What the panel ordered
Petitions for Reconsideration and Disqualification denied.
Applicant filed multiple Petitions for Reconsideration and Disqualification which were considered by the Appeals Board after the WCJ's Findings and Order denying the claimed injury.
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 petitions did not set forth sufficient verified facts to establish disqualification or reconsideration grounds, and the WCJ's report was adopted and incorporated.
From the decision · page 1While still represented by counsel, applicant filed two Petitions for Reconsideration and Disqualification on April 5, 2022. On April 8, 2022, applicant filed a third Petition for Reconsideration and Disqualification and a dismissal of her attorney. On May 16, 2022, applicant filed a request to file supplemental pleading. We accept that request pursuant to our authority. (Cal. Code Regs., tit. 8, § 10964.) We have considered the allegations of the Petitions for Reconsideration and Disqualification and the contents of the Report of the workers' compensation administrative law judge (WCJ) with respect thereto. Based on our review of the record, and for the reasons stated in the WCJ's Report, which we adopt and incorporate, and for the reasons stated below, we will deny reconsideration and applicant's request for disqualification of the WCJ.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Hoffman's QME report diagnosed applicant with a chronic psychotic illness and found employment events were not the predominant cause of psychiatric injury.
Favours Defendant prevailed
This medical opinion constituted substantial evidence relied upon to deny the claimed injury and petitions for reconsideration.
From the decision · page 5II FACTS On June 2, 2020, the applicant underwent psychiatric evaluation with psychiatric testing performed by QME, Micah Hoffman, M.D. The doctor reviewed the complaints and allegations made by the applicant as set forth in multiple e-mails. (Exhibit A, Dr. Hoffman report dated 6/29/20, pgs. 7 § 42). The doctor also reviewed the applicant's prior medical records and conducted psychiatric testing. (Id. at pgs. 42 § 54; 57 § 61.) Dr. Hoffman indicated that the applicant meets diagnostic criteria for an unspecified psychotic disorder with long-standing paranoia and delusions. (Id. At pg. 67.) In discussing causation, the doctor stated, "Within reasonable medical
Applicant's allegations of bias and discrimination against the WCJ were unsupported by verified facts and were largely based on subjective perceptions and interpretations.
Favours Defendant prevailed
Lack of credible evidence for disqualification led to denial of petitions for reconsideration and disqualification.
From the decision · page 6III DISCUSSION In her Petition for Disqualification, the applicant alleges that the undersigned showed bias or the appearance of bias in preparing the Findings of Fact, Order and Opinion on Decision as shown by the vocabulary and symbols used and that the name "Debra Sandoval" is controversial and is associated with organized stalking and privacy invasion. (Applicant's Petition for Reconsideration/Disqualification, dated 4/2/22, pg. 3.) The applicant does not provide any evidence or even credible arguments to support her allegations. It appears that most of her allegations consist of the undersigned not finding in her favor as evidence of bias and discrimination. Many of the allegations applicant makes support Dr. Hoffman's diagnosis of a psychotic disorder with paranoia and delusions. For example, the applicant notes the first name of the assigned judge is the same as a person named "Deborah Lobo" allegedly discussed by the applicant
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 meets diagnostic criteria for unspecified psychotic disorder with paranoia and delusions; employment events were not predominant cause of psychiatric injury; injury attributed 100% to chronic psychotic illness, not industrial in nature.
Dr. Hoffman's report was found to constitute substantial medical evidence and was relied upon by the court to deny the claimed injury.
From the decision · page 5II FACTS On June 2, 2020, the applicant underwent psychiatric evaluation with psychiatric testing performed by QME, Micah Hoffman, M.D. The doctor reviewed the complaints and allegations made by the applicant as set forth in multiple e-mails. (Exhibit A, Dr. Hoffman report dated 6/29/20, pgs. 7 § 42). The doctor also reviewed the applicant's prior medical records and conducted psychiatric testing. (Id. at pgs. 42 § 54; 57 § 61.) Dr. Hoffman indicated that the applicant meets diagnostic criteria for an unspecified psychotic disorder with long-standing paranoia and delusions. (Id. At pg. 67.) In discussing causation, the doctor stated, "Within reasonable medical
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc)
A medical opinion must be framed in terms of reasonable medical probability, not speculative, based on pertinent facts and adequate examination, and set forth reasoning in support of conclusions to constitute substantial evidence.
Dr. Hoffman's QME report met these criteria and was relied upon by the court.
From the decision · page 7Applicant contends that it was error to rely upon Dr. Hoffman's QME report. To constitute substantial evidence a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).)
What proof carried it
The evidence the panel weighed, by kind.
Applicant's statements and interpretations lacked credibility and conflicted with evidence such as personnel file and performance evaluations.
From the decision · page 7The majority of the applicant's contentions imply that the undersigned erred by not accepting as truth not only all of applicant's statements but also her interpretation as to the meaning and motivation behind those statements. For example, the applicant claims that her employer intentionally utilized the words "flasher notes" in reference to notes needing to be locked in order to humiliate and harass her. (Id. at pg. 10.) The applicant reiterates all of the complaints that she has made against her employer which were contained within the e-mails reviewed by Dr. Hoffman in his QME report. (Id. at pgs. 10 § 28.) Many of Applicant's statements lack credibility on their face such as the examples cited above, but also some lack credibility due to a direct conflict in the evidence. For example, Applicant states that her exemplary performance evaluations led to salary increases through the same year of her employment. (Id. at pg. 10, #9.) However, the applicant's personnel file only contains one performance evaluation dated 8/2/19, wherein she was given an overall score of 1.57, which is between 1 Developing and 2 Competent. (Exhibit C, Personnel file, dated 10/15/19, pg. 26.)
Dr. Hoffman's psychiatric testing and evaluation supported his diagnosis and causation opinion.
From the decision · page 5II FACTS On June 2, 2020, the applicant underwent psychiatric evaluation with psychiatric testing performed by QME, Micah Hoffman, M.D. The doctor reviewed the complaints and allegations made by the applicant as set forth in multiple e-mails. (Exhibit A, Dr. Hoffman report dated 6/29/20, pgs. 7 § 42). The doctor also reviewed the applicant's prior medical records and conducted psychiatric testing. (Id. at pgs. 42 § 54; 57 § 61.) Dr. Hoffman indicated that the applicant meets diagnostic criteria for an unspecified psychotic disorder with long-standing paranoia and delusions. (Id. At pg. 67.) In discussing causation, the doctor stated, "Within reasonable medical
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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.
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