ADJ12083629 — California WCAB decision

What the panel ordered

The Workers' Compensation Appeals Board denies the County of Ventura's Petition for Reconsideration.

Defendant County of Ventura seeks reconsideration of a WCJ's Findings, Award and Orders of December 21, 2021, regarding industrial injury and apportionment issues.

Read the official decision →

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.

ApportionmentApplicant prevailedheart · valvular heart disease · coronary artery disease · hypertensive heart disease

The Board found that Labor Code section 4663 does not apply due to the law enforcement presumption, and section 4664 does not apply because there was no prior award of permanent disability. The Compromise and Release settlement did not specify permanent disability or apportionment. Liability is limited to the one-year period under section 5500.5, and section 5005 credit applies only if two carriers are on risk during the same period, which was not the case here.

From the decision · page 1Defendant County of Ventura, the self-insured employer, seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings, Award and Orders of December 21, 2021, wherein it was found that while employed as a deputy sheriff during a cumulative period ending on March 18, 2016, applicant sustained industrial injury in the forms valvular heart disease, coronary artery disease and hypertensive heart disease, causing permanent disability of 80% and the need for further medical treatment. With regard to the issue of apportionment, it was found that "Labor Code section 4663 does not apply based on the law enforcement presumption." It was also found that "Labor Code section 4664 does not apply based on no evidence of a prior award, finding or stipulation of disability."

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Applicant sustained a single cumulative injury spanning entire employment period as found by QME Dr. Mark Lensky.

Favours Applicant prevailed

This medical finding supports no apportionment to prior claims or insurers.

From the decision · page 2Turning back to the instant case, applicant was evaluated by panel qualified medical evaluator internist and cardiologist Mark Lensky, M.D. Dr. Lensky testified that applicant sustained a single cumulative injury spanning his entire period of employment. (October 22, 2020 deposition at p. 18.)

The Compromise and Release settled multiple claims with no specific amount or permanent disability award for hypertension claim ADJ3962284.

Favours Applicant prevailed

No prior permanent disability award means no apportionment under Labor Code section 4664.

From the decision · page 2Applicant filed the instant claim in 2019, alleging heart injury with dates of exposure spanning applicant's entire employment with the County from 1991 to March 18, 2016. Previously, in late 2001, applicant filed an Application for Adjudication of Claim alleging industrial injury in the form of hypertension, pleading a date of exposure through February 2, 2002 (ADJ3962284). Defendant was insured by National Union until June 30, 2002 and as of July 1, 2002 has been self-insured. The claim in ADJ3962284 was settled in a Compromise and Release approved on May 7, 2015, along with 24 other cases brought by applicant for injuries during National Union's coverage period. The Compromise and Release was between applicant and National Union without the County's involvement. The Compromise and Release contains no stipulation to injury by National Union in case ADJ3962284, does not specify the amount of the settlement attributable to case ADJ3962284 as distinct from the other 24 cases settled, and contains no stipulation regarding any permanent disability attributable to case ADJ3962284.

Labor Code section 5500.5 limits liability to the employer/carrier on risk during the one-year period preceding last injurious exposure or date of injury.

Favours Applicant prevailed

This limits the County's liability to its self-insured period, excluding prior insurer National Union Fire Insurance Company.

From the decision · page 2Labor Code section 5500.5(a) states, "liability for occupational disease or cumulative injury claims... shall be limited to those employers who employed the employee during a period of [one year] immediately preceding either the date of injury, as determined pursuant to Section 5412, or the last date on which the employee was employed in an occupation exposing him or her to the hazards of the occupational disease or cumulative injury, whichever occurs first."

Labor Code section 5005 credit applies only if two employers/carriers are on risk during the same liability period under section 5500.5.

Favours Applicant prevailed

No credit allowed here because the prior insurer and self-insured employer were not on risk during the same period.

From the decision · page 4The County also seeks a credit pursuant to Labor Code section 5005, which states in

ADJ12083629 · March 11, 2022

What the panel ordered

What was disputed, and how it came out

Your case already resembles someone else’s. Find whose.

The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

About this page