What the panel ordered
Petition for Reconsideration denied
Petition for Reconsideration filed by Applicant and denied by WCAB panel after review of WCJ report
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 the PQME Dr. Charles Schwarz's medical reports to be substantial evidence supporting no industrial causation, and the applicant failed to meet the burden of proof for injury arising out of employment.
From the decision · page 1The employee bears the initial burden of proving injury arising out of and in the course of employment (AOE/COE) by a preponderance of the evidence. (Lab. Code, § 5705; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3202.5, 3600(a).) In this case, we agree with the WCJ that the opinion of panel qualified medical examiner (PQME) Charles Schwarz, M.D., is substantial medical evidence that supports the finding of no industrial causation. Therefore, applicant did not meet their burden of proof. Applicant did not exercise due diligence in developing the record prior to trial and the request to do so now is too late.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
PQME Dr. Charles Schwarz's reports concluded the injuries were non-industrial and not caused by employment.
Favours Defendant prevailed
The panel found these reports to be substantial medical evidence supporting no industrial causation, leading to denial of the petition.
From the decision · page 1The employee bears the initial burden of proving injury arising out of and in the course of employment (AOE/COE) by a preponderance of the evidence. (Lab. Code, § 5705; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3202.5, 3600(a).) In this case, we agree with the WCJ that the opinion of panel qualified medical examiner (PQME) Charles Schwarz, M.D., is substantial medical evidence that supports the finding of no industrial causation. Therefore, applicant did not meet their burden of proof. Applicant did not exercise due diligence in developing the record prior to trial and the request to do so now is too late.
Applicant did not exercise due diligence in developing the record prior to trial and did not rebut the medical evidence.
Favours Defendant prevailed
This failure contributed to the panel's decision to deny reconsideration as the applicant did not meet the burden of proof.
From the decision · page 1The employee bears the initial burden of proving injury arising out of and in the course of employment (AOE/COE) by a preponderance of the evidence. (Lab. Code, § 5705; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3202.5, 3600(a).) In this case, we agree with the WCJ that the opinion of panel qualified medical examiner (PQME) Charles Schwarz, M.D., is substantial medical evidence that supports the finding of no industrial causation. Therefore, applicant did not meet their burden of proof. Applicant did not exercise due diligence in developing the record prior to trial and the request to do so now is too late.
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. Schwarz examined the applicant multiple times and issued an initial and three supplemental reports concluding the injuries were non-industrial and not caused by employment, based on examination, patient history, and medical records.
The panel found Dr. Schwarz's reports to be well reasoned, supported by examination, history, and records, and substantial evidence supporting no industrial causation.
From the decision · page 4Nevertheless, the reporting of Dr. Schwarz was evaluated by the WCJ and found to be substantial evidence on the issue of causation. Doctor Schwarz evaluated the applicant and issued an initial evaluation (Joint 4). The doctor did an examination, took the patients history,which included her assertion that she worked 60-70 hours per week, reviewed records, provided a diagnosis, and wrote a 17 page report. However, he could not give an opinion on causation and requested more records.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 5705; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302; Lab. Code, 3202.5, 3600(a)
The employee bears the initial burden of proving injury arising out of and in the course of employment (AOE/COE) by a preponderance of the evidence.
The panel applied this standard to find the applicant did not meet the burden of proof for industrial causation based on the PQME reports.
From the decision · page 1The employee bears the initial burden of proving injury arising out of and in the course of employment (AOE/COE) by a preponderance of the evidence. (Lab. Code, § 5705; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3202.5, 3600(a).) In this case, we agree with the WCJ that the opinion of panel qualified medical examiner (PQME) Charles Schwarz, M.D., is substantial medical evidence that supports the finding of no industrial causation. Therefore, applicant did not meet their burden of proof. Applicant did not exercise due diligence in developing the record prior to trial and the request to do so now is too late.
What proof carried it
The evidence the panel weighed, by kind.
Voluminous medical records and well reasoned reports of Dr. Schwarz
From the decision · page 5The conclusion of Applicant's Petition for Reconsideration states that a deposition of Dr. Schwarz is necessary for a fair and accurate report. However, there is nothing offered in evidence to contradict the reporting of Dr. Schwarz. In fact, the voluminous records, and well reasoned conclusion of doctor Schwarz, with three supplemental reports being issued, indicates that the doctor was very conscientious and fair when reaching his conclusions.
No testimony or evidence rebutting Dr. Schwarz's history and conclusions
From the decision · page 4The final report issued on August 5, 2020 (Joint 1). After reviewing the job description, the doctor repeats his conclusion that he feels the injuries are non-industrial. He repeats the reasons that he had recited in the prior reports which include: prior motor vehicle accident with cervical spine injury April 30, 2005; X-rays and acute back pain on October 24, 2006; Additional neck pain noted September 9, 2010; Low back pain and x-rays November 16 & 18, 2010; Right upper extremity pain, February 24, 2014; Upper extremities pain November 14, 2018 due to an injury working out. (Joint 1 pg 4) No testimony was offered to rebut this history given by the doctor.
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About this page
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