What the panel ordered
Petition for reconsideration granted to correct clerical error regarding insurance carrier; merits of petition denied; Findings and Order affirmed except amended to find injury industrial and matter returned for further proceedings.
Petition for reconsideration filed by defendant after December 2, 2022 decision; petition initially not acted upon timely due to clerical error; reconsideration granted to correct clerical error and merits reviewed.
This docket was decided more than once. Shown here is the latest released decision; we also hold December 2, 2022.
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 panel found that the applicant sustained an industrial injury to the right ankle based on substantial medical evidence from QME Dr. Guzman and medical records, outweighing the WCJ's credibility assessment against the applicant's testimony.
From the decision · page 18Accordingly, we will grant reconsideration, and, as our Decision After Reconsideration, we will affirm the F&O, except that we will amend to find that that applicant sustained injury AOE/COE to the right ankle, defer the issue of what other parts of the body were injured, defer the issue of whether applicant is entitled to further medical treatment to cure or relieve the effects of injury, and rescind the order that applicant take nothing on his claim; and we will return the matter to the trial level for further proceedings consistent with this decision.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
QME Dr. David Guzman's April 19, 2022 report based on adequate medical history and examination constitutes substantial medical evidence of industrial causation.
Favours Applicant prevailed
This report was relied upon to overturn the WCJ's initial finding that the injury was not industrial.
From the decision · page 17On this record, it is clear that as of April 13, 2022, Dr. Guzman's reporting was informed by adequate medical history and otherwise based on pertinent facts and an adequate medical examination; and, as such, was sufficient to constitute substantial medical evidence. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 620-621 [2005 Cal. Wrk. Comp. LEXIS 71] (Appeals Bd. en banc).) Therefore, we conclude that the WCJ erroneously failed to consider Dr. Guzman's reporting when she found that applicant did not sustain injury AOE/COE to the right ankle.
Medical records from Dr. Choung, Dr. Ledean, and Concentra trace applicant's pain progression to work activity and injury jumping from work truck.
Favours Applicant prevailed
These records provided considerable substantial evidence outweighing inconsistent evidence of non-industrial injury, supporting the finding of industrial injury.
From the decision · page 18However, in addition to Dr. Guzman's medical reporting--reporting which describes with specificity the progression of applicant's pain symptomatology after he stepped out of his work truck--the medical records of Dr. Choung, Dr. Ledean, and Concentra all trace applicant's pain progression back to strenuous work activity or otherwise indicate that applicant injured himself while jumping from his work truck. (Ex. 102, QME Report of David Guzman, DPM, April 19, 2022, p. 4; Report, p. 2.) We deem this evidence that applicant sustained injury at work to be of considerable substantiality that outweighs the inconsistent and rather limited evidence that applicant sustained injury off work. Accordingly, we conclude that the WCJ erroneously found that applicant did not sustain injury AOE/COE to the right ankle based upon her assessment of applicant's credibility.
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.
Found industrial causation for the right ankle injury based on review of medical records and history, despite initial incomplete information.
His April 19, 2022 report was based on adequate medical history and examination, constituting substantial medical evidence supporting industrial causation.
From the decision · page 17On this record, it is clear that as of April 13, 2022, Dr. Guzman's reporting was informed by adequate medical history and otherwise based on pertinent facts and an adequate medical examination; and, as such, was sufficient to constitute substantial medical evidence. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 620-621 [2005 Cal. Wrk. Comp. LEXIS 71] (Appeals Bd. en banc).) Therefore, we conclude that the WCJ erroneously failed to consider Dr. Guzman's reporting when she found that applicant did not sustain injury AOE/COE to the right ankle.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code §§ 5705, 3202.5
Preponderance of the evidence
Applicant has the burden to prove injury arose out of and in course of employment by preponderance of evidence.
From the decision · page 17The burden of proof rests on the party holding the affirmative of the issue, which must be met by a preponderance of the evidence. (§ 5705, 3202.5.) Applicant therefore has the affirmative burden of proving by a preponderance of the evidence that his injury arose out of and in the course of his employment.
What proof carried it
The evidence the panel weighed, by kind.
Medical records of Dr. Choung, Dr. Ledean, and Concentra tracing pain progression to work activity and injury jumping from work truck
From the decision · page 18However, in addition to Dr. Guzman's medical reporting--reporting which describes with specificity the progression of applicant's pain symptomatology after he stepped out of his work truck--the medical records of Dr. Choung, Dr. Ledean, and Concentra all trace applicant's pain progression back to strenuous work activity or otherwise indicate that applicant injured himself while jumping from his work truck. (Ex. 102, QME Report of David Guzman, DPM, April 19, 2022, p. 4; Report, p. 2.) We deem this evidence that applicant sustained injury at work to be of considerable substantiality that outweighs the inconsistent and rather limited evidence that applicant sustained injury off work. Accordingly, we conclude that the WCJ erroneously found that applicant did not sustain injury AOE/COE to the right ankle based upon her assessment of applicant's credibility.
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.
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