What the panel treated as outcome-determinative, and which side it favoured.
QME Dr. Banks found medical evidence insufficient to substantiate injury claim due to inconsistencies and delayed symptom reporting.
Favours Defendant prevailed
This undermined applicant's burden of proof for industrial injury, leading to denial of claim.
From the decision · page 6I have carefully reviewed and considered the evidence submitted to me, including the
medical records in evidence, as well as applicant's testimony at trial. In view of the
overall record, I find that applicant has not met his burden of proof with regard to
injury AOE/COE. See Mendoza v. Huntington Hospital (2010) 75 Cal. Comp. Cases
634, 644 ["it is the employee's burden to prove industrial causation, not the defendant's
burden to disprove causation..]. I have reached this conclusion due to the lack of
medical support of applicant's claim as well as due to the questionable factual basis
for the claim.
The only medical reports in evidence are the three reports of the QME, Dr. Banks,
joint exhibits 1 through 3. In his final report, joint exhibit 3, Dr.
Applicant's testimony credibility was questioned by WCJ based on demeanor and inconsistencies.
Favours Defendant prevailed
Credibility concerns contributed to denial of claim for lack of reliable evidence.
From the decision · page 6I have carefully reviewed and considered the evidence submitted to me, including the
medical records in evidence, as well as applicant's testimony at trial. In view of the
overall record, I find that applicant has not met his burden of proof with regard to
injury AOE/COE. See Mendoza v. Huntington Hospital (2010) 75 Cal. Comp. Cases
634, 644 ["it is the employee's burden to prove industrial causation, not the defendant's
burden to disprove causation..]. I have reached this conclusion due to the lack of
medical support of applicant's claim as well as due to the questionable factual basis
for the claim.
The only medical reports in evidence are the three reports of the QME, Dr. Banks,
joint exhibits 1 through 3. In his final report, joint exhibit 3, Dr.
No witness testimony corroborated applicant's report of injury to supervisors on date of incident.
Favours Defendant prevailed
Lack of corroboration weakened applicant's claim and supported denial.
From the decision · page 17Given these inconsistencies, and the absence of medical evidence
related to the claimed injury of June 16, 2020, with the first mention of
symptoms being in March 2021, concern is raised for subsequent
employment being responsible for components of the injury (and may
be the injury itself). As such I do believe industrial causation should
be determined by the trier of fact as the medical evidence produced
is insufficient in substantiating the claim of injury as noted by the
applicant. Of note, the applicant did state his claimed injury of June
16, 2020, was witnessed and he promptly reported it to his supervisors
who did not offer him medical attention. To date I have not received
any witness testimonies to corroborate this history. (Id., at p. 5,
emphasis added.)
Medical records show first mention of symptoms related to claimed injury months after alleged incident, raising concern for subsequent employment as cause.
Favours Defendant prevailed
Delayed symptom reporting undermined claim of industrial injury causation.
From the decision · page 17Given these inconsistencies, and the absence of medical evidence
related to the claimed injury of June 16, 2020, with the first mention of
symptoms being in March 2021, concern is raised for subsequent
employment being responsible for components of the injury (and may
be the injury itself). As such I do believe industrial causation should
be determined by the trier of fact as the medical evidence produced
is insufficient in substantiating the claim of injury as noted by the
applicant. Of note, the applicant did state his claimed injury of June
16, 2020, was witnessed and he promptly reported it to his supervisors
who did not offer him medical attention. To date I have not received
any witness testimonies to corroborate this history. (Id., at p. 5,
emphasis added.)