ADJ10518881 — California WCAB decision

What the panel ordered

Findings and Awards issued December 17, 2024 are affirmed except amended to defer permanent disability impairment rating and psychiatric injury issues.

Applicant sought reconsideration of the Findings and Awards issued on December 17, 2024 by a WCJ, challenging the PD rating and exclusion of psychiatric component; WCJ recommended denial; WCAB granted reconsideration and amended findings and awards to defer PD rating and psychiatric injury issues.

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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.

Permanent disability ratingRemandedhead · neck · low back · left hip · left knee · left shoulder · psyche

The WCJ's original findings on PD rating and psychiatric component exclusion lacked sufficient evidentiary and legal basis, including reliance on inadmissible DEU consultative rating and failure to properly assess catastrophic injury criteria, necessitating deferral of these issues for further consideration.

From the decision · page 3Applicant raises issues as to the WCJ's findings of fact as to the PD rating and the exclusion of any psychiatric component pursuant to Labor Code2 section 4660.1, subdivision (c)(1) (section 4660.1(c)(1)), and thus, the award of PD. However, neither the WCJ's Opinion on Decision nor Report3 is sufficient to make the right of reconsideration meaningful on these issues.

The facts that decided it

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

WCJ relied on inadmissible DEU consultative rating for 40% PD rating.

Favours Applicant prevailed

This reliance invalidated the PD rating and required rescission and deferral of the issue.

From the decision · page 5In addition, the WCJ admitted that he relied on a consultative rating determination from the Disability Evaluation Unit (DEU) of the Division of Worker's Compensation, which coincidentally found a 40% PD rating based on "[t]hose reports" of PQME Dr. Chang.4 It may be that applicant submitted a DEU consultative rating determination as evidence at trial without any objection from defendant's counsel; however, the WCJ should know that "Consultative Rating Determinations will not be admissible in judicial proceedings." (Cal. Code Regs., tit. 8, § 10166(b).) Therefore, pursuant to WCAB Rule 10166(b), the DEU consultative rating should never have come into evidence, and therefore, the WCJ's finding of fact of 40% PD based in part on this inadmissible evidence must be rescinded. (Hamilton, supra, 66 Cal.Comp.Cases at p. 476 [a WCJ's decision must be based on admissible evidence].)

WCJ failed to provide sufficient findings and legal basis for excluding psychiatric component and for catastrophic injury determination.

Favours Applicant prevailed

Lack of findings and legal reasoning made reconsideration meaningful and proper adjudication impossible.

From the decision · page 4Therefore, neither the WCJ's Opinion on Decision nor the Report complies with section 5313 and we cannot ascertain either the evidentiary or legal basis for the WCJ's legal conclusions related to the PD rating or the psychiatric injury.

PQME Dr. Chang's reports were inconsistent and lacked sufficient evaluation to support PD rating.

Favours Applicant prevailed

Inadequate medical evidence undermined the WCJ's PD rating and psychiatric exclusion.

From the decision · page 7We note that the serial permanent and stationary reports of PQME Dr. Chang appear to be inconsistent and lacking in their assessment and evaluation of applicant pursuant to Blackledge. For example, Dr. Chang's mere conclusion that applicant's low back impairment is no greater than

The rules the panel named

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

Labor Code section 4660.1(c)(1)

Labor Code section 4660.1(c)(1) regarding psychiatric component in PD rating

The WCJ's exclusion of psychiatric component was challenged and found insufficiently supported.

From the decision · page 3Applicant raises issues as to the WCJ's findings of fact as to the PD rating and the exclusion of any psychiatric component pursuant to Labor Code2 section 4660.1, subdivision (c)(1) (section 4660.1(c)(1)), and thus, the award of PD. However, neither the WCJ's Opinion on Decision nor Report3 is sufficient to make the right of reconsideration meaningful on these issues.

Labor Code section 5313

Labor Code section 5313 requiring WCJ to provide findings and reasons based on evidence

The WCJ's opinion on decision did not comply with section 5313 requirements for evidentiary and legal basis.

From the decision · page 4Section 5313 requires that after a matter is submitted, and together with findings of fact, orders, and/or awards, a WCJ "shall" serve "a summary of the evidence received and relied upon and the reasons or grounds upon which the determination was made." (Lab. Code, § 5313; see also Blackledge v. Bank of America, ACE American Insurance Company (Blackledge) (2010) 75 Cal.Comp.Cases 613, 621-22 (Appeals Bd. en banc).) This opinion on decision must be based on admitted evidence (Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Bd. en banc) (Hamilton)), and must be supported by substantial evidence. (Lab. Code, § 5903, 5952 (d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500] (Garza); Le Vesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) The WCJ's opinion on decision "enables the parties, and the Board if reconsideration is sought, to ascertain the basis for the decision, and makes the right of seeking reconsideration more meaningful." (Hamilton, supra, 66 Cal.Comp.Cases at p. 476, citing Evans v. Workmen's Comp. Appeals Bd. (1968) 68 Cal.2d 753, 755 [33 Cal.Comp.Cases 350, 351].)

Blackledge v. Bank of America, ACE American Insurance Company (2010) 75 Cal.Comp.Cases 613

The WCJ's reliance on inadmissible DEU consultative rating was improper under Blackledge.

From the decision · page 5In addition, the WCJ admitted that he relied on a consultative rating determination from the Disability Evaluation Unit (DEU) of the Division of Worker's Compensation, which coincidentally found a 40% PD rating based on "[t]hose reports" of PQME Dr. Chang.4 It may be that applicant submitted a DEU consultative rating determination as evidence at trial without any objection from defendant's counsel; however, the WCJ should know that "Consultative Rating Determinations will not be admissible in judicial proceedings." (Cal. Code Regs., tit. 8, § 10166(b).) Therefore, pursuant to WCAB Rule 10166(b), the DEU consultative rating should never have come into evidence, and therefore, the WCJ's finding of fact of 40% PD based in part on this inadmissible evidence must be rescinded. (Hamilton, supra, 66 Cal.Comp.Cases at p. 476 [a WCJ's decision must be based on admissible evidence].)

Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473

The WCJ's decision must be based on admissible evidence and provide sufficient findings.

From the decision · page 4Section 5313 requires that after a matter is submitted, and together with findings of fact, orders, and/or awards, a WCJ "shall" serve "a summary of the evidence received and relied upon and the reasons or grounds upon which the determination was made." (Lab. Code, § 5313; see also Blackledge v. Bank of America, ACE American Insurance Company (Blackledge) (2010) 75 Cal.Comp.Cases 613, 621-22 (Appeals Bd. en banc).) This opinion on decision must be based on admitted evidence (Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Bd. en banc) (Hamilton)), and must be supported by substantial evidence. (Lab. Code, § 5903, 5952 (d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500] (Garza); Le Vesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) The WCJ's opinion on decision "enables the parties, and the Board if reconsideration is sought, to ascertain the basis for the decision, and makes the right of seeking reconsideration more meaningful." (Hamilton, supra, 66 Cal.Comp.Cases at p. 476, citing Evans v. Workmen's Comp. Appeals Bd. (1968) 68 Cal.2d 753, 755 [33 Cal.Comp.Cases 350, 351].)

Wilson v. State Cal Fire (2019) 84 Cal.Comp.Cases 393

Applicant has burden to prove psychiatric injury causation; WCJ failed to make findings on direct or compensable consequence of orthopedic injuries.

Psychiatric injury rating increases allowed if injury arises directly from employment events; WCJ did not properly assess catastrophic injury criteria.

ADJ10518881 · March 17, 2025

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