ADJ10630875 — California WCAB decision

ADJ10630875 · September 13, 2024

Petitions for Reconsideration of the Joint Findings and Award issued on April 2, 2024 were denied, affirming the WCJ's findings except amending the Labor Code section 5412 date of injury in case ADJ15700993 to November 2, 2016.

Issues decided

Medical opinions weighed

Authorities named

District office

Anaheim

What the panel ordered

Petitions for Reconsideration filed by Defendants Travelers Indemnity Company and Ace American Insurance Company were denied by the Appeals Board on September 13, 2024, affirming the WCJ's findings and prior Board decision dated June 17, 2024.

Read the official decision →

This docket was decided more than once. Shown here is the latest released decision; we also hold June 17, 2024.

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 prevailedleft shoulder · right elbow · lumbar spine · cervical spine · both knees · both ankles

The Board affirmed the WCJ's findings that the applicant sustained injury to multiple body parts during employment periods with the St. Louis Cardinals, Pittsburgh Pirates, and Cincinnati Reds, supported by medical evidence and testimony.

From the decision · page 1Defendants Travelers Indemnity Company and Ace American Insurance Company seek reconsideration of our Opinion and Order Granting Petitions for Reconsideration and Decision After Reconsideration issued on June 17, 2024, wherein we affirmed the workers' compensation administrative law judge's (WCJ) findings in relevant part that (1) applicant sustained injury to his left shoulder, right elbow, lumbar and cervical spine, both knees and both ankles arising out of and in the course of employment (AOE/COE) during the periods of February 1, 1999 through May 2, 2004, while employed by the St.

The facts that decided it

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

Applicant sustained injury to multiple body parts during employment periods with the St. Louis Cardinals, Pittsburgh Pirates, and Cincinnati Reds.

Favours Applicant prevailed

This fact supports the Board's finding of compensable injury arising out of and in the course of employment.

From the decision · page 1Defendants Travelers Indemnity Company and Ace American Insurance Company seek reconsideration of our Opinion and Order Granting Petitions for Reconsideration and Decision After Reconsideration issued on June 17, 2024, wherein we affirmed the workers' compensation administrative law judge's (WCJ) findings in relevant part that (1) applicant sustained injury to his left shoulder, right elbow, lumbar and cervical spine, both knees and both ankles arising out of and in the course of employment (AOE/COE) during the periods of February 1, 1999 through May 2, 2004, while employed by the St.

Applicant was temporarily partially disabled from November 1, 2010 through June 13, 2012 and temporarily totally disabled from December 22, 2005 through January 1, 2007.

Favours Applicant prevailed

This fact supports the Board's award of temporary disability benefits for these periods.

Permanent disability ratings of 40% and 20% were assigned for the respective cases based on medical evidence.

Favours Applicant prevailed

This fact supports the Board's award of permanent disability benefits.

Applicant filed his claim in 2016 after becoming aware of his injury, making the claim timely and not barred by the statute of limitations.

Favours Applicant prevailed

This fact supports the Board's finding that the claim was timely filed and not barred by limitations.

From the decision · page 8The Applicant credibly testified that he became aware that he could file a workers' compensation claim in California in 2016. The Application was filed in 2016. Therefore, the claims are not barred by the Statute of Limitations.

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.

PTPRelied upon

Dr. Wood's reports were framed in terms of reasonable medical probability, based on pertinent facts and adequate examination and history, supporting the injury period ending May 2, 2004.

The Board found no error in the WCJ's reliance on Dr. Wood's reports as substantial evidence.

From the decision · page 14Here, as stated in the Report on Travelers' Petition, although applicant's history of exposure is complicated, Dr. Wood's finding as to the first period of exposure is consistent with the medical record. (Report on Travelers' Petiiton, pp. 3-4.) Accordingly, we are unable to discern error in the WCJ's setting the end date of injurious exposure in case number ADJ15700993 as May 2, 2004.

PTPRelied upon

Dr. Wood found two separate cumulative trauma injuries with periods of temporary disability and return to work, supported by medical records and applicant's testimony.

Dr. Wood's reports and deposition were found to be substantial evidence supporting the injury findings and dates.

From the decision · page 8Based upon Dr. Wood's reporting, deposition transcript and a review of the record which includes the applicant's testimony, it is found that the applicant sustained two (2) separate cumulative trauma injuries. The applicant had a period where he was injured on a cumulative trauma basis, went off work, sustained a period of temporary disability, required medical treatment and then returned to his usual and customary duties. There is not one cumulative trauma injury as claimed by the applicant as there was a period between 2006 and 2008 where he did not play professional baseball and stopped work due to his injury and then recovered sufficiently to return to professional baseball. Likewise, there was not only one continuous trauma period as claimed by defendants from February 5, 2008 through November 1, 2010, although this does appear to be the time period for the second continuous trauma. This is similar to a Western Growers situation. This is supported as stated above by the medical record and the applicant's testimony.

The rules the panel named

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

California Labor Code section 5412

Labor Code section 5412 - Date of injury for cumulative trauma injury

The Board applied this standard to determine the date of injury and to affirm the injury findings.

From the decision · page 10Labor Code Section 5412 states that the date of injury for a cumulative trauma injury is the date upon which the employee first suffered disability therefrom and either knew, or in the exercise of reasonable diligence should have known that such disability was caused by his present or prior employment. The applicant did have disability in 2004. Respectfully, the applicant not having wage loss does not preclude that he would have had compensable permanent disability at the time of the surgery and during his recovery. He was paid wages pursuant to a contract, not wages for actually being able to perform his work duties during the recovery period. While he attempted to perform some duties in training, he was not able to return to his usual and customary duties. He had significant work restrictions and trying to perform those duties appear to have aggravated his condition leading to another surgery. Labor Code Section 5412 is in fact satisfied by the facts in this case. Labor Code Section 3208.1 notes that an injury may either be specific or a continuous trauma injury. A continuous trauma injury is defined as occurring due to repetitive traumatic activities over a period of time, the combined effect of which causes any disability or need for medical treatment.

California Labor Code section 5909

Labor Code section 5909 - Petition for reconsideration time limit

The Board applied this standard to deny successive petitions for reconsideration as untimely.

From the decision · page 2We received Answers from applicant. We have reviewed the contents of the Petitions and the Answers. Based upon our review of the record, and for the reasons stated below and in the June 17, 2024 Opinion and Order Granting Petitions for Reconsideration and Decision After Reconsideration, which we adopt and incorporate herein, we will deny the Petitions for Reconsideration. Former Labor Code section 5909 provided that a petition for reconsideration was deemed denied unless the Appeals Board acted on the petition within 60 days from the date of filing. (Lab. Code, § 5909.) Effective July 2, 2024, Labor Code section 5909 was amended to state in relevant part that: (a) A petition for reconsideration is deemed to have been denied by the appeals board unless it is acted upon within 60 days from the date a trial judge transmits a case to the appeals board.

California Labor Code section 5405

Labor Code section 5405 - Time limit for commencing proceedings for benefits

The Board applied this standard to find the claim timely filed within one year of injury knowledge.

From the decision · page 18The period within which proceedings may be commenced for the collection of the benefits provided by Article 2 (commencing with Section 4600) or Article 3 (commencing with Section 4650), or both, of Chapter 2 of Part 2 is one year from any of the following: (a) The date of injury.... (Lab. Code § 5405.)

What proof carried it

The evidence the panel weighed, by kind.

Testimony and credibilityfavours Applicant prevailed

Applicant's credible testimony regarding contract execution and residence in California during off-season

From the decision · page 11The Applicant credibly testified to having his contract forwarded to him in California and that he signed the contract in California. Petitioner asserts that the applicant was not credible in his testimony. Per Garza v. WCAB (1970) 35 CCC 500 the determination of credibility lies with the trier of fact. the applicant credibly testified that he had his mail forwarded, that in the off season he was generally at his father's house in California. At the time when the Reds first offered a contract (MOH, SOE January 11, 2024 page 5, lines 15 through 17) the Applicant was in Sacramento when he accepted the offer and signed in Long Beach at his father's home. While the contract may have been sent to Tennessee initially, the contract was then forwarded to California where the Applicant was with family and executed in California. Petitioner has no expectation of where the contract will be executed for their professional players as they mail the contracts all over the country and it is not unexpected that the Applicant may sign his contract in the state where he grew up, resides during the off season, and ultimately returned to after he could no longer play. It seems inaccurate to state that the Applicant "carried his contract across California's state line to vest California with jurisdiction.

Medical recordsfavours Applicant prevailed

Medical records and applicant's testimony supporting two separate cumulative trauma injuries and periods of disability

From the decision · page 8Based upon Dr. Wood's reporting, deposition transcript and a review of the record which includes the applicant's testimony, it is found that the applicant sustained two (2) separate cumulative trauma injuries. The applicant had a period where he was injured on a cumulative trauma basis, went off work, sustained a period of temporary disability, required medical treatment and then returned to his usual and customary duties. There is not one cumulative trauma injury as claimed by the applicant as there was a period between 2006 and 2008 where he did not play professional baseball and stopped work due to his injury and then recovered sufficiently to return to professional baseball. Likewise, there was not only one continuous trauma period as claimed by defendants from February 5, 2008 through November 1, 2010, although this does appear to be the time period for the second continuous trauma. This is similar to a Western Growers situation. This is supported as stated above by the medical record and the applicant's testimony.

ADJ10630875 · September 13, 2024

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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