What the panel ordered
Petition for Reconsideration denied; Findings and Award of July 14, 2023, upheld.
Defendant filed a Petition for Reconsideration of the Findings and Award issued July 14, 2023; the WCJ issued a Report and Recommendation to deny the Petition; the WCAB panel adopted and incorporated the WCJ Report and denied the Petition for Reconsideration.
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.
Dr. Jacks' evaluation and apportionment of 70% industrial causation and 30% preexisting conditions was accepted, resulting in a 27% permanent disability award.
From the decision · page 8As the QME, Dr. Jacks performed a psychiatric evaluation and consultation with psychological testing and interview. Dr. Jacks found impairment and a GAF score of 58, which is 18% WPI. Regarding apportionment, Dr. Jacks describes Applicant's history which includes marital problems and a divorce in 2015. Applicant was put on Lexapro and Ambien. Dr. Jacks opines this earlier breakdown with anxiety and depression made Applicant more vulnerable for a later breakdown and probably explains the extent of his reactions and current problems at work. Dr. Jacks indicates Applicant was divorced again in 2019 around the time of the claimed work difficulties. Dr. Jacks finds the divorce probably caused factors of permanent disability. Dr. Jacks indicates Applicant's sister died in 2018 and his father died in 2020. Dr. Jacks highlights prior panic attacks in 2013 and 2015 and explains that panic attacks can relapse. Dr. Jacks finds but for the preexisting and personal nonindustrial stress, the disability would not be as great. Dr. Jacks apportions 30% to preexisting and personal nonindustrial stressors and 70% to work stress. (Joint Exhibit AA)
The WCJ found, based on the well-reasoned psychiatric QME report of Dr. Brian Jacks, that the applicant sustained a psychiatric injury predominantly caused by actual events of employment, supported by substantial evidence.
From the decision · page 1Defendant seeks reconsideration of the Findings and Award (F&A), issued by the workers' compensation administrative law judge (WCJ) on July 14, 2023, wherein the WCJ found in pertinent part that applicant sustained injury arising out of and in the course of employment to the psyche.
Applicant's credible testimony and Dr. Jacks' opinion supported the finding of temporary disability due to psychiatric injury during the stated period.
From the decision · page 7Applicant claims temporary disability from February 14, 2022, until he was permanent and stationary. This is supported by the record.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Brian Jacks' psychiatric evaluation and report finding predominant work-related causation of psychiatric injury.
Favours Applicant prevailed
The WCJ relied on Dr. Jacks' well-reasoned and solidly based medical opinion to find industrial causation and compensability.
From the decision · page 2A WCJ's decision must be supported by substantial evidence. (Lab. Code, § 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274, 281 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 317 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 635 [35 Cal.Comp.Cases 16].) To be substantial evidence, a medical opinion must be well-reasoned, based on an adequate history and examination, and it must disclose a solid underlying basis for the opinion. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Bd. en banc).) Here, applicant was examined by psychiatric Qualified Medical Evaluator (QME) Brian P. Jacks, M.D., F.A.A.C.P. Dr. Jacks examined applicant, performed diagnostic testing, took a detailed history, and articulated a solid basis for his opinions. Dr. Jacks opined that applicant's psychiatric injuries were predominantly work related. (Exhibit AA, Dr. Jack's December 1, 2022 report, p. 25.) Based on Dr. Jacks' reporting, the WCJ determined that applicant's psychiatric injury involved actual events of employment, which were the predominant cause of the psychiatric injury.
Applicant's credible testimony about his work stress and time off work due to psychiatric injury.
Favours Applicant prevailed
Supported the finding of temporary disability and the period of disability awarded.
From the decision · page 7Applicant claims temporary disability from February 14, 2022, until he was permanent and stationary. This is supported by the record.
Dr. Jacks' apportionment of 70% industrial causation and 30% preexisting conditions.
Favours Applicant prevailed
Supported the permanent disability rating and award of 27%.
From the decision · page 8As the QME, Dr. Jacks performed a psychiatric evaluation and consultation with psychological testing and interview. Dr. Jacks found impairment and a GAF score of 58, which is 18% WPI. Regarding apportionment, Dr. Jacks describes Applicant's history which includes marital problems and a divorce in 2015. Applicant was put on Lexapro and Ambien. Dr. Jacks opines this earlier breakdown with anxiety and depression made Applicant more vulnerable for a later breakdown and probably explains the extent of his reactions and current problems at work. Dr. Jacks indicates Applicant was divorced again in 2019 around the time of the claimed work difficulties. Dr. Jacks finds the divorce probably caused factors of permanent disability. Dr. Jacks indicates Applicant's sister died in 2018 and his father died in 2020. Dr. Jacks highlights prior panic attacks in 2013 and 2015 and explains that panic attacks can relapse. Dr. Jacks finds but for the preexisting and personal nonindustrial stress, the disability would not be as great. Dr. Jacks apportions 30% to preexisting and personal nonindustrial stressors and 70% to work stress. (Joint Exhibit AA)
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's psychiatric injuries were predominantly work related; apportioned 70% to work stress and 30% to preexisting and personal nonindustrial stressors; diagnosed with dysthymia, panic disorder, and generalized anxiety disorder; found temporary total disability due to emotional condition.
Dr. Jacks examined applicant, performed diagnostic testing, took a detailed history, and articulated a solid basis for his opinions; his report was relied upon by the WCJ.
From the decision · page 2A WCJ's decision must be supported by substantial evidence. (Lab. Code, § 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274, 281 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 317 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 635 [35 Cal.Comp.Cases 16].) To be substantial evidence, a medical opinion must be well-reasoned, based on an adequate history and examination, and it must disclose a solid underlying basis for the opinion. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Bd. en banc).) Here, applicant was examined by psychiatric Qualified Medical Evaluator (QME) Brian P. Jacks, M.D., F.A.A.C.P. Dr. Jacks examined applicant, performed diagnostic testing, took a detailed history, and articulated a solid basis for his opinions. Dr. Jacks opined that applicant's psychiatric injuries were predominantly work related. (Exhibit AA, Dr. Jack's December 1, 2022 report, p. 25.) Based on Dr. Jacks' reporting, the WCJ determined that applicant's psychiatric injury involved actual events of employment, which were the predominant cause of the psychiatric injury.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 3208.3(b)(1)
Labor Code section 3208.3(b)(1) requires showing that actual events of employment predominantly caused the psychiatric injury.
The WCJ applied this standard to determine industrial causation of psychiatric injury.
From the decision · page 2We note that Labor Code section 3208.31 states that in order to establish industrial causation of a psychiatric injury, an injured worker must show by a preponderance of the evidence that actual events of employment predominantly caused the psychological injury.2 (Lab. Code, § 3208.3(b)(1).) After considering all the medical evidence, and the other documentary and testimonial evidence of record, the WCJ must determine (1) whether the alleged psychiatric injury involves actual events of employment, a factual/legal determination for the WCJ; and if so, (2) whether such actual events were the predominant cause of the psychiatric injury, a determination which requires competent medical evidence. (Rolda v. Pitney Bowes, Inc. (2001) 66 Cal.Comp.Cases 241, 247 (Appeals Bd. en banc); San Francisco Unified School Dist. v. Workers' Comp. Appeals Bd. (Cardozo) (2013) 190 Cal.App.4th 1 [75 Cal.Comp.Cases 1251] (writ den.).)
What proof carried it
The evidence the panel weighed, by kind.
Applicant's credible testimony about his work stress and time off work
From the decision · page 7Applicant claims temporary disability from February 14, 2022, until he was permanent and stationary. This is supported by the record.
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