ADJ11946779 — California WCAB decision

What the panel ordered

Joint Findings and Order issued May 13, 2019 is rescinded and the matter is returned to the trial level for further proceedings consistent with this decision.

Petition for reconsideration of a Joint Findings and Order (F&O) issued May 13, 2019, which barred applicant's recovery for specific and cumulative trauma psychiatric injuries. WCAB previously granted reconsideration to further study the issues.

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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.

Psyche AOE/COEApplicant prevailedpsyche

Both Dr. Mosby and Dr. Staehle opined that applicant sustained one cumulative trauma injury to his psyche from various workplace stressors, not two separate injuries.

From the decision · page 8Here, and contrary to the WCJ's conclusions, we find no evidence in the record from either Dr. Mosby or Dr. Staehle that applicant sustained two, separate injuries. Rather, the concurring opinions of both doctors is that applicant sustained one, cumulative trauma injury resulting from various job stressors over a period of years. (See Western Growers Ins. Co. v. Workers' Comp.Appeals Bd. (Austin) (1993) 16 Cal.App.4th 227, 236-237 [58 Cal.Comp.Cases 323].) There is no statement in any of the reports from Dr. Mosby that the February 6, 2017 meeting caused a separate, specific injury, or that any of his diagnoses were separately caused just by that meeting. Dr. Mosby agrees with Dr. Staehle that the meeting was simply the "final straw" that broke applicant not a new or distinct injury but the culmination of a cumulative trauma stress injury.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Both Dr. Mosby and Dr. Staehle opined that applicant sustained one cumulative trauma injury to his psyche from various workplace stressors, not two separate injuries.

Favours Applicant prevailed

This medical consensus was the basis for finding a single cumulative trauma injury and not two distinct injuries.

From the decision · page 8Here, and contrary to the WCJ's conclusions, we find no evidence in the record from either Dr. Mosby or Dr. Staehle that applicant sustained two, separate injuries. Rather, the concurring opinions of both doctors is that applicant sustained one, cumulative trauma injury resulting from various job stressors over a period of years. (See Western Growers Ins. Co. v. Workers' Comp.Appeals Bd. (Austin) (1993) 16 Cal.App.4th 227, 236-237 [58 Cal.Comp.Cases 323].) There is no statement in any of the reports from Dr. Mosby that the February 6, 2017 meeting caused a separate, specific injury, or that any of his diagnoses were separately caused just by that meeting. Dr. Mosby agrees with Dr. Staehle that the meeting was simply the "final straw" that broke applicant not a new or distinct injury but the culmination of a cumulative trauma stress injury.

Defendant knew of cumulative trauma diagnosis before filing application but pled only specific injury.

Favours Applicant prevailed

Showed that the amendment to allege cumulative trauma was not a wholly different case and related back to the original application, avoiding statute of limitations bar.

From the decision · page 8Unfortunately, the procedural history in this case itself created the appearance that there was an issue as to the nature of applicant's injury. Defendant filed the application for adjudication on behalf of applicant on March 14, 2017, when applicant was not yet represented. Defendant identified the injury as a specific injury that occurred on February 6, 2017 as a result of feeling trapped in an office by two Sergeants on February 6, 2017. However, at the time defendant filed the Application, it already knew from Dr. Staehle's March 3, 2017 report that applicant sustained a "cumulative anxiety reaction" to his workplace caused by mandatory overtime, violent incidents with inmates, and the February 6, 2017 meeting. Instead of relying on Dr. Staehle's expert opinion, defendant relied on applicant's report of injury and the DWC-1 claim form, including applicant's lay opinion that the February 6, 2017 meeting caused his injury.

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.

QMERelied upon · psychology

Applicant sustained one cumulative trauma injury to his psyche from various workplace stressors, not two separate injuries. Agreed with Dr. Staehle that the February 6, 2017 meeting was the 'final straw' and not a separate injury.

Both Dr. Mosby and Dr. Staehle concurred that applicant's injury was cumulative, not specific.

From the decision · page 8Here, and contrary to the WCJ's conclusions, we find no evidence in the record from either Dr. Mosby or Dr. Staehle that applicant sustained two, separate injuries. Rather, the concurring opinions of both doctors is that applicant sustained one, cumulative trauma injury resulting from various job stressors over a period of years. (See Western Growers Ins. Co. v. Workers' Comp.Appeals Bd. (Austin) (1993) 16 Cal.App.4th 227, 236-237 [58 Cal.Comp.Cases 323].) There is no statement in any of the reports from Dr. Mosby that the February 6, 2017 meeting caused a separate, specific injury, or that any of his diagnoses were separately caused just by that meeting. Dr. Mosby agrees with Dr. Staehle that the meeting was simply the "final straw" that broke applicant not a new or distinct injury but the culmination of a cumulative trauma stress injury.

PTPRelied upon · psychology

Diagnosed applicant with cumulative anxiety reaction due to workplace stressors, including mandatory overtime, violent incidents with inmates, and the February 6, 2017 meeting. Concurred with Dr. Mosby that injury was cumulative.

Both Dr. Mosby and Dr. Staehle concurred that applicant's injury was cumulative, not specific.

From the decision · page 8Here, and contrary to the WCJ's conclusions, we find no evidence in the record from either Dr. Mosby or Dr. Staehle that applicant sustained two, separate injuries. Rather, the concurring opinions of both doctors is that applicant sustained one, cumulative trauma injury resulting from various job stressors over a period of years. (See Western Growers Ins. Co. v. Workers' Comp.Appeals Bd. (Austin) (1993) 16 Cal.App.4th 227, 236-237 [58 Cal.Comp.Cases 323].) There is no statement in any of the reports from Dr. Mosby that the February 6, 2017 meeting caused a separate, specific injury, or that any of his diagnoses were separately caused just by that meeting. Dr. Mosby agrees with Dr. Staehle that the meeting was simply the "final straw" that broke applicant not a new or distinct injury but the culmination of a cumulative trauma stress injury.

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Aetna Cas. & Surety Co. v. Workmen's Comp. Appeals Bd. (Coltharp) (1973) 35 Cal.App.3d 329, 340-341 [38 Cal.Comp.Cases 720]

Whether an injury is specific or cumulative is a question of fact for the WCAB, and if supported by substantial evidence, is conclusive on review.

Applied to determine that applicant sustained one cumulative trauma injury, not two separate injuries.

From the decision · page 8Whether an injury, which can be said to have been caused either by the immediate application of force or by past repetitive trauma is to be treated as specific (i.e., "occurring as the result of one incident or exposure") or cumulative (i.e., "occurring as repetitive mentally or physically traumatic activities extending over a period of time") is an issue of fact to be resolved by the WCAB and, if supported by substantial evidence, that determination is conclusive upon review. (Lab. Code, § 5952, 5953; LeVesque v. Workmen's Comp. App. Bd., 1 Cal.3d 627, 637 [83 Cal.Rptr. 208, 463 P.2d 432].) (Aetna Cas. & Surety Co. v. Workmen's Comp. Appeals Bd. (Coltharp) (1973) 35 Cal.App.3d 329, 340-341 [38 Cal.Comp.Cases 720].)

Rubio v. Workers' Comp. Appeals Bd. (1985) 165 Cal.App.3d 196

Pleadings may be amended by the WCAB to conform to proof, and an amended application relates back to the original timely application, preserving jurisdiction and not triggering the statute of limitations.

Applied to hold that amendment to allege cumulative trauma relates back to original application and is not barred by statute of limitations.

From the decision · page 10Consequently, workers' compensation "[p]leadings may be amended by the Workers' Compensation Appeals Board to conform to proof." (Cal. Code Regs., tit. 8, § 10517.) An amended application that "sets forth the required detail" but is filed more than one year from an applicant's date of injury "relates back to the original timely application and preserves the jurisdiction of the Board to hear the matter." (Rubio, supra, 165 Cal.App.3d at p. 199-200.)

What proof carried it

The evidence the panel weighed, by kind.

Testimony and credibilityfavours Applicant prevailed

Applicant's testimony and medical records from Drs. Mosby and Staehle established credibility and supported cumulative trauma injury.

From the decision · page 9Defendant also chose to call applicant's credibility into question when the issue of the cumulative trauma injury was raised rather than amend the Application to conform to the evidence provided by Drs. Mosby and Staehle. (See App. Exh. 1, Deposition of Melissa Staehle, Ph.D., March 16, 2018, supra. ["His claim is denied. And now we see all the emphasis is on cumulative stress. Do you think that there might be a personal motivator to change the basis for the claim, in order to get his claim accepted?"].) First, Dr. Staehle testified that applicant's identification of his injury as specific to the February 6, 2017 meeting is consistent with the way public safety officers perceive psychiatric injury, i.e., they identify the last stressor the stressor straw that broke the camel's back as the injury, or date of injury. More importantly, it begs credulity to accuse applicant of being disingenuous when it was defendant that filed the Application, and defendant who chose to ignore Dr. Staehle's medical reporting that applicant sustained a cumulative trauma injury. Regardless, Dr. Mosby reported that applicant was a credible patient, and was frank, open, and truthful.

Medical recordsfavours Applicant prevailed

Medical records and expert opinions from Drs. Mosby and Staehle established cumulative trauma from workplace stressors.

From the decision · page 9In sum, neither Dr. Mosby nor Dr. Staehle identified a separate, distinct psychiatric or physical injury resulting from the February 6, 2017 meeting. As stated, there is substantial evidence in the record from the concurring opinions of Dr. Mosby and Dr. Staehle that there is one, cumulative trauma injury to applicant's psyche resulting from workplace stress (including mandatory overtime, violent incidents with inmates, and the February 6, 2017 meeting). We note that because of the strategy employed by defendant in this matter, there has been no Rolda analysis related to applicant's cumulative trauma injury claim.

ADJ11946779 · April 11, 2022