What the panel ordered
Petition for Reconsideration denied; WCJ's findings of injury to sleep disorder and psyche and temporary disability period upheld.
Defendant filed a Petition for Reconsideration of the WCJ's Finding of Fact, Award and Order issued on June 13, 2025, challenging injury findings and temporary disability period; WCJ filed a Report recommending denial; WCAB timely acted on the petition on September 22, 2025.
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.
Dr. Flores provided predominant causation analysis showing more than 51% of psychiatric injury caused by work events; applicant's credible testimony consistent; defendant did not raise good faith personnel action defense, so claim not barred.
From the decision · page 10Defendant claims secondary treating physician, Nelson Flores, Ph.D. does not discuss predominant causes. This is incorrect. Dr. Flores, in his initial report dated 10/28/2014, indicated that more than 51% of all combined factors contributed to the applicant's mental disorder and current level of psychiatric disability were directly related to cumulative trauma injuries (CT
Applicant met burden of proving injury in the form of sleep disorder by preponderance of evidence, supported by credible testimony, polysomnogram, and AME Dr. Levine's opinion linking sleep disorder to industrial fibromyalgia injury.
From the decision · page 4To find a sleep disorder and arousal disorder injury occurred, the WCJ relied upon applicant's credible testimony about her sleep disorder injury. (Opinion on Decision, at p. 4; Report, at p. 4.) Additionally, on October 30, 2014, applicant underwent an overnight polysomnogram which revealed she had difficulty initiating sleep, repositioning, arousals were observed and the ECG revealed an irregular sinus rhythm throughout the night with some artifact. (Exhibit J1, at p. 5.) As the WCJ noted, applicant reported that she has sleep difficulties to many doctors. (Report, at p. 4.) Finally, agreed medical evaluator (AME) Seymour Levine, M.D., determined that applicant's accepted and industrially related fibromyalgia caused applicant nonrestorative sleep. (Exhibit J5, at p. 29, MOH/SOE, at p. 2:12-13.)
WCJ relied on QME Dr. Kim's reports, which reviewed entire medical record and found applicant temporarily disabled through 08/25/2022; Dr. Kim's opinion more substantial than PTP Dr. Pratley's earlier report.
From the decision · page 12The orthopedic QME, Dr. Donald Kim in his report dated 10/04/2022, declared the applicant MMI on 08/25/2022, the date of her last evaluation. (Exhibit #8, page 11) Dr. Kim provided this date after he reviewed records and evaluated the applicant numerous times. Dr. Kim's report was more substantial medical evidence than PTP, Dr. Brent Prately's report dated 01/29/2014. (Exhibit #A) Dr. Kim reviewed several reports, including the rheumatology and psychology reports. Dr. Prately did not appear to review any report after 01/29/2014, the date of his last report. Dr. Pratley did not address the applicant's increased symptoms as documented in QME, Dr. Kim's reports, dated 05/29/2018 and dated 08/29/2022. (Exhibits J4, page 1-2 and #J6, page 1-2). Her orthopedic injuries were complicated by her fibromyalgia. Dr. Kim's report was found to be substantial medical evidence and more persuasive on the issue of MMI status.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant's credible testimony and polysomnogram evidence showed sleep disorder symptoms.
Favours Applicant prevailed
Supported finding of compensable sleep disorder injury.
From the decision · page 4To find a sleep disorder and arousal disorder injury occurred, the WCJ relied upon applicant's credible testimony about her sleep disorder injury. (Opinion on Decision, at p. 4; Report, at p. 4.) Additionally, on October 30, 2014, applicant underwent an overnight polysomnogram which revealed she had difficulty initiating sleep, repositioning, arousals were observed and the ECG revealed an irregular sinus rhythm throughout the night with some artifact. (Exhibit J1, at p. 5.) As the WCJ noted, applicant reported that she has sleep difficulties to many doctors. (Report, at p. 4.) Finally, agreed medical evaluator (AME) Seymour Levine, M.D., determined that applicant's accepted and industrially related fibromyalgia caused applicant nonrestorative sleep. (Exhibit J5, at p. 29, MOH/SOE, at p. 2:12-13.)
AME Dr. Levine's opinion linked sleep disorder to industrial fibromyalgia injury.
Favours Applicant prevailed
Provided substantial medical evidence supporting compensability of sleep disorder.
From the decision · page 4To find a sleep disorder and arousal disorder injury occurred, the WCJ relied upon applicant's credible testimony about her sleep disorder injury. (Opinion on Decision, at p. 4; Report, at p. 4.) Additionally, on October 30, 2014, applicant underwent an overnight polysomnogram which revealed she had difficulty initiating sleep, repositioning, arousals were observed and the ECG revealed an irregular sinus rhythm throughout the night with some artifact. (Exhibit J1, at p. 5.) As the WCJ noted, applicant reported that she has sleep difficulties to many doctors. (Report, at p. 4.) Finally, agreed medical evaluator (AME) Seymour Levine, M.D., determined that applicant's accepted and industrially related fibromyalgia caused applicant nonrestorative sleep. (Exhibit J5, at p. 29, MOH/SOE, at p. 2:12-13.)
Dr. Flores' predominant causation analysis showed psychiatric injury was primarily caused by work events.
Favours Applicant prevailed
Met statutory requirement for compensability of psychiatric injury.
From the decision · page 10Defendant claims secondary treating physician, Nelson Flores, Ph.D. does not discuss predominant causes. This is incorrect. Dr. Flores, in his initial report dated 10/28/2014, indicated that more than 51% of all combined factors contributed to the applicant's mental disorder and current level of psychiatric disability were directly related to cumulative trauma injuries (CT
QME Dr. Kim's review of entire medical record supported extended temporary disability period through 08/25/2022.
Favours Applicant prevailed
Supported WCJ's finding of temporary disability period beyond PTP's MMI date.
From the decision · page 12The orthopedic QME, Dr. Donald Kim in his report dated 10/04/2022, declared the applicant MMI on 08/25/2022, the date of her last evaluation. (Exhibit #8, page 11) Dr. Kim provided this date after he reviewed records and evaluated the applicant numerous times. Dr. Kim's report was more substantial medical evidence than PTP, Dr. Brent Prately's report dated 01/29/2014. (Exhibit #A) Dr. Kim reviewed several reports, including the rheumatology and psychology reports. Dr. Prately did not appear to review any report after 01/29/2014, the date of his last report. Dr. Pratley did not address the applicant's increased symptoms as documented in QME, Dr. Kim's reports, dated 05/29/2018 and dated 08/29/2022. (Exhibits J4, page 1-2 and #J6, page 1-2). Her orthopedic injuries were complicated by her fibromyalgia. Dr. Kim's report was found to be substantial medical evidence and more persuasive on the issue of MMI status.
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.
Determined applicant's industrial fibromyalgia caused nonrestorative sleep and sleep/arousal disorder was generated by chronic pain syndrome disturbing sleep.
AME opinion supported finding of compensable sleep disorder injury linked to fibromyalgia.
From the decision · page 4To find a sleep disorder and arousal disorder injury occurred, the WCJ relied upon applicant's credible testimony about her sleep disorder injury. (Opinion on Decision, at p. 4; Report, at p. 4.) Additionally, on October 30, 2014, applicant underwent an overnight polysomnogram which revealed she had difficulty initiating sleep, repositioning, arousals were observed and the ECG revealed an irregular sinus rhythm throughout the night with some artifact. (Exhibit J1, at p. 5.) As the WCJ noted, applicant reported that she has sleep difficulties to many doctors. (Report, at p. 4.) Finally, agreed medical evaluator (AME) Seymour Levine, M.D., determined that applicant's accepted and industrially related fibromyalgia caused applicant nonrestorative sleep. (Exhibit J5, at p. 29, MOH/SOE, at p. 2:12-13.)
Provided predominant causation analysis that more than 51% of psychiatric injury caused by work events and cumulative trauma.
Flores' report contained predominant causation analysis required by Labor Code 3208.3(b)(1).
From the decision · page 10Defendant claims secondary treating physician, Nelson Flores, Ph.D. does not discuss predominant causes. This is incorrect. Dr. Flores, in his initial report dated 10/28/2014, indicated that more than 51% of all combined factors contributed to the applicant's mental disorder and current level of psychiatric disability were directly related to cumulative trauma injuries (CT
Found applicant temporarily disabled through 08/25/2022, reviewing entire medical record including AME and psychology reports; more substantial than PTP report.
Kim's opinion was substantial medical evidence supporting extended temporary disability period.
From the decision · page 12The orthopedic QME, Dr. Donald Kim in his report dated 10/04/2022, declared the applicant MMI on 08/25/2022, the date of her last evaluation. (Exhibit #8, page 11) Dr. Kim provided this date after he reviewed records and evaluated the applicant numerous times. Dr. Kim's report was more substantial medical evidence than PTP, Dr. Brent Prately's report dated 01/29/2014. (Exhibit #A) Dr. Kim reviewed several reports, including the rheumatology and psychology reports. Dr. Prately did not appear to review any report after 01/29/2014, the date of his last report. Dr. Pratley did not address the applicant's increased symptoms as documented in QME, Dr. Kim's reports, dated 05/29/2018 and dated 08/29/2022. (Exhibits J4, page 1-2 and #J6, page 1-2). Her orthopedic injuries were complicated by her fibromyalgia. Dr. Kim's report was found to be substantial medical evidence and more persuasive on the issue of MMI status.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code 3208.3(b)(1)
Psychiatric injury compensability requires predominant causation by work events over all causes combined.
Applied to injury in the form of psyche.
From the decision · page 5III. Defendant further contends the reporting of Nelson Flores, Ph.D., does not contain a predominant causation analysis necessary to establish an industrial psychiatric injury and is therefore not substantial medical evidence. Section 3208.3 provides, in relevant part:
South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291
Applicant bears burden of proving injury AOE/COE by preponderance of evidence; work need only be a contributing cause; all doubts resolved in favor of employee.
Applied to injury in the form of sleep disorder.
From the decision · page 3In addition to the analysis set forth in the WCJ's Report, we observe the following. With respect to applicant's claim for injury in the form of sleep, applicant 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.) It is sufficient to show that work was a contributing cause of the injury. (See Clark, supra, 61 Cal.4th at p. 298; McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408, 413 [33 Cal.Comp.Cases 660].) Applicant need only show that industrial causation was "not zero" to show sufficient contribution from work exposure for the claim to be compensable. (Clark, supra, 61 Cal.4th at p. 303.) The burden of proof "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].) It has also long been established that "all reasonable doubts as to whether an injury is compensable are to be resolved in favor of the employee." (Guerra v. Workers' Comp. Appeals Bd. (2016) 246 Cal.App.4th 1301, 1310 [81 Cal.Comp.Cases 324], citing Clemmons v. Workmen's Comp. Appeals Bd. (1968) 261 Cal.App.2d 1, 8; see also Garza, supra, 3 Cal.3d at p. 317; Lab. Code, § 3202.)
Place v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 372
Relevant and considered opinion of one physician may constitute substantial evidence even if inconsistent with others.
Applied to temporary disability period determination.
From the decision · page 7It 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].) Here, the WCJ explained why she chose to rely on Dr. Kim's reporting and found such reporting to be substantial medical evidence on the issue of MMI and temporary disability status. We find no basis to overturn those findings.
What proof carried it
The evidence the panel weighed, by kind.
Applicant's credible testimony about sleep disorder and psyche injury
From the decision · page 4To find a sleep disorder and arousal disorder injury occurred, the WCJ relied upon applicant's credible testimony about her sleep disorder injury. (Opinion on Decision, at p. 4; Report, at p. 4.) Additionally, on October 30, 2014, applicant underwent an overnight polysomnogram which revealed she had difficulty initiating sleep, repositioning, arousals were observed and the ECG revealed an irregular sinus rhythm throughout the night with some artifact. (Exhibit J1, at p. 5.) As the WCJ noted, applicant reported that she has sleep difficulties to many doctors. (Report, at p. 4.) Finally, agreed medical evaluator (AME) Seymour Levine, M.D., determined that applicant's accepted and industrially related fibromyalgia caused applicant nonrestorative sleep. (Exhibit J5, at p. 29, MOH/SOE, at p. 2:12-13.)
Polysomnogram showing difficulty initiating sleep and arousals
From the decision · page 4To find a sleep disorder and arousal disorder injury occurred, the WCJ relied upon applicant's credible testimony about her sleep disorder injury. (Opinion on Decision, at p. 4; Report, at p. 4.) Additionally, on October 30, 2014, applicant underwent an overnight polysomnogram which revealed she had difficulty initiating sleep, repositioning, arousals were observed and the ECG revealed an irregular sinus rhythm throughout the night with some artifact. (Exhibit J1, at p. 5.) As the WCJ noted, applicant reported that she has sleep difficulties to many doctors. (Report, at p. 4.) Finally, agreed medical evaluator (AME) Seymour Levine, M.D., determined that applicant's accepted and industrially related fibromyalgia caused applicant nonrestorative sleep. (Exhibit J5, at p. 29, MOH/SOE, at p. 2:12-13.)
Medical reports noting sleep disturbance and increased symptoms
From the decision · page 11Many of the medical reports noted the applicant had trouble sleeping. The orthopedic PQME, Dr. Donald Kim, in his report dated 07/28/2015, noted the applicant had sleep disturbance. (Exhibit #J2, page 9) He his 05/29/2018 report, he noted an increase in symptoms and sleep disturbance. (Exhibit #J4, page 2)
Dr. Flores' predominant causation analysis for psychiatric injury
From the decision · page 10Defendant claims secondary treating physician, Nelson Flores, Ph.D. does not discuss predominant causes. This is incorrect. Dr. Flores, in his initial report dated 10/28/2014, indicated that more than 51% of all combined factors contributed to the applicant's mental disorder and current level of psychiatric disability were directly related to cumulative trauma injuries (CT
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.