What the panel ordered
Petition for Reconsideration denied.
Petition for Reconsideration filed by defendant and denied by the WCAB panel on review of the 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 QME Dr. McSweeney's medical opinion, based on reasonable medical probability and supported by credible applicant testimony and medical records, constitutes substantial evidence that the injury arose out of and in the course of employment on 09/12/2019.
From the decision · page 6Dr. McSweeney stated in his February 18, 2020 report that "It is my medical opinion, based on the information provided, that the applicant did sustain an industrial related injury to the right knee when he was walking on uneven terrain. (Joint Exhibit 8. Page 10). He also stated under "Causation" that "The patient's present symptoms, descriptions of the injury, review of the provided medical records, and the physical examination are consistent with the mechanics of injury as described by the applicant (Joint exhibit 8, Page 9, EAMS Doc ID 35514230).
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
applicant testified credibly about the injury event on 09/12/2019 involving walking on uneven terrain and stepping on a tapered edge.
Favours Applicant prevailed
This testimony supported the finding that the injury arose out of and in the course of employment.
From the decision · page 12The applicant's testimony was credible. Based on the credible testimony of applicant and the reporting of James McSweeney dated 02/18/2020 and 10/21/2020, it is found that the applicant sustained an injury arising out of and in the course of employment to his right knee on 09/12/2019. There is sufficient direct evidence to find injury AOE/COE based on the totality of evidence. Further, "circumstantial evidence is sufficient to support an award of the commission, and it may be based upon the reasonable inferences that arise from the reasonable probabilities flowing from the evidence; neither absolute certainty nor demonstration is required." (Guerra v. Workers' Comp. Appeals Bd. (2016) 246 Cal.App.4th 1301, p. 1307.). Based upon the reasonable inferences from the evidence in the case, including applicant's testimony, the medical reporting of Dr. McSweeney, contemporaneous medical reporting, the applicant reporting his injury to employer, the applicant did suffer and injury to his right knee on 09/12/2019.
Panel QME Dr. James McSweeney provided a medical opinion within reasonable medical probability that the injury was industrial and causally related to employment activities on 09/12/2019.
Favours Applicant prevailed
The WCJ and WCAB relied on this opinion as substantial medical evidence to establish causation.
From the decision · page 6Dr. McSweeney stated in his February 18, 2020 report that "It is my medical opinion, based on the information provided, that the applicant did sustain an industrial related injury to the right knee when he was walking on uneven terrain. (Joint Exhibit 8. Page 10). He also stated under "Causation" that "The patient's present symptoms, descriptions of the injury, review of the provided medical records, and the physical examination are consistent with the mechanics of injury as described by the applicant (Joint exhibit 8, Page 9, EAMS Doc ID 35514230).
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. McSweeney opined within reasonable medical probability that applicant sustained an industrial injury to the right knee on 09/12/2019, consistent with the injury mechanism described by applicant and supported by medical records and examination.
The opinion was relied upon by the WCJ and the WCAB panel as substantial medical evidence supporting causation.
From the decision · page 6Dr. McSweeney stated in his February 18, 2020 report that "It is my medical opinion, based on the information provided, that the applicant did sustain an industrial related injury to the right knee when he was walking on uneven terrain. (Joint Exhibit 8. Page 10). He also stated under "Causation" that "The patient's present symptoms, descriptions of the injury, review of the provided medical records, and the physical examination are consistent with the mechanics of injury as described by the applicant (Joint exhibit 8, Page 9, EAMS Doc ID 35514230).
Dr. Anand provided treatment reports confirming the industrial injury but did not discuss causation, focusing mainly on treatment.
From the decision · page 11The applicant has treated with Veerinder Anand MD from 06/03/2020- 04/14/2021. Dr. Anand provided an interim history in which he stated in every report virtually the same thing: the applicant sustained a documented industrial injury during the course of his employment with USG Corporation on 09/12/2019 as to his right knee as a mechanic. Dr. Anand does not discuss causation and mainly focuses on and discusses treatment.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 3600(a); Maher v. Workers' Comp. Appeals Bd. (1983) 33 Cal.3d 729
Preponderance of the evidence standard for proving injury arising out of and in the course of employment.
Applicant met burden by credible testimony and substantial medical evidence from QME report.
From the decision · page 9Pursuant to Labor Code 5705, "The burden of proof rests upon the party or lien claimant holding the affirmative of the issue." The applicant has the affirmative on proving injury arising out of employment and in the course of employment (AOE/COE).
What proof carried it
The evidence the panel weighed, by kind.
Credible testimony of applicant regarding injury mechanism and circumstances.
From the decision · page 12The applicant's testimony was credible. Based on the credible testimony of applicant and the reporting of James McSweeney dated 02/18/2020 and 10/21/2020, it is found that the applicant sustained an injury arising out of and in the course of employment to his right knee on 09/12/2019. There is sufficient direct evidence to find injury AOE/COE based on the totality of evidence. Further, "circumstantial evidence is sufficient to support an award of the commission, and it may be based upon the reasonable inferences that arise from the reasonable probabilities flowing from the evidence; neither absolute certainty nor demonstration is required." (Guerra v. Workers' Comp. Appeals Bd. (2016) 246 Cal.App.4th 1301, p. 1307.). Based upon the reasonable inferences from the evidence in the case, including applicant's testimony, the medical reporting of Dr. McSweeney, contemporaneous medical reporting, the applicant reporting his injury to employer, the applicant did suffer and injury to his right knee on 09/12/2019.
Medical reports of panel QME Dr. McSweeney providing a reasoned medical opinion based on examination and records.
From the decision · page 6Dr. McSweeney stated in his February 18, 2020 report that "It is my medical opinion, based on the information provided, that the applicant did sustain an industrial related injury to the right knee when he was walking on uneven terrain. (Joint Exhibit 8. Page 10). He also stated under "Causation" that "The patient's present symptoms, descriptions of the injury, review of the provided medical records, and the physical examination are consistent with the mechanics of injury as described by the applicant (Joint exhibit 8, Page 9, EAMS Doc ID 35514230).
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.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
- If you are named in this decision and want this page removed, write to privacy@similarcase.com.