What the panel ordered
Petition for reconsideration granted; Joint Findings and Award of September 2, 2023, rescinded; matter returned to WCJ for further proceedings.
Applicant sought reconsideration of the Joint Findings and Award issued by the WCJ on September 2, 2023, which was rescinded and the matter returned to the WCJ for further proceedings.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The record was found inadequate to determine permanent disability and EDD lien issues; further proceedings were ordered.
The record was found inadequate to determine if applicant sustained a psychiatric injury; further proceedings were ordered.
The record was found inadequate to determine temporary disability status; further proceedings were ordered.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Record contained numerous inconsistencies regarding the entity that was applicant's employer on the two dates of injury.
Favours neutral
This inconsistency made the record inadequate for final determination and required rescission and further proceedings.
From the decision · page 4As discussed above, the record contains numerous inconsistencies regarding the entity that was applicant's employer on the two dates of injury at issue herein. The record contains no information as to whether Acadia Management and 4 Wall Entertainment are in any way related or if they are in fact two separate employers. Review of the entire record in both cases does not indicate that 4 Wall Entertainment was joined as a party defendant, but the F&A includes an award of further medical treatment in case number ADJ10918846 which initially identified 4 Wall Entertainment as the employer.
Applicant testified last day worked was December 23, 2019, with lifting restrictions preventing job search.
Favours Applicant prevailed
Supported the need for further proceedings on temporary disability and related issues.
From the decision · page 3The last day that she worked for any employer was December 23, 2019 while working for 4 Wall. She has not looked for any other job because she has a lifting restriction of no more than five pounds since the 2019 date of injury as well as no lifting or bending. (MOH/SOE, June 28, 2023, p. 3.) She confirmed [in] her testimony that she first had incontinence after the 2016 date of injury. She would urinate all the time after the 2016 date of injury, but it got worse after the 2019 date of injury and she estimates it might have gotten three times more frequent. (MOH/SOE, June 28, 2023, p. 4.)
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Report challenged as not substantial evidence on temporary disability and permanent disability caused by urinary incontinence.
From the decision · page 1Applicant contends that the report from urology qualified medical examiner (QME) Alec Koo, M.D., is not substantial evidence on the issue of applicant's temporary disability status so the record should be further developed; that the reports from urology treating physician Alexander Gershman M.D., are substantial evidence regarding the permanent disability caused by applicant's urinary incontinence and the report from Dr. Koo is not substantial evidence as to that issue; and that the reports from treating psychologist Judith Schwafel, Ph.D., are substantial evidence that applicant sustained a psychiatric injury as claimed, or in the alternative if they are found not to be substantial evidence, then the record should be further developed in regard to that issue.
Reports asserted as substantial evidence of psychiatric injury; record found inadequate to confirm.
From the decision · page 1Applicant contends that the report from urology qualified medical examiner (QME) Alec Koo, M.D., is not substantial evidence on the issue of applicant's temporary disability status so the record should be further developed; that the reports from urology treating physician Alexander Gershman M.D., are substantial evidence regarding the permanent disability caused by applicant's urinary incontinence and the report from Dr. Koo is not substantial evidence as to that issue; and that the reports from treating psychologist Judith Schwafel, Ph.D., are substantial evidence that applicant sustained a psychiatric injury as claimed, or in the alternative if they are found not to be substantial evidence, then the record should be further developed in regard to that issue.
Report asserted as substantial evidence regarding permanent disability caused by urinary incontinence.
From the decision · page 1Applicant contends that the report from urology qualified medical examiner (QME) Alec Koo, M.D., is not substantial evidence on the issue of applicant's temporary disability status so the record should be further developed; that the reports from urology treating physician Alexander Gershman M.D., are substantial evidence regarding the permanent disability caused by applicant's urinary incontinence and the report from Dr. Koo is not substantial evidence as to that issue; and that the reports from treating psychologist Judith Schwafel, Ph.D., are substantial evidence that applicant sustained a psychiatric injury as claimed, or in the alternative if they are found not to be substantial evidence, then the record should be further developed in regard to that issue.
Initial report noted employer inconsistencies and employment history relevant to injury claims.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Hamilton v. Lockheed Corp. (2001) 66 Cal.Comp.Cases 473, 477 (Appeals Board en banc)
It is the responsibility of the parties and the WCJ to ensure the record is complete when a case is submitted for decision on the record.
The record was found incomplete and inadequate for final determination, requiring further proceedings.
From the decision · page 3"... [T]he Labor Code and the Board's rules contain explicit instructions concerning the contents of the record of a case. It is the responsibility of the parties and the WCJ to ensure that the record is complete when a case is submitted for decision on the record." (Hamilton v. Lockheed Corp. (2001) 66 Cal.Comp.Cases 473, 477 (Appeals Board en banc).) It is the responsibility of the parties to properly identify the injured worker's employer. (Cal.Code Regs., tit. 8, § 10390; see also: Coldiron v. Compuware Corporation (2002) 67 Cal.Comp.Cases 289 (Appeals Board en banc).)
Cal.Code Regs., tit. 8, 10390; Coldiron v. Compuware Corporation (2002) 67 Cal.Comp.Cases 289 (Appeals Board en banc)
It is the responsibility of the parties to properly identify the injured worker's employer.
The record contained inconsistencies regarding employer identification, necessitating clarification and further proceedings.
From the decision · page 3"... [T]he Labor Code and the Board's rules contain explicit instructions concerning the contents of the record of a case. It is the responsibility of the parties and the WCJ to ensure that the record is complete when a case is submitted for decision on the record." (Hamilton v. Lockheed Corp. (2001) 66 Cal.Comp.Cases 473, 477 (Appeals Board en banc).) It is the responsibility of the parties to properly identify the injured worker's employer. (Cal.Code Regs., tit. 8, § 10390; see also: Coldiron v. Compuware Corporation (2002) 67 Cal.Comp.Cases 289 (Appeals Board en banc).)
What proof carried it
The evidence the panel weighed, by kind.
Applicant's testimony about last day worked and lifting restrictions
From the decision · page 3The last day that she worked for any employer was December 23, 2019 while working for 4 Wall. She has not looked for any other job because she has a lifting restriction of no more than five pounds since the 2019 date of injury as well as no lifting or bending. (MOH/SOE, June 28, 2023, p. 3.) She confirmed [in] her testimony that she first had incontinence after the 2016 date of injury. She would urinate all the time after the 2016 date of injury, but it got worse after the 2019 date of injury and she estimates it might have gotten three times more frequent. (MOH/SOE, June 28, 2023, p. 4.)
Inconsistencies in employer identification in medical reports and testimony
From the decision · page 4As discussed above, the record contains numerous inconsistencies regarding the entity that was applicant's employer on the two dates of injury at issue herein. The record contains no information as to whether Acadia Management and 4 Wall Entertainment are in any way related or if they are in fact two separate employers. Review of the entire record in both cases does not indicate that 4 Wall Entertainment was joined as a party defendant, but the F&A includes an award of further medical treatment in case number ADJ10918846 which initially identified 4 Wall Entertainment as the employer.
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
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