What the panel ordered
The Board affirmed the December 10, 2021 Findings and Order denying the applicant's claim for injury AOE/COE to his back.
Petition for Reconsideration of the December 10, 2021 Findings and Order denying applicant's claim for injury arising out of and in the course of employment (AOE/COE) to his back was granted for further review; the WCJ's Report recommended denial of the petition; the Board reviewed the record and WCJ Report and issued a Decision After Reconsideration affirming the WCJ's 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 Board found the WCJ's credibility determinations supported by substantial evidence, including inconsistencies in applicant's testimony and medical and payroll records, and thus affirmed the denial of injury AOE/COE.
From the decision · page 2On December 10, 2021, the WCJ issued her decision, determining in relevant part that applicant did not sustain his evidentiary burden of establishing injury AOE/COE occurring on February 20, 2019. (Finding of Fact No. 4.) In the accompanying Opinion on Decision, the WCJ explained that medical records in evidence from applicant's treating physician Dr. Fisher indicated an initial visit date of February 14, 2019, and that applicant testified that he had seen Dr. Fisher on the day following the specific injury. The WCJ observed that this date was inconsistent with the date provided by applicant to subsequent evaluating physicians. (Opinion on Decision, at pp. 3-4.) The WCJ observed that payroll records demonstrate that applicant was not working on February 13, 2019, which would have been the day preceding his initial visit with Dr. Fisher. Because the history applicant provided to his evaluating physicians regarding the date of injury was not consistent with his trial testimony, the WCJ concluded that applicant had not met his
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant's testimony about the date of injury and treatment was inconsistent and lacked credibility
Favours Defendant prevailed
This undermined the applicant's burden of proof for injury AOE/COE, leading to denial of the claim.
From the decision · page 3The WCJ's Report states that the WCJ did not find applicant's testimony to be credible, that while applicant's testimony on direct examination was clear and concise, applicant was unable to recall many significant details on cross-examination. (Report, at p. 3.) The WCJ further notes that even were the date of injury conformed to applicant's testimony, it would not reconcile the multi-day gap between applicant's last day worked and when he first obtained chiropractic treatment with Dr. Fisher. Because applicant's testimony was not credible, and because conforming the date of injury to proof would not otherwise remediate the contradictions in the evidentiary record, the WCJ recommends we deny reconsideration. (Id. at p. 5.)
Payroll records showed applicant's last day worked was February 8, 2019, inconsistent with claimed injury and treatment dates
Favours Defendant prevailed
This documentary evidence contradicted applicant's testimony and supported denial of injury claim.
From the decision · page 3Defendant's Answer observes that per payroll records and witness testimony, the last day applicant worked for the defendant was February 8, 2019, and that the earliest evidence that applicant sought medical treatment reflects a date of February 14, 2019, which is inconsistent with applicant's testimony that he sought medical treatment the day following his injury. (Answer, at p. 5:16.) Defendant also observes that the records of applicant's treating chiropractor Dr. Fisher do not contain evidence that applicant's injury was industrial in nature. (Ibid.)
Medical records from treating chiropractor Dr. Fisher did not support an industrial injury
Favours Defendant prevailed
This medical evidence further supported the denial of the injury claim.
From the decision · page 3Defendant's Answer observes that per payroll records and witness testimony, the last day applicant worked for the defendant was February 8, 2019, and that the earliest evidence that applicant sought medical treatment reflects a date of February 14, 2019, which is inconsistent with applicant's testimony that he sought medical treatment the day following his injury. (Answer, at p. 5:16.) Defendant also observes that the records of applicant's treating chiropractor Dr. Fisher do not contain evidence that applicant's injury was industrial in nature. (Ibid.)
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.
From the decision · page 2The parties have selected Arthur Schwartz, M.D., and Divakar Krishnareddy, M.D., as the Qualified Medical Evaluators (QMEs) in orthopedic medicine.
From the decision · page 2The parties have selected Arthur Schwartz, M.D., and Divakar Krishnareddy, M.D., as the Qualified Medical Evaluators (QMEs) in orthopedic medicine.
Medical records from treating chiropractor Dr. Fisher indicated an initial visit date inconsistent with applicant's testimony and did not support an industrial injury.
The WCJ found the medical records from Dr. Fisher did not support the industrial nature of the injury and noted inconsistencies with applicant's testimony about treatment dates.
From the decision · page 2On December 10, 2021, the WCJ issued her decision, determining in relevant part that applicant did not sustain his evidentiary burden of establishing injury AOE/COE occurring on February 20, 2019. (Finding of Fact No. 4.) In the accompanying Opinion on Decision, the WCJ explained that medical records in evidence from applicant's treating physician Dr. Fisher indicated an initial visit date of February 14, 2019, and that applicant testified that he had seen Dr. Fisher on the day following the specific injury. The WCJ observed that this date was inconsistent with the date provided by applicant to subsequent evaluating physicians. (Opinion on Decision, at pp. 3-4.) The WCJ observed that payroll records demonstrate that applicant was not working on February 13, 2019, which would have been the day preceding his initial visit with Dr. Fisher. Because the history applicant provided to his evaluating physicians regarding the date of injury was not consistent with his trial testimony, the WCJ concluded that applicant had not met his
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291
Employee bears burden of proving injury AOE/COE by preponderance of evidence
The Board applied this standard to evaluate whether the applicant met the burden of proof for injury arising out of and in the course of employment.
From the decision · page 3In California workers' compensation proceedings, the employee bears the burden of proving injury 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.) An injury must be proximately caused by the employment to be compensable. (Lab. Code, § 3600(a)(3); see also Clark, supra, at pp. 297§ 298.) Proximate cause in workers' compensation requires the employment be a contributing cause of the injury. (Ibid.) Whether an injury arose out of and in the course of employment is generally a question of fact to be determined based upon the circumstances of each case. (Wright v. Beverly Fabrics (2002) 95 Cal.App.4th 346, 353 [67 Cal.Comp.Cases 51].)
Labor Code section 3600(a)(3)
An injury must be proximately caused by the employment to be compensable
The Board applied this statute to determine that the employment must be a contributing cause of the injury for compensability.
From the decision · page 3In California workers' compensation proceedings, the employee bears the burden of proving injury 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.) An injury must be proximately caused by the employment to be compensable. (Lab. Code, § 3600(a)(3); see also Clark, supra, at pp. 297§ 298.) Proximate cause in workers' compensation requires the employment be a contributing cause of the injury. (Ibid.) Whether an injury arose out of and in the course of employment is generally a question of fact to be determined based upon the circumstances of each case. (Wright v. Beverly Fabrics (2002) 95 Cal.App.4th 346, 353 [67 Cal.Comp.Cases 51].)
What proof carried it
The evidence the panel weighed, by kind.
Medical records from treating chiropractor Dr. Fisher did not support industrial injury
From the decision · page 3Defendant's Answer observes that per payroll records and witness testimony, the last day applicant worked for the defendant was February 8, 2019, and that the earliest evidence that applicant sought medical treatment reflects a date of February 14, 2019, which is inconsistent with applicant's testimony that he sought medical treatment the day following his injury. (Answer, at p. 5:16.) Defendant also observes that the records of applicant's treating chiropractor Dr. Fisher do not contain evidence that applicant's injury was industrial in nature. (Ibid.)
Applicant's inconsistent testimony regarding the date of injury and treatment, and inability to recall significant details on cross-examination
From the decision · page 3The WCJ's Report states that the WCJ did not find applicant's testimony to be credible, that while applicant's testimony on direct examination was clear and concise, applicant was unable to recall many significant details on cross-examination. (Report, at p. 3.) The WCJ further notes that even were the date of injury conformed to applicant's testimony, it would not reconcile the multi-day gap between applicant's last day worked and when he first obtained chiropractic treatment with Dr. Fisher. Because applicant's testimony was not credible, and because conforming the date of injury to proof would not otherwise remediate the contradictions in the evidentiary record, the WCJ recommends we deny reconsideration. (Id. at p. 5.)
Payroll records showing applicant's last day worked was February 8, 2019, inconsistent with claimed injury and treatment dates
From the decision · page 3Defendant's Answer observes that per payroll records and witness testimony, the last day applicant worked for the defendant was February 8, 2019, and that the earliest evidence that applicant sought medical treatment reflects a date of February 14, 2019, which is inconsistent with applicant's testimony that he sought medical treatment the day following his injury. (Answer, at p. 5:16.) Defendant also observes that the records of applicant's treating chiropractor Dr. Fisher do not contain evidence that applicant's injury was industrial in nature. (Ibid.)
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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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