What the panel ordered
Petition for Reconsideration denied, affirming the finding of industrial injury.
Defendant sought reconsideration of the November 18, 2020 Findings and Order that found applicant sustained an industrial injury to his respiratory system and valley fever during employment.
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 PQME Dr. Hendel provided a reasoned medical opinion based on reasonable medical probability that the applicant contracted valley fever at work, supported by the applicant's outdoor work exposure and antibody evidence, which the WCJ and panel found substantial.
From the decision · page 1Defendant seeks reconsideration of the November 18, 2020 Findings and Order wherein the workers' compensation administrative law judge (WCJ) found that applicant, while employed by the State of California as a vocational instructor during the period January 14, 2014 through June 1, 2018, sustained injury arising out of and in the course of his employment to his respiratory system and in the form of valley fever.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant had elevated IgM antibody for coccidioidomycosis in September 2017 indicating acute infection in July or August 2017.
Favours Applicant prevailed
This timing of infection supported the finding that the injury arose during employment.
From the decision · page 2As mentioned above, Eli Hendel, M.D., acted as PQME in this case. At his deposition, Dr. Hendel testified that applicant "was found to have the elevated antibody of coccidioidomycosis in September of 2017. The antibody that he was discovered was the IgM type, which is the acute antibody. (Exh. C, November 13, 2019, Deposition of Eli Hendel, M.D., p. 14:21-25.) Dr. Hendel was able to determine that applicant was infected in July or August of 2017. (Id. at 15:3-4.) Dr. Hendel explained "But to the level of reasonable medical probability, the preponderance of the time that he's been outdoors during that period was during work. (Id. at 31:22-24.) When questioned about whether soil samples would be helpful in assessing where applicant was exposed to the valley fever spores (coccidioidomycosis), Dr. Hendel testified as follows:
Applicant spent the preponderance of his outdoor time during the infection period at work rather than at home.
Favours Applicant prevailed
This supported the medical opinion that the infection was contracted at work.
From the decision · page 2As mentioned above, Eli Hendel, M.D., acted as PQME in this case. At his deposition, Dr. Hendel testified that applicant "was found to have the elevated antibody of coccidioidomycosis in September of 2017. The antibody that he was discovered was the IgM type, which is the acute antibody. (Exh. C, November 13, 2019, Deposition of Eli Hendel, M.D., p. 14:21-25.) Dr. Hendel was able to determine that applicant was infected in July or August of 2017. (Id. at 15:3-4.) Dr. Hendel explained "But to the level of reasonable medical probability, the preponderance of the time that he's been outdoors during that period was during work. (Id. at 31:22-24.) When questioned about whether soil samples would be helpful in assessing where applicant was exposed to the valley fever spores (coccidioidomycosis), Dr. Hendel testified as follows:
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.
Dr. Hendel opined it was reasonably probable that the applicant contracted valley fever at work based on the timing of infection, antibody evidence, and the preponderance of time spent outdoors during work.
Dr. Hendel's opinion was based on the applicant's elevated IgM antibody in September 2017 indicating acute infection in July or August 2017, and the applicant's outdoor work exposure during that period, which he found to be the most probable source of infection.
From the decision · page 2As mentioned above, Eli Hendel, M.D., acted as PQME in this case. At his deposition, Dr. Hendel testified that applicant "was found to have the elevated antibody of coccidioidomycosis in September of 2017. The antibody that he was discovered was the IgM type, which is the acute antibody. (Exh. C, November 13, 2019, Deposition of Eli Hendel, M.D., p. 14:21-25.) Dr. Hendel was able to determine that applicant was infected in July or August of 2017. (Id. at 15:3-4.) Dr. Hendel explained "But to the level of reasonable medical probability, the preponderance of the time that he's been outdoors during that period was during work. (Id. at 31:22-24.) When questioned about whether soil samples would be helpful in assessing where applicant was exposed to the valley fever spores (coccidioidomycosis), Dr. Hendel testified as follows:
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291
The employee bears the burden of proving injury AOE/COE by a preponderance of the evidence.
Substantial evidence of industrial causation must be based on reasonable medical probability, not scientific certainty.
From the decision · page 2The employee bears the burden of proving injury AOE/COE by a preponderance of the evidence. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a); 3202.5.) Substantial evidence of industrial causation must be based on reasonable medical probability--it is not required to prove causation to a "scientific certainty." (See McAllister v. Workmen's Comp. App. Bd. (1968) 69 Cal.
What proof carried it
The evidence the panel weighed, by kind.
Applicant's outdoor work exposure during July-August 2017 was the preponderant time spent outdoors, supporting industrial causation.
From the decision · page 2As mentioned above, Eli Hendel, M.D., acted as PQME in this case. At his deposition, Dr. Hendel testified that applicant "was found to have the elevated antibody of coccidioidomycosis in September of 2017. The antibody that he was discovered was the IgM type, which is the acute antibody. (Exh. C, November 13, 2019, Deposition of Eli Hendel, M.D., p. 14:21-25.) Dr. Hendel was able to determine that applicant was infected in July or August of 2017. (Id. at 15:3-4.) Dr. Hendel explained "But to the level of reasonable medical probability, the preponderance of the time that he's been outdoors during that period was during work. (Id. at 31:22-24.) When questioned about whether soil samples would be helpful in assessing where applicant was exposed to the valley fever spores (coccidioidomycosis), Dr. Hendel testified as follows:
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