What the panel ordered
The WCAB rescinded the January 28, 2021 Findings and Orders and substituted a new Findings and Orders finding applicant sustained cumulative injury to cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee from January 1, 1995 to June 28, 2007, deferring injury to other body parts.
Defendant sought reconsideration of the WCJ Findings and Orders issued January 28, 2021, which found defendant bound by prior stipulations that applicant sustained injury arising out of and in the course of employment during January 1, 1995 through June 28, 2007. The WCJ found no good cause to set aside the stipulations and deemed moot the issue of whether Dr. Brourman's reports were substantial evidence on causation. The WCJ recommended denial of the Petition for Reconsideration.
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 that the prior stipulations were not enforceable because the WCJ did not make findings or orders approving them, implicitly rejecting the stipulations. The AME Dr. Siebold's reports were found to constitute substantial evidence supporting cumulative injury to specified body parts during the employment period. The reports of Dr. Brourman were rejected as not substantial evidence due to inadequate history and incorrect legal standard application.
From the decision · page 5Here, AME Dr. Siebold issued eight reports and was deposed on three occasions. Dr. Siebold concluded that applicant sustained cumulative injury to his cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee. While the WCJ may have had some qualms about the sufficiency of the reporting with respect to more complex issues such as applicant's level of permanent disability and causation of permanent disability and apportionment, we believe that Dr. Siebold's reporting more than meets the standard articulated in Clark, supra, as to causation of injury. Therefore, we will rescind the F&O and substitute a new F&O that finds that applicant sustained injury AOE/COE to his cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The WCJ did not make findings or orders approving the stipulations entered on February 16, 2010 and January 4, 2016, thus the stipulations were not enforceable and implicitly rejected.
Favours Applicant prevailed
This led the WCAB to reject the stipulations and require independent proof of injury AOE/COE.
From the decision · page 4Here, the orders of May 17, 2010 and March 9, 2016 by the WCJ are silent with respect to the stipulations. That is, the WCJ did not make findings as to the stipulations, and without a findings, award or order by the WCJ regarding the stipulations, they are not enforceable. Said
AME Dr. Siebold issued multiple reports concluding applicant sustained cumulative injury to cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee, meeting the standard for causation of injury.
Favours Applicant prevailed
The WCAB relied on these reports as substantial evidence to find injury AOE/COE.
From the decision · page 5Here, AME Dr. Siebold issued eight reports and was deposed on three occasions. Dr. Siebold concluded that applicant sustained cumulative injury to his cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee. While the WCJ may have had some qualms about the sufficiency of the reporting with respect to more complex issues such as applicant's level of permanent disability and causation of permanent disability and apportionment, we believe that Dr. Siebold's reporting more than meets the standard articulated in Clark, supra, as to causation of injury. Therefore, we will rescind the F&O and substitute a new F&O that finds that applicant sustained injury AOE/COE to his cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee.
Dr. Brourman's reports were based on an inadequate history and incorrect legal standard, focusing only on right and left knees and a limited period, failing to address the full injury period and body parts claimed.
Favours Defendant prevailed
The WCAB rejected these reports as not substantial evidence on causation of injury AOE/COE.
From the decision · page 6As set forth above, Dr. Brourman described the date of cumulative injury as from June 20, 2006 to June 20, 2007, an apparent reference to the division of liability in section 5500.5 when there are multiple defendants, rather than considering the actual period of exposure of January 1, 1995 through June 28, 2007. He failed to discuss AOE/COE with respect to all of the claimed body parts, and he instead focused on causation of disability to applicant's right and left knees. Thus, we conclude that Dr. Brourman's reporting is not substantial evidence with respect to causation of injury AOE/COE because it is based on an inadequate history and applies an incorrect legal standard for the date of injury, and because it fails to discuss the issue presented here, which is whether applicant sustained cumulative injury to his cervical spine, right shoulder, right upper extremity, lower back, left knee, and right knee while employed by defendant from January 1, 1995 to June 28, 2007.
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.
Concluded applicant sustained cumulative injury to cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee.
Reports met the standard for causation of injury and were relied upon by the WCAB to find cumulative injury.
From the decision · page 5Here, AME Dr. Siebold issued eight reports and was deposed on three occasions. Dr. Siebold concluded that applicant sustained cumulative injury to his cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee. While the WCJ may have had some qualms about the sufficiency of the reporting with respect to more complex issues such as applicant's level of permanent disability and causation of permanent disability and apportionment, we believe that Dr. Siebold's reporting more than meets the standard articulated in Clark, supra, as to causation of injury. Therefore, we will rescind the F&O and substitute a new F&O that finds that applicant sustained injury AOE/COE to his cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee.
Stated no evidence applicant sustained cumulative injury from June 20, 2006 to June 20, 2007; only discussed causation for right and left knees; applied incorrect legal standard and inadequate history.
Reports were rejected as not substantial evidence due to inadequate history and incorrect legal standard.
From the decision · page 6As set forth above, Dr. Brourman described the date of cumulative injury as from June 20, 2006 to June 20, 2007, an apparent reference to the division of liability in section 5500.5 when there are multiple defendants, rather than considering the actual period of exposure of January 1, 1995 through June 28, 2007. He failed to discuss AOE/COE with respect to all of the claimed body parts, and he instead focused on causation of disability to applicant's right and left knees. Thus, we conclude that Dr. Brourman's reporting is not substantial evidence with respect to causation of injury AOE/COE because it is based on an inadequate history and applies an incorrect legal standard for the date of injury, and because it fails to discuss the issue presented here, which is whether applicant sustained cumulative injury to his cervical spine, right shoulder, right upper extremity, lower back, left knee, and right knee while employed by defendant from January 1, 1995 to June 28, 2007.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 5702
Section 5702 authorizes the WCAB to make findings and awards based on stipulations or to reject stipulations and direct further investigation.
The WCJ did not make findings or orders approving stipulations, so they were not enforceable and implicitly rejected.
From the decision · page 4The parties to a controversy may stipulate the facts relative thereto in writing and file such stipulation with the appeals board. The appeals board may thereupon make its findings and award based upon such stipulation, or may set the matter down for hearing and take further testimony or make the further investigation necessary to enable it to determine the matter in controversy.
Lab. Code, 3600(a); Lab. Code, 3202.5; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291
Employee bears burden of proving injury AOE/COE by preponderance of evidence; proof must be reasonably probable, not certain.
The AME's opinion met the standard for causation of injury and was relied upon by the WCAB.
From the decision · page 5An employee bears the burden of proving injury AOE/COE by a preponderance of the evidence. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a), 3202.5.) The Supreme Court of California has long held that an employee need only show that the "proof of industrial causation is reasonably probable, although not certain or `convincing.`" (McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408, 413 [33 Cal.Comp.Cases 660].) "That burden manifestly does not require the applicant to prove causation by scientific certainty." (Rosas v. Workers' Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692, 1701 [58 Cal.Comp.Cases 313].) We observe, moreover, it is well-established that the relevant and considered opinion of one physician may constitute substantial evidence, even if inconsistent with other medical opinions. (Place v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 372, 378-379 [35 Cal.Comp.Cases 525].) The parties presumably choose an AME because of the AME's expertise and neutrality, and we will follow the opinions of the AME unless good cause exists to find their opinion unpersuasive. (Power v. Workers' Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].)
Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc)
Medical opinion must be framed in reasonable medical probability, not speculative, based on pertinent facts, adequate exam and history, and set forth reasoning.
Dr. Brourman's opinion was rejected as it was based on inadequate history and incorrect legal standard, failing to discuss the full period and body parts.
From the decision · page 6facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) "Medical reports and opinions are not substantial evidence if they are known to be erroneous, or if they are based on facts no longer germane, on inadequate medical histories and examinations, or on incorrect legal theories. Medical opinion also fails to support the Board's findings if it is based on surmise, speculation, conjecture or guess." (Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93, 97].)
What proof carried it
The evidence the panel weighed, by kind.
AME Dr. Siebold's reports
From the decision · page 5Here, AME Dr. Siebold issued eight reports and was deposed on three occasions. Dr. Siebold concluded that applicant sustained cumulative injury to his cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee. While the WCJ may have had some qualms about the sufficiency of the reporting with respect to more complex issues such as applicant's level of permanent disability and causation of permanent disability and apportionment, we believe that Dr. Siebold's reporting more than meets the standard articulated in Clark, supra, as to causation of injury. Therefore, we will rescind the F&O and substitute a new F&O that finds that applicant sustained injury AOE/COE to his cervical spine, right shoulder, right upper extremity, lumbar spine, left knee, and right knee.
Dr. Brourman's reports based on inadequate history and incorrect legal standard
From the decision · page 6As set forth above, Dr. Brourman described the date of cumulative injury as from June 20, 2006 to June 20, 2007, an apparent reference to the division of liability in section 5500.5 when there are multiple defendants, rather than considering the actual period of exposure of January 1, 1995 through June 28, 2007. He failed to discuss AOE/COE with respect to all of the claimed body parts, and he instead focused on causation of disability to applicant's right and left knees. Thus, we conclude that Dr. Brourman's reporting is not substantial evidence with respect to causation of injury AOE/COE because it is based on an inadequate history and applies an incorrect legal standard for the date of injury, and because it fails to discuss the issue presented here, which is whether applicant sustained cumulative injury to his cervical spine, right shoulder, right upper extremity, lower back, left knee, and right knee while employed by defendant from January 1, 1995 to June 28, 2007.
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
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