ADJ11377820 · October 5, 2022

The WCJ found that the lien claimant met its burden of proving injury AOE/COE based on the unrebutted medical opinion of PQME Dr. Jay Jurkowitz that applicant's work caused exacerbations of her MS during employment, constituting an industrial injury as an aggravation of a pre-existing condition.

From the decision · page 3On July 28, 2022, this trier of fact issued her Opinion on Decision and Findings and Award finding that applicant sustained injury arising out of and occurring in the course of employment in the form of multiple sclerosis. It is from this threshold finding that the Petition for Reconsideration was filed contending that 1) this WCJ erred in relying upon portions of the deposition testimony of the applicant that was not admitted into evidence; 2) this WCJ was prohibited from finding injury AOE/COE because the body part at issue remained denied throughout the pendency of the case and the parties stipulated to no injury in the form of multiple sclerosis when settling the claim by way Compromise and Release; and 3) This WCJ misinterpreted and misapplied the law regarding what constitutes an injury. No response has been received from the Lien Claimant.

PQME Dr. Jay Jurkowitz opined that all MS exacerbations during employment were caused by heat and stress exposures at work, constituting an industrial injury as an aggravation of a pre-existing condition.

Favours Applicant prevailed

This unrebutted medical opinion was the basis for the WCJ's finding of injury AOE/COE in the form of multiple sclerosis.

From the decision · page 7"There is no doubt from the medical records that the patient in fact has multiple sclerosis and that she has had multiple exacerbations as well working for the Sheriff's Department. It is well known that heat, anything that raises body heat such as fever, or even external heat, can produce symptoms suggesting an exacerbation and in fact can produce an exacerbation. Therefore, all the exacerbations that she had while she was working for the Sheriff's Department, which appear to be from June 1996 to April 25, 2018, were brought on by her exposures to heat and stress as a Sheriff's deputy, however the basic disease of MS was not caused by her job as the Sheriff's Department." (LC Exhibit 8 at page 5, EAMS Doc ID 41107667.)

Applicant's unrebutted deposition testimony described the stress and strain of her job duties as Deputy Sheriff/Sergeant, supporting the medical opinion of work-related exacerbations of MS.

Favours Applicant prevailed

This testimony supported the credibility and factual basis for the medical opinion finding injury AOE/COE.

From the decision · page 6Applicant's unrebutted testimony as outlined in the designated pages of her deposition transcript, provides a very clear picture of the incredible stress and strain she experienced as a result of her job duties working as a Deputy Sheriff/Sergeant for the County of Orange. The complete deposition transcript was provided to PQME Dr. Jay Jurkowitz for review and is discussed within his medical reporting as a source used when rendering his opinions. After citing to and utilizing only those specifically designated pages of applicant's unrebutted deposition testimony, this WCJ finds no reason to change her Opinion on Decision as it stands fully supported by the evidence and the law.

Applicant has multiple sclerosis with exacerbations during employment caused by heat and stress exposures at work, constituting an industrial injury as an aggravation of a pre-existing condition. Temporary disability periods were work-related, but the basic disease was not caused by work.

The WCJ relied on Dr. Jurkowitz's unrebutted opinion as substantial medical evidence to find injury AOE/COE.

From the decision · page 7Applicant's neurological complaints were submitted to PQME Dr. Jay Jurkowitz and his three reports were admitted into evidence as LC's Exhibits 6-8. Dr. Jurkowitz evaluated the applicant on one occasion, March 25, 2019, at which time he took a history. Thereafter, over the course of several months Dr. Jurkowitz reviewed multiple medical records and in his report of June 16, 2019 discussed the causation of applicant's MS as follows:

Tanenbaum v. Industrial Acc. Com. (1935) 4 Cal. 2d 615

An aggravation of a pre-existing condition is an industrial injury.

The WCJ applied this standard to find that the applicant's MS exacerbations caused by work exposures constituted an industrial injury.

From the decision · page 8The acceleration, aggravation or `lighting up' of a preexisting condition "is an injury in the occupation causing the same." (Tanenbaum v. Industrial Acc. Com. (1935) 4 Cal. 2d 615, 617 [52 P.2d 215]; Zemke v. Workers' Comp. Appeals Bd. (1968) 68 Cal. 2d 794 [69 Cal. Rptr. 88, 441 P.2d 928, 33 Cal. Comp. Cases 358]; Reynolds Electrical & Engineering Co. v. Workers' Comp. Appeals Bd. (Buckner) (1966) 65 Cal. 2d 438 [55 Cal. Rptr. 254, 421 P.2d 102, 31 Cal. Comp. Cases 421].) An aggravation of a pre-existing condition is an industrial injury. (Argonaut Ins. Co. v. Industrial Acc. Comm. (Harries) (1964) 231 Cal. App. 2d 111 [29 Cal. Comp. Cases 279]; Patco Trucking, Inc., Centre Insurance Co., Petitioners v. Workers' Comp. Appeals Bd., (Everett) (2004) 69 Cal. Comp. Cases 1167 (writ denied).)

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

For causation, it is sufficient if the work is a contributing cause of the injury.

The WCJ applied this standard to find that the applicant's work was a contributing cause of the MS exacerbations.

From the decision · page 8It is well established that for the purpose of meeting the causation requirement in a workers' compensation injury claim, it is sufficient if the work is a contributing cause of the injury. (South Coast Framing, Inc. v. Workers' Comp. Appeals Bd. (2015) 61 Cal.4th 291, [80 Cal.Comp.Cases 489].)

Applicant's unrebutted deposition testimony describing stress and strain of job duties as Deputy Sheriff/Sergeant

From the decision · page 6Applicant's unrebutted testimony as outlined in the designated pages of her deposition transcript, provides a very clear picture of the incredible stress and strain she experienced as a result of her job duties working as a Deputy Sheriff/Sergeant for the County of Orange. The complete deposition transcript was provided to PQME Dr. Jay Jurkowitz for review and is discussed within his medical reporting as a source used when rendering his opinions. After citing to and utilizing only those specifically designated pages of applicant's unrebutted deposition testimony, this WCJ finds no reason to change her Opinion on Decision as it stands fully supported by the evidence and the law.