ADJ18001417 · September 5, 2025

The Board found the applicant's meningioma to be Grade II based on the treating neurosurgeon's opinion, which was more substantial than the IME's Grade I opinion. The cancer presumption under Labor Code section 3212.1 applies, making the injury compensable.

From the decision · page 6The issue here is injury AOE/COE. Applicant has two avenues by which to prove this. If his meningioma is or shows signs of malignancy, then he comes within the cancer presumption of Labor Code sec. 3212.1. Alternatively, his injury is compensable if there is evidence that applicant's exposure to toxins, carcinogens, smoke and other substances during his employment caused, contributed to or accelerated the growth of the meningioma.

The Appeals Board acted timely on the petition for reconsideration within 60 days of transmission to the Appeals Board, despite a failure to provide accurate notice of transmission to the parties. The Board affirmed the Arbitrator's findings and denied the petition.

From the decision · page 1We have considered the allegations in defendant's Petition for Reconsideration, applicant's Answer, and the contents of the Arbitrator's Report and Recommendation issued May 21, 2025, with respect thereto. Based on our review of the record, and for the reasons stated in the Arbitrator's Report, which we adopt and incorporate, we will deny reconsideration.

Applicant's meningioma classified as Grade II by treating neurosurgeon Dr. Bruce McCormack.

Favours Applicant prevailed

This classification supported the cancer presumption under Labor Code section 3212.1, making the injury compensable.

From the decision · page 7There are two qualified doctors reporting in this case, who disagree on the grade of applicant's tumor. Dr. McCormack classifies it as a Grade II and Dr. Bellinger as Grade I. Neither doctor relies on speculation. Both are experienced and qualified IMEs and are familiar with the workers' compensation system. In this case, Dr. Bellinger, is acting as the IME. Dr. McCormack is the treating surgeon who removed the meningioma. Based on his letterhead, Dr. Bellinger's areas of expertise appears to be in internal medicine, cardiology and rheumatology. Dr. McCormack has been a board certified neurosurgeon and in practice as such since 1998. (Ex. F 5:14-15)

Applicant testified to exposure to toxic chemicals, smoke, and carcinogens during firefighting employment.

Favours Applicant prevailed

Supported the finding that exposure caused or contributed to the meningioma.

From the decision · page 5At the April 16, 2025, arbitration. the applicant testified about some of the toxic chemicals, smoke and other carcinogenic substances to which he was exposed during his 20-plus years of employment as a firefighter. the applicant fought hundreds of fires in homes, at commercial sites and vehicles. (Reporter's transcript, 4/16/25, 21:10-23) After a house fire was put out, firefighters removed their masks and were exposed to residual smoke from burned furniture, plastics and other chemicals that remained in the air. (Rpt trans 22:9-20) Among the many commercial fires to which he responded were drycleaners, paint and other warehouses. (Hrg trans. 23:11-16) Breathing apparatus was not worn at vehicle fires because they were outside. These fires generated a lot of "nasty chemicals" including magnesium from electric cars. Afterwards applicant told of feeling nauseous. (Rpt trans 22:21-23:5)

Classified the tumor as Grade II meningioma based on surgery observations and pathology report, supporting cancer presumption.

His firsthand surgical observations and experience as a neurosurgeon gave his opinion greater weight over the IME's.

From the decision · page 7There are two qualified doctors reporting in this case, who disagree on the grade of applicant's tumor. Dr. McCormack classifies it as a Grade II and Dr. Bellinger as Grade I. Neither doctor relies on speculation. Both are experienced and qualified IMEs and are familiar with the workers' compensation system. In this case, Dr. Bellinger, is acting as the IME. Dr. McCormack is the treating surgeon who removed the meningioma. Based on his letterhead, Dr. Bellinger's areas of expertise appears to be in internal medicine, cardiology and rheumatology. Dr. McCormack has been a board certified neurosurgeon and in practice as such since 1998. (Ex. F 5:14-15)

Classified the tumor as Grade I meningioma, less malignant than Grade II.

Disagreed with treating surgeon's Grade II classification; opinion given less weight.

From the decision · page 7There are two qualified doctors reporting in this case, who disagree on the grade of applicant's tumor. Dr. McCormack classifies it as a Grade II and Dr. Bellinger as Grade I. Neither doctor relies on speculation. Both are experienced and qualified IMEs and are familiar with the workers' compensation system. In this case, Dr. Bellinger, is acting as the IME. Dr. McCormack is the treating surgeon who removed the meningioma. Based on his letterhead, Dr. Bellinger's areas of expertise appears to be in internal medicine, cardiology and rheumatology. Dr. McCormack has been a board certified neurosurgeon and in practice as such since 1998. (Ex. F 5:14-15)

Place v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 372

The considered opinion of one physician may constitute substantial evidence even if inconsistent with others.

The Board relied on the treating surgeon's opinion over the IME's.

From the decision · page 7It is well established that the "considered opinion of one physician, though inconsistent with other medical opinions, may constitute substantial evidence." Place v. Workers' Comp. Appeals Bd, 3 Cal. 3d 372, 378.

Labor Code section 3212.1

Labor Code section 3212.1 provides a cancer presumption for firefighters exposed to carcinogens.

Applicant met burden under this presumption based on tumor grade and exposure.

From the decision · page 6The issue here is injury AOE/COE. Applicant has two avenues by which to prove this. If his meningioma is or shows signs of malignancy, then he comes within the cancer presumption of Labor Code sec. 3212.1. Alternatively, his injury is compensable if there is evidence that applicant's exposure to toxins, carcinogens, smoke and other substances during his employment caused, contributed to or accelerated the growth of the meningioma.

Labor Code section 5909

Labor Code section 5909 requires the Appeals Board to act on a petition for reconsideration within 60 days of transmission.

The Board acted timely on the petition despite notice issues.

From the decision · page 1We note that former Labor Code section 59091 provided that a petition for reconsideration was deemed denied unless the Appeals Board acted on the petition within 60 days from the date of filing. (Lab. Code, § 5909.) Effective July 2, 2024, section 5909 was amended to state in relevant part that:

Applicant's testimony about exposure to toxic chemicals, smoke, and carcinogens during firefighting.

From the decision · page 5At the April 16, 2025, arbitration. the applicant testified about some of the toxic chemicals, smoke and other carcinogenic substances to which he was exposed during his 20-plus years of employment as a firefighter. the applicant fought hundreds of fires in homes, at commercial sites and vehicles. (Reporter's transcript, 4/16/25, 21:10-23) After a house fire was put out, firefighters removed their masks and were exposed to residual smoke from burned furniture, plastics and other chemicals that remained in the air. (Rpt trans 22:9-20) Among the many commercial fires to which he responded were drycleaners, paint and other warehouses. (Hrg trans. 23:11-16) Breathing apparatus was not worn at vehicle fires because they were outside. These fires generated a lot of "nasty chemicals" including magnesium from electric cars. Afterwards applicant told of feeling nauseous. (Rpt trans 22:21-23:5)

Pathologist's report noting atypical cells, high cellularity, and conspicuous nucleoli supporting Grade II diagnosis.

From the decision · page 7Although the pathologist concludes that the findings are not "considered enough for a grade II meningioma," she goes on to say that there are enough irregularities to have considered a diagnosis of a grade II meningioma because "some features that raise concern for a grade II atypical meningioma (relatively high cellularity and conspicuous nucleoli in subset)." (Ex. H).