to science. The QMEs use the term "non- industrial" in a lay sense, in that absent a legal presumption, the injury would be found non-industrial because the cause cannot be ascertained. Defendant did not prove that the cause of sarcoidosis was non-industrial. Defendant's QME clearly and unequivocally stated numerous times that causation of sarcoidosis was unknown to science. Defendant's assertions that it proved the cause as non- industrial appear to be misstatements of the factual record.

Diagnosed pulmonary sarcoidosis and sarcoid heart; opined nonischemic dilated cardiomyopathy is 'heart trouble' under Labor Code Section 3212.5; stated sarcoidosis cause is unknown and that the 2015 takedown event aggravated the underlying heart disease; agreed with Dr. Levy that cardiac sarcoidosis was pre-existing but further refinement was needed.

Dr. Bellinger's opinions supported the finding of industrial injury and the failure of defendant to rebut the presumption.

From the decision · page 4Applicant was evaluated by internist QMEs for each claim. Dr. Raye Bellinger reported as a QME in the claim against City of Sacramento. Dr. Richard Levy reported as QME in the claim against UC Davis.

Opined sarcoidosis is generally not industrial but acknowledged the heart condition was aggravated during UC Davis employment; stated underlying sarcoidosis likely present during City of Sacramento employment; did not explain cause of sarcoidosis, reflecting the unknown cause in science.

Dr. Levy's opinion was considered but did not rebut the presumption of industrial injury because he did not prove the cause of sarcoidosis was non-industrial.

From the decision · page 6UC Davis obtained reporting from QME Dr. Richard Levy, who initially opined as follows:

Offered no opinions as to causation of injury.

No causation opinion was given by Dr. Parikh, so her opinion did not affect the outcome.

From the decision · page 8The parties took the deposition of applicant's treating physician, Dr. Swapna Parikh, who offered no opinions as to causation of injury. (See generally, Exhibit 17.)

City and County of San Francisco v. Workers' Comp. Appeals Bd. (Wiebe) (1978) 22 Cal. 3d 103

Once a prima facie case is established, the burden shifts to defendant to rebut the presumption of industrial causation by showing substantial medical evidence that a nonwork-related event was the sole cause of the heart trouble.

Defendant failed to meet this burden as the cause of sarcoidosis is unknown and not proven to be non-industrial.

From the decision · page 9Once a prima facie case is established, as was stipulated here, the burden shifts to defendant to rebut the presumption of industrial causation. To do so, defendant must show through substantial medical evidence "that some contemporaneous nonwork-related event - for example, a victim's strenuous recreational exertion - was the sole cause" of the applicant's heart trouble. (City and County of San Francisco v. Workers' Comp. Appeals Bd. (Wiebe) (1978) 22 Cal. 3d 103 [43 Cal. Comp. Cases 984].)

Applicant qualifies for a presumption of compensability per Labor Code section 3212.5 against City of Sacramento.

From the decision · page 3This matter proceed to a consolidated trial wherein applicant alleged injury to his heart, circulatory system, and respiratory system. (Minutes of Hearing and Summary of Evidence (MOH/SOE), March 30, 2022, pp. 2-3.) Applicant's injury occurred on September 10, 2015, while he worked as a police officer for UC Davis. (Id. at p. 2, lines 28-32.) However, applicant also filed a claim of cumulative trauma against his former employer, City of Sacramento, where he worked as a police officer through October 4, 2013. (Id. at p. 3, lines 3-9.) The presumption of industrial injury per Labor Code section 3212.53 applied against City of Sacramento, but not UC Davis. (Id. at p. 3, lines 19-24.)

Defendant failed to prove the cause of sarcoidosis was non-industrial; cause is unknown to science.

From the decision · page 10Defendant's petition cherry picks the factual record multiple times in falsely asserting that applicant's sarcoidosis was proven non-industrial. Both QMEs in this case are essentially in agreement. The cause of applicant's sarcoidosis is presently unknown to science. The QMEs use the term "non- industrial" in a lay sense, in that absent a legal presumption, the injury would be found non-industrial because the cause cannot be ascertained. Defendant did not prove that the cause of sarcoidosis was non-industrial. Defendant's QME clearly and unequivocally stated numerous times that causation of sarcoidosis was unknown to science. Defendant's assertions that it proved the cause as non- industrial appear to be misstatements of the factual record.