ADJ15495990 — California WCAB decision

What the panel ordered

Petition for reconsideration denied, Findings and Order affirmed.

Applicant seeks reconsideration of the Findings and Order issued by the WCJ on April 4, 2024, which found no compensable cumulative trauma injury and ordered that applicant take nothing.

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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.

AOE/COEDefendant prevailedhead · back · neck

The WCJ and WCAB found that the medical opinions of AME Dr. Stark and AME Dr. Gupta were substantial evidence supporting no compensable cumulative trauma injury arising out of employment. Applicant failed to provide credible evidence to rebut these opinions.

From the decision · page 1Applicant seeks reconsideration of the Findings and Order (F&O), issued by the workers' compensation administrative law judge (WCJ) on April 4, 2024, wherein the WCJ found in pertinent part that during the period ending April 23, 2021, applicant did not sustain a cumulative trauma injury arising out of and in the course of employment (AOE/COE) to the head (in the form of headaches), the back, or to the neck, and thus ordered that applicant take nothing.

The facts that decided it

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Bd. en banc)

To be substantial evidence, a medical opinion must be well-reasoned, based on an adequate history and examination, and disclose a solid underlying basis for the opinion.

The WCJ and WCAB applied this standard to evaluate the AME reports and found them substantial evidence.

From the decision · page 1To be substantial evidence, a medical opinion must be well-reasoned, based on an adequate history and examination, and it must disclose a solid underlying basis for the opinion. (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Bd. en banc); see also E.L. Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 928 [71 Cal.Comp.Cases 1687].) A medical report must also set forth the reasoning behind the physician's

Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162 [36 Cal.Comp.Cases 93]

A medical report must set forth the reasoning behind the physician's opinion and not merely conclusions to be substantial evidence.

The WCJ and WCAB applied this standard to the AME reports, finding the reasoning sufficient to constitute substantial evidence.

From the decision · page 2opinion and not merely their conclusions in order to be substantial evidence. (Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162 [36 Cal.Comp.Cases 93]; Granado v. Workmen's Comp. Appeals Bd. (1970) 69 Cal.2d 399 [33 Cal.Comp.Cases 647]; Escobedo, supra.)

Labor Code, Section 3600

The employment must be a substantial contributing cause of the injury for compensability under Labor Code Section 3600.

The WCJ and WCAB applied this standard to determine that the applicant did not sustain an injury arising out of employment.

From the decision · page 4The basic California statutory requirement is that to be compensable, an injury must arise out of and in the course of the employment (See Labor Code, Section 3600). The phrase "arising out of employment" is the causal element and refers to the origin of the accident. That is, the employment must be said to be the cause of the injury. For an injury to "arise out of" the employment, it must occur by reason of a condition or incident of the employment. That is, the employment and the injury must be linked in some causal fashion. This has been referred to as proximate cause and

ADJ15495990 · June 24, 2024

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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What the panel did with the medical opinions

The rules the panel named

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