What the panel ordered
Petition for Reconsideration granted; WCJ's Findings and Order rescinded and amended to find injury AOE/COE; lien issues deferred.
Petition for Reconsideration granted by the WCAB panel, rescinding the WCJ's Findings and Order and substituting a new Findings and Order.
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 WCAB found that the QME Dr. Bolling's medical opinion was substantial evidence supporting injury AOE/COE, rejecting the WCJ's prior finding that the QME's opinion was not substantial due to occupational history discrepancies, and granted reconsideration to find injury AOE/COE.
From the decision · page 8Next, we disagree with the WCJ's overly technical reliance on stipulated occupation numbers in order to justify making the determination that applicant's job description in the medical reporting was somehow not credible. Dr. Bolling provided a detailed list of applicant's job duties, and Dr. Bolling was aware that applicant was the manager. Even if applicant was a manager, when she performed the more physical duties, she would have been entitled to a higher occupational variant. Thus, we conclude that the medical reporting by the QME Dr. Bolling is substantial medical evidence and sufficient to find AOE/COE.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
QME Dr. Bolling's medical opinion was substantial evidence supporting injury AOE/COE.
Favours Applicant prevailed
The Board found the QME's detailed medical opinion credible and sufficient to establish injury arising out of and in the course of employment, overruling the WCJ's contrary finding.
From the decision · page 8Next, we disagree with the WCJ's overly technical reliance on stipulated occupation numbers in order to justify making the determination that applicant's job description in the medical reporting was somehow not credible. Dr. Bolling provided a detailed list of applicant's job duties, and Dr. Bolling was aware that applicant was the manager. Even if applicant was a manager, when she performed the more physical duties, she would have been entitled to a higher occupational variant. Thus, we conclude that the medical reporting by the QME Dr. Bolling is substantial medical evidence and sufficient to find AOE/COE.
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.
Applicant sustained injury to right shoulder, left shoulder, lumbar spine, cervical spine, right wrist, and left knee, directly related to employment from October 1, 2010 to September 23, 2021, except left knee partially apportioned.
Dr. Bolling opined that the injuries and sequelae were the direct result of employment injuries during the relevant period, providing substantial medical evidence for injury AOE/COE.
From the decision · page 4Dr. William Bolling, the Panel Qualified Medical Examiner, provided the opinion that the applicant had an injury to her right shoulder, left shoulder, lumbar spine, cervical spine, right wrist, and left knee. As to causation, Dr. Bolling opined that "[t]he injuries and sequelae the patient sustained are the direct result of her employment injuries which occurred during the course of her employment from October l, 2010 - September 23, 2021." Dr. Bolling identified only a single injury occurring during this period, an undated specific injury to the applicant's right shoulder.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 3600
To be compensable, an injury must arise out of and occur in the course of employment.
The Board applied this standard to determine injury AOE/COE based on medical evidence and burden of proof.
From the decision · page 6II. To be compensable, an injury must arise out of and occur in the course of employment. (Lab. Code, § 3600.) The employee bears the burden of proving the injury arose out of and in the course of employment (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.) Medical evidence that industrial causation was reasonably probable, although not certain, constitutes substantial evidence for a finding of injury AOE/COE. (McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408, 417 [33 Cal.Comp.Cases 660].) "That burden manifestly does not require the applicant to prove causation by scientific certainty." (Rosas v. Worker's Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692, 1701 [58 Cal.Comp.Cases 313], emphasis added.)
What proof carried it
The evidence the panel weighed, by kind.
Discrepancy between stipulated occupation and job duties reported to QME
From the decision · page 8Next, we disagree with the WCJ's overly technical reliance on stipulated occupation numbers in order to justify making the determination that applicant's job description in the medical reporting was somehow not credible. Dr. Bolling provided a detailed list of applicant's job duties, and Dr. Bolling was aware that applicant was the manager. Even if applicant was a manager, when she performed the more physical duties, she would have been entitled to a higher occupational variant. Thus, we conclude that the medical reporting by the QME Dr. Bolling is substantial medical evidence and sufficient to find AOE/COE.
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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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