ADJ10809542 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted in part; WCJ's decision affirmed except for amendment to include express finding of Labor Code section 5412 date of injury as August 2, 2017; The Hartford dismissed without prejudice

Petition for Reconsideration filed by defendant Oak River Insurance Company, granted by the Appeals Board with amendment to the WCJ's decision

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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.

AOE/COEApplicant prevailedhearing · cervical spine · lumbar spine · shoulders · elbows · wrists · bilateral carpal tunnel

The date of injury was found to be August 2, 2017, based on the finding that compensable temporary disability began on that date and the condition became permanent and stationary later, supported by substantial evidence including medical opinions and applicant's testimony.

From the decision · page 3Turning to the merits, since "date of injury" was specifically placed at issue at trial (Minutes of Hearing and Summary of Evidence of December 17, 2024 trial at p. 2) and the WCJ explained in the Opinion on Decision that "the date of injury is August 2, 2017...." (Opinion on Decision at p. 8), we will amend the WCJ's decision to include an express finding that the Labor Code section 5412 date of injury is August 2, 2017. We will otherwise affirm the WCJ's decision for the reasons stated by the WCJ in the Report, which we adopt, incorporate and quote below.

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.

AMEGiven great weight

Applicant's heavy job caused injury to cervical spine, lumbar spine, shoulders, elbows, and wrists; 25% of impairments caused by subsequent employment, remainder by cumulative trauma at prior job.

Agreed medical evaluator's opinion was given great weight as presumed correct and not set aside by substantial evidence.

From the decision · page 10Here, the agreed medical evaluator stated that it was medically probable that that applicant's "heavy job" caused injury to applicant's cervical spine, lumbar spine, shoulders, elbows, and wrists. (Exhibit 104 at pp. 7-8.) This determination is supported by the description of applicant's job duties in Exhibit B. (Exhibit B at pp. 90-93.) Furthermore, Dr. Mandell considered applicant's subsequent employment and the subsequent claimed injury, yet still found applicant's employment with defendant caused injury. Accordingly, Dr. Mandell's opinions are more than adequate for applicant to meet the low burden of proving injury.

AMEGiven great weight

Date of injury is August 2, 2017, when compensable temporary disability began; condition became permanent and stationary on February 16, 2022.

The date of injury finding was supported by Dr. Mandell's medical opinion and applicant's testimony, which were found substantial evidence.

From the decision · page 3Turning to the merits, since "date of injury" was specifically placed at issue at trial (Minutes of Hearing and Summary of Evidence of December 17, 2024 trial at p. 2) and the WCJ explained in the Opinion on Decision that "the date of injury is August 2, 2017...." (Opinion on Decision at p. 8), we will amend the WCJ's decision to include an express finding that the Labor Code section 5412 date of injury is August 2, 2017. We will otherwise affirm the WCJ's decision for the reasons stated by the WCJ in the Report, which we adopt, incorporate and quote below.

The rules the panel named

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

California Labor Code

Labor Code section 5412

Defines date of injury for cumulative injuries as the date when compensable disability first occurred and was known or should have been known to be work-related.

From the decision · page 8In relevant part, Labor Code section 5500.5 states that the liability for cumulative injuries is one year preceding the 5412 date of injury, or one year from the "last date on which the employee was employed in an occupation exposing him or her to the hazards of the occupational disease or cumulative injury, whichever occurs first." (Lab. Code § 5500.5 (a), emphasis added.)

California Labor Code

Labor Code section 5500.5

Defines the liability period for cumulative injuries as one year preceding the date of injury or last exposure to hazard, whichever is earlier.

From the decision · page 8In relevant part, Labor Code section 5500.5 states that the liability for cumulative injuries is one year preceding the 5412 date of injury, or one year from the "last date on which the employee was employed in an occupation exposing him or her to the hazards of the occupational disease or cumulative injury, whichever occurs first." (Lab. Code § 5500.5 (a), emphasis added.)

California Court of Appeal

State Comp. Ins. Fund v. Workers' Comp. Appeals Bd. (Rodarte) (2004) 119 Cal.App.4th 998

Clarifies that date of injury under section 5412 requires compensable temporary or permanent disability, not just medical treatment.

California Labor Code

Labor Code sections 5705, 3600(a)

Applicant bears burden of proving injury arising out of and in the course of employment.

From the decision · page 9Applicant bears the burden of proving injury AOE/COE. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302; Lab. Code, § 5705; 3600(a); Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 612 (Appeals Board en banc).) The Supreme Court of California has long

California Supreme Court

South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291

Proof of industrial causation requires showing that it is reasonably probable, not certain or scientific certainty.

From the decision · page 9Applicant bears the burden of proving injury AOE/COE. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302; Lab. Code, § 5705; 3600(a); Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 612 (Appeals Board en banc).) The Supreme Court of California has long

California Supreme Court

McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408

Proof of industrial causation burden is low, requiring only reasonable probability.

From the decision · page 10held that an employee need only show that the "proof of industrial causation is reasonably probable, although not certain or `convincing.'" (McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408, 413.) "That burden manifestly does not require the applicant to prove causation by scientific certainty." (Rosas v. Workers' Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692, 1701.)

What proof carried it

The evidence the panel weighed, by kind.

Testimony and credibilityfavours Applicant prevailed

Applicant's testimony describing worsening pain in shoulders, wrists, lower back, neck, arms, and elbows, and lack of modified duties despite reporting injury in 2016

From the decision · page 7On December 17, 2024, the matter progressed to trial. As relevant herein, applicant testified that he worked for defendant from February 13, 1992 to August 2, 2017, and that his job required him to move furniture and rugs. He developed pain in his shoulders, wrists, and lower back. He also developed pain in his neck, arms, and elbows. The pain would worsen throughout the day and work week. He also noticed that his hearing was worsening. In 2016, he reported the injury and kept working. Modified duties were not provided, and he needed to keep his job because he was the sole provider. In 2017, he was taken off work because he could no longer do his job. He was not told which body parts were preventing him from working. He believes he reported an injury to his low back, arms, and carpal tunnel in 2016. It has been a while, and he does not recall filling out forms describing what body parts were injured. Between 2016 and his last day of work, he received treatment for all of the injured body parts. He started

work activityfavours Applicant prevailed

Description of applicant's job duties requiring prolonged standing, walking, kneeling, squatting, bending, stooping, climbing, and lifting up to 50 pounds

From the decision · page 10Here, the agreed medical evaluator stated that it was medically probable that that applicant's "heavy job" caused injury to applicant's cervical spine, lumbar spine, shoulders, elbows, and wrists. (Exhibit 104 at pp. 7-8.) This determination is supported by the description of applicant's job duties in Exhibit B. (Exhibit B at pp. 90-93.) Furthermore, Dr. Mandell considered applicant's subsequent employment and the subsequent claimed injury, yet still found applicant's employment with defendant caused injury. Accordingly, Dr. Mandell's opinions are more than adequate for applicant to meet the low burden of proving injury.

ADJ10809542 · April 1, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

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The rules the panel named

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