What the panel ordered
August 21, 2020 Findings and Order rescinded and substituted; matter returned to trial level for further proceedings and decision by WCJ.
Petition for Removal filed by defendant regarding August 21, 2020 Findings and Order by WCJ; decision after reconsideration issued rescinding and substituting prior Findings and Order and returning matter to trial level 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 compensability of the psychiatric injury could not be determined on the available record and requires further development; the matter is returned to the trial level for further proceedings.
From the decision · page 3FINDINGS OF FACT (1) the applicant, while employed on February 13, 2019, in Livermore, California, as a firefighter, occupational group number 490, by the Livermore- Pleasanton Fire Department, permissibly self-insured for workers' compensation, its claims administered by Innovative Claims Solutions, Incorporated, claims to have sustained an injury arising out of and in the course of employment to his psyche. (2) The compensability of said injury cannot be determined by means of the available evidentiary record, and that record requires further development, consistent with the opinion on decision herein. (3) All other issues must be deferred.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The compensability of the psychiatric injury could not be determined by the available evidentiary record.
Favours neutral
This lack of sufficient evidence required further development of the record and remand to the trial level for further proceedings.
From the decision · page 3FINDINGS OF FACT (1) the applicant, while employed on February 13, 2019, in Livermore, California, as a firefighter, occupational group number 490, by the Livermore- Pleasanton Fire Department, permissibly self-insured for workers' compensation, its claims administered by Innovative Claims Solutions, Incorporated, claims to have sustained an injury arising out of and in the course of employment to his psyche. (2) The compensability of said injury cannot be determined by means of the available evidentiary record, and that record requires further development, consistent with the opinion on decision herein. (3) All other issues must be deferred.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Rolda v. Pitney Bowes, Inc. (2001) 66 Cal.Comp.Cases 241, 246 (Appeals Board en banc)
Multilevel analysis for determining compensability of psychiatric injury when good faith personnel action defense is raised.
The WCJ must determine if the psychiatric injury involves actual employment events, if those events were the predominant cause, if the personnel actions were lawful and in good faith, and if those actions were a substantial cause of the injury.
From the decision · page 21 In Rolda, we set forth the multilevel analysis for determining if a claimed psychiatric injury is compensable when the affirmative defense of lawful, nondiscriminatory, good faith personnel action has been raised: "The WCJ, after considering all the medical evidence, and the other documentary and testimonial evidence of record, must determine: (1) whether the alleged psychiatric injury involves actual events of employment, a factual/legal determination; (2) if so, whether such actual events were the predominant cause of the psychiatric injury, a determination which requires medical evidence; (3) if so, whether any of the actual employment events were personnel actions that were lawful, nondiscriminatory and in good faith, a factual/legal determination; and (4) if so, whether the lawful, nondiscriminatory, good faith personnel actions were a "substantial cause" of the psychiatric injury, a determination which requires medical evidence." (Rolda, supra, 66 Cal. Comp. Cases at pp. 245-247.)
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About this page
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