What the panel ordered
Findings and Order dated January 31, 2022 is rescinded and matter returned to trial level for further proceedings.
Petition for Reconsideration of the Findings and Order issued January 31, 2022, seeking review of denial of compensability and post-termination defense under Labor Code section 3600(a)(10).
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 WCJ's denial of injury AOE/COE was based on lack of evidence of termination date and failure to prove post-termination exceptions. The WCAB found the record incomplete and requiring further development, including determination of date of injury under section 5412 and review of medical records.
From the decision · page 1Applicant seeks reconsideration1 of the Findings and Order (F&O) issued on January 31, 2022 wherein the workers' compensation administrative law judge (WCJ) found, in relevant part, that applicant failed to prove that she sustained injury arising out of and in the course of employment (AOE/COE) to her back, neck, hands, right upper extremity, left arm, and shoulders while employed by defendant as a housekeeper during the period June 29, 2018 to June 29, 2019; and that the alleged injury is not compensable as it was not reported "until subsequent to Applicant's termination" and applicant had not demonstrated that any "of the exceptions listed under Labor Code2 section 3600(a)(10)" applied herein. The WCJ thus ordered applicant "[a] take nothing on her application" and held that "no compensation would be owed, even if such injuries had occurred."
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
No evidence in record confirming applicant's termination or termination date.
Favours Applicant prevailed
Without proof of termination date, post-termination defense under Labor Code section 3600(a)(10) cannot be applied.
From the decision · page 4Turning now to the merits of the Petition, the WCJ concluded that applicant failed to report her injury prior to termination. However, there is nothing in the evidentiary record which provides confirmation of 1) applicant's termination, or 2) the termination date. As explained in Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Bd. en banc), a decision "must be based on admitted evidence in the record" (Id. at p. 478) and must be supported by substantial evidence. (Lab. Code, § 5903, 5952, subd. (d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500]; LeVesque v. Workers' Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) An adequate and complete record is necessary to understand the basis for the WCJ's decision. (Lab. Code, § 5313; see also Cal. Code Regs., tit. 8, § 10787.) "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. At a minimum, the record must contain, in properly organized form, the issues submitted for decision, the admissions and stipulations of the parties, and admitted evidence." (Hamilton, supra, at pp. 473, 475.) As required by section 5313
Dr. Pratt opined cumulative trauma work-related injury causation based on applicant's repetitive housekeeping duties.
Favours Applicant prevailed
Supports compensability and injury causation, contradicting WCJ's denial.
From the decision · page 2On August 6, 2019, defendant issued a denial notice. (Exhibit A) The parties proceeded with discovery, retaining Kerrie Pratt, D.C. as the chiropractic panel Qualified Medical Evaluator (PQME). Dr. Pratt evaluated applicant on November 7, 2019, and issued a corresponding report, as well as two supplemental reports, dated February 16, 2020, and June 26, 2020. (Exhibits 1-3.) In her November 7, 2019 report, Dr. Pratt opined that "given [applicant's] repetitive and frequent work duties as a housekeeper involving lifting, bending, carrying, and prolong[ed] posturing of her neck" she suffered a "cumulative trauma work-related injury." (Exhibit 3, p. 12.) Dr. Pratt noted, however, that "more objective information was required[,] including the MRI scans and the Electrodiagnostic studies to establish the extent of impairment, disability, apportionment, causation and future medical care, if any[.]" (Ibid.) Thereafter, Dr. Pratt received and reviewed various diagnostics, including an EMG/NCS of the bilateral upper and lower extremities and an MRI of the lumbar spine. (Exhibit 2, p.
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.
Applicant sustained cumulative trauma work-related injury due to repetitive housekeeping duties involving lifting, bending, carrying, and prolonged posturing of neck. Impairment ratings: 8% whole person impairment cervical spine, 13% lumbar spine, 1% each shoulder, 3% pain-related impairment. Apportioned 25% to cumulative injury and 25% to preexisting arthritis for spine; 100% to cumulative injury for shoulders.
Dr. Pratt's reports opined cumulative trauma injury causation and impairment, but noted need for further objective information and medical records review.
From the decision · page 2On August 6, 2019, defendant issued a denial notice. (Exhibit A) The parties proceeded with discovery, retaining Kerrie Pratt, D.C. as the chiropractic panel Qualified Medical Evaluator (PQME). Dr. Pratt evaluated applicant on November 7, 2019, and issued a corresponding report, as well as two supplemental reports, dated February 16, 2020, and June 26, 2020. (Exhibits 1-3.) In her November 7, 2019 report, Dr. Pratt opined that "given [applicant's] repetitive and frequent work duties as a housekeeper involving lifting, bending, carrying, and prolong[ed] posturing of her neck" she suffered a "cumulative trauma work-related injury." (Exhibit 3, p. 12.) Dr. Pratt noted, however, that "more objective information was required[,] including the MRI scans and the Electrodiagnostic studies to establish the extent of impairment, disability, apportionment, causation and future medical care, if any[.]" (Ibid.) Thereafter, Dr. Pratt received and reviewed various diagnostics, including an EMG/NCS of the bilateral upper and lower extremities and an MRI of the lumbar spine. (Exhibit 2, p.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code sections 3600(a)(10), 5412
Post-termination defense under Labor Code section 3600(a)(10) and date of injury determination under section 5412.
Defendant failed to prove termination date and post-termination exceptions; date of injury must be determined before applying section 3600(a)(10).
From the decision · page 5Further, the WCJ concluded that applicant did not fall under any of the exceptions listed under section 3600(a)(10). As relevant here, section 3600(a)(10) states, that:
What proof carried it
The evidence the panel weighed, by kind.
Applicant's testimony about injury reporting and treatment while employed, but no medical records were submitted for review.
From the decision · page 3Applicant testified in relevant part as follows:
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
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.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
- If you are named in this decision and want this page removed, write to privacy@similarcase.com.