ADJ13410693 — California WCAB decision

ADJ13410693 · November 21, 2023

The WCAB affirmed the WCJ's Findings of Fact that applicant sustained industrial injury to his psyche in the form of PTSD during the period February 12, 2017 through July 15, 2020, under the presumption of Labor Code section 3212.15, rejecting defendant's contentions regarding the inapplicability of the presumption and the predominant cause requirement.

Issues decided

Medical opinions weighed

Authorities named

District office

Oxnard

What the panel ordered

Defendant filed a timely petition for reconsideration of the WCJ's decision; the WCAB granted reconsideration and issued a Decision After Reconsideration affirming the WCJ's Findings of Fact of June 22, 2021.

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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.

Psyche AOE/COEApplicant prevailedpsyche

The WCAB found the presumption of industrial PTSD under Labor Code section 3212.15 applicable and not rebutted, and that the predominant cause requirement of Labor Code section 3208.3 does not apply to the presumption, affirming the WCJ's finding of injury during the period 2/12/2017 to 7/15/2020.

From the decision · page 1In the Findings of Fact of June 22, 2021, the workers' compensation administrative law judge ("WCJ") found that during the period February 12, 2017 through July 15, 2020, applicant, while employed as a District Attorney Investigator by the County of Ventura, sustained industrial injury to his psyche in the form of post-traumatic stress disorder ("PTSD").

The rules the panel named

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

Labor Code section 3212.15

Presumption of industrial injury for PTSD under Labor Code section 3212.15

The presumption applies when PTSD is diagnosed and manifests during employment with a covered employer; it is disputable but binding unless controverted.

From the decision · page 4Labor Code section 3212.15(b), as relevant here, states: "[...] [T]he term "injury," as used in this division, includes "post-traumatic stress disorder," as diagnosed according to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association and that develops or manifests itself during a period in which any [employee covered by the statute] is in the service of the [employer covered by the statute]." Subdivision (c)(2) then states in relevant part, "[f]or an injury that is diagnosed as specified in subdivision (b): [...] (2) The injury so developing or manifesting itself in these cases shall be presumed to arise out of and in the course of the employment. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the appeals board is bound to find in accordance with the presumption. [...]" Thus, under section 3212.15(b) and (c), a "disputable" presumption of industrial injury arises where (1) there is a professional diagnosis of PTSD; and (2) the PTSD "develops or manifests itself" during a period in which an employee covered by the statute is in the service of an employer covered by the statute. (Here there is no dispute that applicant and defendant are

Labor Code section 3208.3

Predominant cause requirement under Labor Code section 3208.3(b)(1)

Requires work-related cause to be greater than 50% of all causes combined for compensability; not applicable to the presumption under section 3212.15.

From the decision · page 4Defendant further contends that notwithstanding the presumption of industrial PTSD provided by Labor Code section 3212.15, the long-standing predominant cause requirement of Labor Code section 3208.3(b)(1) remains applicable. Defendant alleges that since Dr. Spencer found applicant's PTSD only 20% caused by his employment by the County of Ventura, the predominant cause standard is not met. (Petition for Reconsideration, p. 8:25-9:5.)

Labor Code section 5412

Date of injury determination under Labor Code section 5412

Date of injury for cumulative trauma is when employee first suffers disability and knows or should know it is work-related.

From the decision · page 3In this case, applicant claims he suffered a cumulative trauma of PTSD from February 12, 2017 through July 15, 2020, while employed by a single employer, the County of Ventura. This means the date of applicant's cumulative trauma injury is properly determined pursuant to Labor Code section 5412, not section 5500.5(a). The reason is that Labor Code section 3208.1(b) defines a cumulative injury as "repetitive mentally or physically traumatic activities extending over a period of time, the combined effect of which causes any disability or need for medical treatment," while section 3208.1 also states that the "[t]he date of a cumulative injury shall be the date determined under Section 5412." Pursuant to section 3208.1, the date of injury is correctly determined by reference to section 5412, regardless of whether or not the Statute of Limitations has been raised as an affirmative defense.

ADJ13410693 · November 21, 2023

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