ADJ15874650 — California WCAB decision

What the panel ordered

The WCAB rescinded the WCJ's Amended Findings and Order and found that applicant sustained industrial injury in the form of COVID-19; other issues deferred and matter returned for further proceedings.

Applicant sought reconsideration of the WCJ's Amended Findings and Order issued August 16, 2023, which denied industrial causation of COVID-19 infection; the WCAB granted reconsideration and rescinded the WCJ's order.

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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/COEApplicant prevailedrespiratory system · psyche

The WCAB found substantial medical evidence from PQME Dr. Greenberg supporting industrial causation, and applicant's uncontradicted testimony about workplace exposure to COVID-19 co-workers was accepted as true, establishing injury AOE/COE.

From the decision · page 6On June 29, 2022, Panel Qualified Medical Evaluator (PQME) Andrew McClintock Greenberg, M.D., Ph.D., performed a physical examination of applicant, took a detailed history, reviewed applicant's deposition transcript, and reviewed medical records and numerous radiology reports. (Exhibit J1, Report of PQME Dr. Greenberg, dated June 29, 2022, pp. 2-7, 7-24 (hereafter Exhibit J1, June 29, 2022 report).

The rules the panel named

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

Lab. Code, 3600.1

An injury must arise out of and occur in the course of employment (AOE/COE). The employee bears the burden of proving injury AOE/COE by a preponderance of the evidence.

Applied to determine compensability of COVID-19 infection.

From the decision · page 8To be compensable, an injury must arise out of and occur in the course of employment (AOE/COE). (Lab. Code, § 3600.1) 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.) 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].)

McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408

Medical evidence that industrial causation was reasonably probable constitutes substantial evidence for a finding of injury AOE/COE.

Applied to evaluate medical evidence of industrial causation.

From the decision · page 8To be compensable, an injury must arise out of and occur in the course of employment (AOE/COE). (Lab. Code, § 3600.1) 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.) 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].)

E.L. Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922

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

Applied to assess the quality of medical opinion evidence.

From the decision · page 8Turning to whether there is substantial medical evidence of industrial causation, 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. (E.L. Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 928 [71 Cal.Comp.Cases 1687]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604 (Appeals Bd. en banc).)

ADJ15874650 · October 31, 2023

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

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The rules the panel named

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