What the panel ordered
Petition for reconsideration granted; WCJ's June 21, 2021 Findings of Fact and Orders rescinded; matter returned to WCJ for further proceedings and new decision.
Petition for reconsideration of the WCJ's Findings of Fact and Orders issued June 21, 2021, granted by the Appeals Board, rescinding the F&O and returning the matter to the WCJ for further proceedings.
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 record does not contain substantial evidence to support a finding on injury AOE/COE; further development of the medical record is necessary to clarify whether the applicant sustained a cumulative injury as claimed.
From the decision · page 4Having reviewed the trial record, including the reports from Dr. Schopler discussed above, it appears that the record does not contain substantial evidence upon which a finding on the issue of injury AOE/COE can be made. An award, order or decision by the Appeals Board must be supported by substantial evidence in light of the entire record. (Lab. Code § 5903, 5952; Garza v. Workmen's Comp. App. Bd. (1970) 3 Cal.3d 312, 317-319 [33 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 635-637 [35 Cal.Comp.Cases 16].) The
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The medical record does not contain substantial evidence to determine injury AOE/COE due to incomplete medical records and unclear causation by Dr. Schopler.
Favours neutral
This lack of substantial evidence prevents a finding on injury AOE/COE and necessitates further development of the record.
From the decision · page 4Having reviewed the trial record, including the reports from Dr. Schopler discussed above, it appears that the record does not contain substantial evidence upon which a finding on the issue of injury AOE/COE can be made. An award, order or decision by the Appeals Board must be supported by substantial evidence in light of the entire record. (Lab. Code § 5903, 5952; Garza v. Workmen's Comp. App. Bd. (1970) 3 Cal.3d 312, 317-319 [33 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 635-637 [35 Cal.Comp.Cases 16].) The
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.
Dr. Schopler diagnosed multilevel lumbar disc protrusions and lumbar strain, concluding a back strain occurred in an industrial injury on July 8, 2014, but lumbar disc pathology was not industrially caused. He apportioned 15% disability to the industrial injury and 85% to non-industrial factors. Later, he found 0% whole body impairment and apportioned 10% disability to the industrial injury. He noted insufficient medical records to determine if the injury was specific or cumulative.
Dr. Schopler's reports and deposition indicate uncertainty about whether the injury was specific or cumulative and the extent of industrial causation, requiring further clarification.
From the decision · page 1Applicant contends that the reports from orthopedic qualified medical examiner (QME) Steven A Schopler, M.D., are not substantial evidence for the issue of injury AOE/COE.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 32018.1; Aetna Casualty and Surety Co. v. Workers' Comp. Appeals Bd. (Coltharp) (1972) 35 Cal.App.3d 329; Ferguson v. City of Oxnard (1970) 35 Cal.Comp.Cases 452 (Appeals Board en banc)
An employment activity, whether specific or cumulative, that causes temporary or permanent disability or the need for medical treatment, constitutes an industrial injury.
The Board noted this standard to clarify that a work incident or cumulative trauma causing disability or need for treatment is an industrial injury, even if it does not cause permanent disability.
From the decision · page 4This is an important issue to be resolved because it has long been the law that an employment activity whether specific or cumulative, that causes temporary or permanent disability, or causes the need for medical treatment, constitutes an industrial injury. (Lab. Code, § 32018.1; Aetna Casualty and Surety Co. v. Workers' Comp. Appeals Bd. (Coltharp) (1972) 35 Cal.App.3d 329, 342 [38 Cal.Comp.Cases 720, 729 - 730]; Ferguson v. City of Oxnard, (1970) 35 Cal.Comp.Cases 452 (Appeals Board en banc).) Otherwise stated, a work incident or work activity over a period of time, that causes temporary disability or the need for medical treatment, is an industrial injury, even if it did not cause permanent disability.2
What proof carried it
The evidence the panel weighed, by kind.
Dr. Schopler's reports and deposition testimony indicating incomplete medical records and uncertainty about injury causation and timing.
From the decision · page 2Q. So my question is, have you made the determination at this point, with the information that you have, that July 18, 2014, is the date of the injury, or is this a cumulative trauma leading up to that date, or did you not make a determination? A. I did not make a determination of that. Q. Okay. So if we needed to know whether or not it was a specific or cumulative trauma, you would need that additional information, the medical records, leading up to this as well as a job analysis, correct? A. Mostly the medical records, any preexisting medical records, primary care office visits, chiropractor, any of those kinds of things would be helpful to me. (App. Exh. 1, pp. 9 § 10.)
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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