ADJ15168100 · August 1, 2024

The WCJ found the psychiatric injury evidence inconclusive and ordered further development of the record, which the WCAB panel upheld, denying the petition for reconsideration.

From the decision · page 1Defendant seeks reconsideration of the Findings of Fact and Order (F&O) issued by the workers' compensation administrative law judge (WCJ) on May 24, 2024. The WCJ found that applicant sustained injury arising out of and in the course of employment (AOE/COE) to her abdominal wall; that the record needs development on the disputed issue of industrial injury to the psychiatric system; and that applicant's claim is presumptively compensable pursuant to Labor Code, section 5402. The WCJ ordered that the "disputed issue of industrial injury to the psychiatric system is deferred pending further development of the record."

The WCJ found Dr. Grewal's psychiatric causation opinion conclusory and insufficient to establish compensability.

Favours Defendant prevailed

This insufficiency mandated further development of the record on psychiatric injury.

From the decision · page 6In this case, the only evidence submitted on this issue was the permanent and stationary report of Bal S. Grewal, Ph.D., dated August 15, 2023. With respect to causation, despite the multiple factors surrounding the Applicant's alleged psychiatric injury, on page 13, Dr. Grewal merely wrote, "I find that, within the reasonable realm of medical probability, the applicant has suffered an industrial injury to the psyche, which was predominantly caused by actual employment events." This was insufficient evidence to render a finding on industrial causation.

Found that the applicant suffered an industrial psychiatric injury predominantly caused by employment events, but the WCJ found the opinion conclusory and insufficient for causation.

The WCJ found Dr. Grewal's causation opinion conclusory and not substantial, requiring further record development.

From the decision · page 5The Applicant submitted into evidence the psychological permanent and stationary evaluation report of Bal S. Grewal, Ph.D., dated August 15, 2023. The Defendant submitted no contrary psychiatric medical evidence to rebut the findings of Dr. Grewal.

Labor Code section 3208.3

An applicant must show by a preponderance of the evidence that actual events of employment predominantly caused the psychiatric injury to establish compensability under Labor Code section 3208.3(b)(1).

Applied to evaluate the sufficiency of evidence for psychiatric injury causation.

From the decision · page 5Pursuant to Labor Code § 3208.3(b)(1), in order to establish that a psychiatric injury is compensable, an applicant must show by a preponderance of the evidence that actual events of employment predominantly caused the psychiatric injury.

Labor Code section 5402

A claim is presumptively compensable under Labor Code section 5402.

The WCJ found the claim presumptively compensable under this section.

From the decision · page 1Defendant seeks reconsideration of the Findings of Fact and Order (F&O) issued by the workers' compensation administrative law judge (WCJ) on May 24, 2024. The WCJ found that applicant sustained injury arising out of and in the course of employment (AOE/COE) to her abdominal wall; that the record needs development on the disputed issue of industrial injury to the psychiatric system; and that applicant's claim is presumptively compensable pursuant to Labor Code, section 5402. The WCJ ordered that the "disputed issue of industrial injury to the psychiatric system is deferred pending further development of the record."

Labor Code sections 5701 and 5906

Labor Code sections 5701 and 5906 authorize the WCJ and Board to obtain additional evidence at any time during proceedings to develop the record.

Supported the WCJ's order to develop the record due to insufficient evidence.

From the decision · page 6Notwithstanding the Defendant's claim that the undersigned WCJ should find unfavorably against the Applicant based solely on an insufficient evidentiary record, where a WCJ identifies "deficiencies, inaccuracies or lack of completeness," in the medical record, "Labor Code [] 5701 and 5906 authorize the WCJ and the Board to obtain additional evidence, including medical evidence, at any time during the proceedings." [McDuffie v. Los Angeles County Metropolitan Transit Authority (2002) 67 Cal. Comp. Cases 138, 141 (Appeals Board en banc).] "[A]llowing full development of the evidentiary record to enable a complete adjudication of the issues is consistent with due process in connection with workers' compensation claims and militates in favor of our presuming the continued vitality of [] 5701 and 5906, absent a clear legislative intention to the contrary." [Tyler v. Workers Comp. Appeals Bd. (1997) 62 Cal. Comp.

Dr. Grewal's psychiatric causation opinion was conclusory and insufficient to establish compensability.

From the decision · page 6In this case, the only evidence submitted on this issue was the permanent and stationary report of Bal S. Grewal, Ph.D., dated August 15, 2023. With respect to causation, despite the multiple factors surrounding the Applicant's alleged psychiatric injury, on page 13, Dr. Grewal merely wrote, "I find that, within the reasonable realm of medical probability, the applicant has suffered an industrial injury to the psyche, which was predominantly caused by actual employment events." This was insufficient evidence to render a finding on industrial causation.