What the panel ordered
The WCAB affirmed the WCJ's Findings of Fact that applicant sustained industrial injury to his psyche in the form of PTSD during the period February 12, 2017 through July 15, 2020, under the presumption of Labor Code section 3212.15, rejecting defendant's contentions regarding the inapplicability of the presumption and the predominant cause requirement.
Defendant filed a timely petition for reconsideration of the WCJ's decision; the WCAB granted reconsideration and issued a Decision After Reconsideration affirming the WCJ's Findings of Fact of June 22, 2021.
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 WCAB found the presumption of industrial PTSD under Labor Code section 3212.15 applicable and not rebutted, and that the predominant cause requirement of Labor Code section 3208.3 does not apply to the presumption, affirming the WCJ's finding of injury during the period 2/12/2017 to 7/15/2020.
From the decision · page 1In the Findings of Fact of June 22, 2021, the workers' compensation administrative law judge ("WCJ") found that during the period February 12, 2017 through July 15, 2020, applicant, while employed as a District Attorney Investigator by the County of Ventura, sustained industrial injury to his psyche in the form of post-traumatic stress disorder ("PTSD").
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant sustained PTSD during employment with County of Ventura from 2/12/2017 to 7/15/2020.
Favours Applicant prevailed
This fact establishes the period of injury relevant to the presumption under Labor Code section 3212.15 and supports compensability.
From the decision · page 1In the Findings of Fact of June 22, 2021, the workers' compensation administrative law judge ("WCJ") found that during the period February 12, 2017 through July 15, 2020, applicant, while employed as a District Attorney Investigator by the County of Ventura, sustained industrial injury to his psyche in the form of post-traumatic stress disorder ("PTSD").
Dr. Spencer found PTSD caused 20% by County of Ventura employment and 80% by City of Ventura employment.
Favours Applicant prevailed
Despite the 20% causation, the presumption under section 3212.15 applies and the predominant cause requirement does not bar compensability.
From the decision · page 9Dr. Spencer found the PTSD to be caused 80% by the employment at the City of Ventura, and 20% by the employment of the County of Ventura. See Joint exhibit A, report of Edward L. Spencer, M.D., dated 3/3/2021, page 25-26.
Applicant first suffered temporary disability on 7/15/2020 and knew or should have known the disability was work-related then.
Favours Applicant prevailed
This date establishes the end of the cumulative trauma injury period under Labor Code section 5412.
From the decision · page 4first suffered disability; that is also when he knew or should have known, from Dr. Spencer's report, that his disability was caused by his present or prior employment. Accordingly, the WCJ correctly found that the date of applicant's cumulative trauma extended through the period ending July 15, 2020.
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.
Found applicant's PTSD caused 80% by employment at City of Ventura and 20% by employment at County of Ventura; found applicant temporarily totally disabled beginning 7/15/2020; found PTSD manifested in August 2020.
The WCAB relied on Dr. Spencer's report as substantial evidence supporting the finding of industrial injury to psyche in the form of PTSD during the period 2/12/2017 to 7/15/2020.
From the decision · page 9On 2/10/2021, applicant was evaluated by PQME Edward L. Spencer, M.D. See Joint exhibit A, report of Edward L. Spencer, M.D., dated 3/3/2021.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 3212.15
Presumption of industrial injury for PTSD under Labor Code section 3212.15
The presumption applies when PTSD is diagnosed and manifests during employment with a covered employer; it is disputable but binding unless controverted.
From the decision · page 4Labor Code section 3212.15(b), as relevant here, states: "[...] [T]he term "injury," as used in this division, includes "post-traumatic stress disorder," as diagnosed according to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association and that develops or manifests itself during a period in which any [employee covered by the statute] is in the service of the [employer covered by the statute]." Subdivision (c)(2) then states in relevant part, "[f]or an injury that is diagnosed as specified in subdivision (b): [...] (2) The injury so developing or manifesting itself in these cases shall be presumed to arise out of and in the course of the employment. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the appeals board is bound to find in accordance with the presumption. [...]" Thus, under section 3212.15(b) and (c), a "disputable" presumption of industrial injury arises where (1) there is a professional diagnosis of PTSD; and (2) the PTSD "develops or manifests itself" during a period in which an employee covered by the statute is in the service of an employer covered by the statute. (Here there is no dispute that applicant and defendant are
Labor Code section 3208.3
Predominant cause requirement under Labor Code section 3208.3(b)(1)
Requires work-related cause to be greater than 50% of all causes combined for compensability; not applicable to the presumption under section 3212.15.
From the decision · page 4Defendant further contends that notwithstanding the presumption of industrial PTSD provided by Labor Code section 3212.15, the long-standing predominant cause requirement of Labor Code section 3208.3(b)(1) remains applicable. Defendant alleges that since Dr. Spencer found applicant's PTSD only 20% caused by his employment by the County of Ventura, the predominant cause standard is not met. (Petition for Reconsideration, p. 8:25-9:5.)
Labor Code section 5412
Date of injury determination under Labor Code section 5412
Date of injury for cumulative trauma is when employee first suffers disability and knows or should know it is work-related.
From the decision · page 3In this case, applicant claims he suffered a cumulative trauma of PTSD from February 12, 2017 through July 15, 2020, while employed by a single employer, the County of Ventura. This means the date of applicant's cumulative trauma injury is properly determined pursuant to Labor Code section 5412, not section 5500.5(a). The reason is that Labor Code section 3208.1(b) defines a cumulative injury as "repetitive mentally or physically traumatic activities extending over a period of time, the combined effect of which causes any disability or need for medical treatment," while section 3208.1 also states that the "[t]he date of a cumulative injury shall be the date determined under Section 5412." Pursuant to section 3208.1, the date of injury is correctly determined by reference to section 5412, regardless of whether or not the Statute of Limitations has been raised as an affirmative defense.
What proof carried it
The evidence the panel weighed, by kind.
Dr. Spencer's report and findings
From the decision · page 9On 2/10/2021, applicant was evaluated by PQME Edward L. Spencer, M.D. See Joint exhibit A, report of Edward L. Spencer, M.D., dated 3/3/2021.
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About this page
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