What the panel ordered
Petition for Reconsideration is granted; matter set for status conference; final decision after reconsideration deferred pending further review.
Applicant seeks reconsideration of the September 11, 2023 Findings and Award issued by the WCJ, which found industrial injury and 60% permanent disability but denied compensability of psychiatric injury; the WCAB grants reconsideration and defers final decision pending further review and status conference.
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 WCJ found no compensability for psychiatric injury based on physical injury exceptions, but the WCAB granted reconsideration to further review the compensability of psychiatric injury under Labor Code section 3208.3 and relevant case law, noting the need for further development of the record and legal analysis.
From the decision · page 1Applicant seeks reconsideration of the September 11, 2023 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein, the WCJ found that applicant sustained industrial injury to his neck, upper extremities, back, right arm, right wrist, left wrist, left shoulder, right shoulder, bladder, colon, upper digestive tract, and injury in form of hypertension while employed as a city manager during the period between April 30, 2014 to April 30, 2015 (ADJ10561152 (MF)), during the period between April 7, 2014 to April 15, 2015 (ADJ10561411), and on July 13, 2016 (ADJ10562671), causing 60% permanent disability. In his Opinion on Decision, the WCJ stated that "there are no increases in impairment rating for psychiatric impairment arising out of a compensable physical injury, with exceptions for violent acts and catastrophic injury, including loss of limb, paralysis, severe burn head injury. Based on the reporting of [Howard Greils, M.D.] (Joint Exhibits E, F, G, H and I), the Applicant's condition is a result of physical injury and thus pursuant to labor code no increase in rating impairment." (Opinion on Decision, at p. 4.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Greils' May 16, 2019 report attributing 80% of psychiatric injury causation to work-related stress.
Favours Applicant prevailed
This medical opinion supports the applicant's claim that the psychiatric injury is predominantly caused by work events, which is required for compensability under Labor Code section 3208.3.
From the decision · page 2II. Preliminarily, we note the following in our review of the record: Although applicant does not alleged psychiatric injury and defendant did not raise the affirmative defense of good faith personnel action, the parties participated in a psychiatric agreed medical examination (AME) with Dr. Greils. In his May 16, 2019 report, Dr. Greils opined that 80% of the cause of the applicant's psychiatric injury was the direct stress resulting from the events at work, 10% was due to the stress secondary to her orthopedic pain and limitations, and 10% was due to stress secondary to her internal medicine conditions. He also provided a Rolda analysis.
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.
In his May 16, 2019 report, Dr. Greils opined that 80% of the cause of the applicant's psychiatric injury was the direct stress resulting from the events at work, 10% was due to the stress secondary to her orthopedic pain and limitations, and 10% was due to stress secondary to her internal medicine conditions. He also provided a Rolda analysis.
Dr. Greils provided a detailed causation opinion with a Rolda analysis supporting compensability of psychiatric injury.
From the decision · page 2II. Preliminarily, we note the following in our review of the record: Although applicant does not alleged psychiatric injury and defendant did not raise the affirmative defense of good faith personnel action, the parties participated in a psychiatric agreed medical examination (AME) with Dr. Greils. In his May 16, 2019 report, Dr. Greils opined that 80% of the cause of the applicant's psychiatric injury was the direct stress resulting from the events at work, 10% was due to the stress secondary to her orthopedic pain and limitations, and 10% was due to stress secondary to her internal medicine conditions. He also provided a Rolda analysis.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 3208.3; Rolda v. Pitney Bowes, Inc. (2001) 66 Cal.Comp.Cases 241 (Appeals Board en banc)
To establish compensability of psychiatric injury, the injured worker must prove by a preponderance of the evidence that actual events of employment were predominant as to all causes combined of the psychiatric injury, meaning work-related cause has greater than 50% share of all causal factors.
Applied to evaluate compensability of psychiatric injury in this case.
From the decision · page 2In order to establish the compensability of a psychiatric injury under Labor Code1 section 3208.3, an injured worker has the burden of establishing "by a preponderance of the evidence that actual events of employment were predominant as to all causes combined of the psychiatric injury." (Lab. Code, § 3208.3(b)(1).) "Predominant as to all causes" means that "the work-related cause has greater than a 50 percent share of the entire set of causal factors." (Dept. of Corrections v. Workers' Comp. Appeals Bd. (Garcia) (1999) 76 Cal.App.4th 810, 816 [64 Cal.Comp.Cases 1356, 1360]; Watts v. Workers' Comp. Appeals Bd. (2004) 69 Cal.Comp.Cases 684, 688 (writ den.); Rolda v. Pitney Bowes, Inc. (2001) 66 Cal.Comp.Cases 241, 246 (Appeals Board en banc).)
What proof carried it
The evidence the panel weighed, by kind.
Medical evidence from Dr. Greils' May 16, 2019 report supporting work-related causation of psychiatric injury.
From the decision · page 2II. Preliminarily, we note the following in our review of the record: Although applicant does not alleged psychiatric injury and defendant did not raise the affirmative defense of good faith personnel action, the parties participated in a psychiatric agreed medical examination (AME) with Dr. Greils. In his May 16, 2019 report, Dr. Greils opined that 80% of the cause of the applicant's psychiatric injury was the direct stress resulting from the events at work, 10% was due to the stress secondary to her orthopedic pain and limitations, and 10% was due to stress secondary to her internal medicine conditions. He also provided a Rolda analysis.
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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.
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