What the panel ordered
Petition for Reconsideration granted; Findings of Fact, Award and Opinion on Decision of July 14, 2023 rescinded; matter returned to trial level for further proceedings.
Defendant sought reconsideration of the Findings of Fact, Award and Opinion on Decision issued on July 14, 2023; the WCJ had found applicant sustained heart injury developing during employment and awarded unapportioned permanent disability; the WCJ Report recommended denial of reconsideration; the Board granted reconsideration and rescinded the F&A, returning the matter to trial for further development on heart trouble development and timing.
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 Board found that the WCJ's finding that heart trouble developed during employment was not supported by substantial medical evidence, specifically the PQME's opinion did not establish when LVH developed; therefore, the matter was remanded for further development of the record on this issue.
From the decision · page 1Defendant seeks reconsideration of the Findings of Fact, Award and Opinion on Decision (F&A) issued on July 14, 2023, wherein the workers' compensation administrative law judge (WCJ) found as relevant that (1) applicant sustained injury to the heart which began developing during his employment with defendant; and (2) applicant is entitled to an unapportioned award for the cardiac portion of the case of permanent disability which the parties agree rates 57 percent.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
PQME Verma testified hypertension contributed to development of LVH and LVH could have been developing during employment despite manifestation in 2020.
Favours Applicant prevailed
This testimony supported the presumption that heart trouble developed during employment, but the exact timing was not established, requiring further record development.
From the decision · page 2Inasmuch as Dr. Verma testified that hypertension is a contributing factor to development of LVH, (Jt Exh f Pg 13:7-14), and since applicant was diagnosed with hypertension well before his termination of employment with CDCR, it follows that LVH was developing as far back as his employment period, although the condition had not manifested itself until much later in 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.
Hypertension contributed to the development of heart trouble (LVH), but it is impossible to determine when LVH manifested itself; did not opine that heart trouble did not develop during employment.
The Board found that Dr. Verma's opinion did not establish when LVH developed and did not negate development during employment.
From the decision · page 2The PQME, Dr. Verma, opined that while hypertension does not constitute "heart trouble", in this case, hypertension contributed to the development of heart trouble.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
LC Sec 3202.2
The heart trouble presumption under LC Sec 3202.2 applies if heart trouble developed or manifested during employment or within the presumption period after termination.
The Board applied this statute to determine the presumption of occupational causation for heart trouble.
From the decision · page 3Such heart trouble so developing or manifesting itself in such 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 it. This presumption shall be extended to a member following termination of service for a period of three calendar months for each full year of the requisite service, but not to exceed 60 months in any circumstance, commencing with the last date actually worked in the specified capacity.
What proof carried it
The evidence the panel weighed, by kind.
PQME Verma's testimony that hypertension contributed to development of LVH and that LVH could have been developing during employment despite manifestation in 2020
From the decision · page 2Inasmuch as Dr. Verma testified that hypertension is a contributing factor to development of LVH, (Jt Exh f Pg 13:7-14), and since applicant was diagnosed with hypertension well before his termination of employment with CDCR, it follows that LVH was developing as far back as his employment period, although the condition had not manifested itself until much later in 2020.
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About this page
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