What the panel ordered
The WCAB rescinded the September 13, 2022 Findings and Order and substituted a new order finding compensable cumulative injury AOE/COE to cervical spine, lumbar spine, bilateral shoulders, and bilateral wrists, and that the claim is not barred by Labor Code section 3600(a)(10); all other issues were deferred.p. 10
Applicant sought reconsideration of the September 13, 2022 Findings and Order by the WCJ, which denied compensability of cumulative injury; the WCJ retired without issuing a Report and Recommendation, so the WCAB reviewed the record and issued a new decision after reconsideration.
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.
The WCAB found Dr. Lockwood’s opinions to be well-reasoned, based on comprehensive physical exams and extensive medical records review, constituting substantial medical evidence supporting injury AOE/COE. Applicant’s claim was found compensable for the cervical spine, lumbar spine, bilateral shoulders, and bilateral wrists.
From the decision · page 7(Rodarte) (2004) 119 Cal.App.4th 998 [69 Cal.Comp.Cases 579].) Moreover, based on our review of the evidentiary record, including the PQME reports of Dr. Lockwood, we observe that Dr. Lockwood’s opinions are grounded not only in the reported history of the injury, but also comprehensive physical examinations of applicant, and thorough review of extensive medical records, numbering more than 2,500 pages. Ultimately, even after review of records pertaining to applicant’s prior injuries with Earthbound Farms, Dr. Lockwood continued to find injury AOE/COE. Defendant contends that Dr. Lockwood relied primarily upon applicant’s inaccurate depiction of her job duties, but in his March 19, 2022 report, Dr. Lockwood noted review of applicant’s actual job description. (Exhibit A1, p. 2.) Thus, despite being given the opportunity to reverse his opinions, he continually opted to find injury. Ultimately, in reviewing Dr. Lockwood’s reports, we find his opinions to be well-reasoned and not based upon surmise, speculation, conjecture, or guess. We thus conclude that Dr. Lockwood’s opinions constitute substantial medical evidence on the issue of injury AOE/COE to the cervical spine, lumbar spine, bilateral shoulders, and bilateral wrists. We also find, for the
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Lockwood reviewed over 2,500 pages of medical records and conducted comprehensive physical examinations.
Favours Applicant prevailed
This thorough review and examination provided a solid factual basis for his well-reasoned opinions supporting injury AOE/COE.
From the decision · page 7(Rodarte) (2004) 119 Cal.App.4th 998 [69 Cal.Comp.Cases 579].) Moreover, based on our review of the evidentiary record, including the PQME reports of Dr. Lockwood, we observe that Dr. Lockwood’s opinions are grounded not only in the reported history of the injury, but also comprehensive physical examinations of applicant, and thorough review of extensive medical records, numbering more than 2,500 pages. Ultimately, even after review of records pertaining to applicant’s prior injuries with Earthbound Farms, Dr. Lockwood continued to find injury AOE/COE. Defendant contends that Dr. Lockwood relied primarily upon applicant’s inaccurate depiction of her job duties, but in his March 19, 2022 report, Dr. Lockwood noted review of applicant’s actual job description. (Exhibit A1, p. 2.) Thus, despite being given the opportunity to reverse his opinions, he continually opted to find injury. Ultimately, in reviewing Dr. Lockwood’s reports, we find his opinions to be well-reasoned and not based upon surmise, speculation, conjecture, or guess. We thus conclude that Dr. Lockwood’s opinions constitute substantial medical evidence on the issue of injury AOE/COE to the cervical spine, lumbar spine, bilateral shoulders, and bilateral wrists. We also find, for the
Applicant did not have knowledge that her disability was work-related until after her layoff on April 3, 2020, as she was first informed by Dr. Lockwood.
Favours Applicant prevailed
This fact supported the finding that the claim was not barred by Labor Code section 3600(a)(10).
From the decision · page 9Lockwood was the first physician to apprise her that she had a new cumulative injury due to her employment at Cintas, and he was the first doctor to give her work restrictions due to this injury. (MOH, p. 4: 19-21.) In light of the foregoing, we conclude that applicant did not have knowledge of her disability, for the purposes of section 5412, until after her April 3, 2020 layoff, nor prior to the date of her examination with Dr. Lockwood on July 2, 2020. Moreover, as noted by the WCJ in his OOD, applicant did not stop working due to her claimed injury, but because of the layoff. While Dr. Lockwood opined that applicant was temporarily disabled at the time that she stopped working,
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.
Diagnosed cervical spine, lumbar spine, bilateral shoulder, and bilateral wrist sprains; opined new cumulative work injury; found injury AOE/COE after reviewing over 2,500 pages of records and conducting physical exams; recommended work restrictions; extended temporary disability retroactively from April 4, 2020 to December 29, 2020.
Dr. Lockwood’s opinions were found well-reasoned, based on thorough record review and physical exams, and constituted substantial medical evidence supporting injury AOE/COE.
From the decision · page 2On September 17, 2020, applicant filed an Application for Adjudication of Claim (Application) alleging that while employed by defendant as a catalogue administrator during the period ending on April 3, 2020, she sustained a cumulative injury AOE/COE to the neck, back, bilateral shoulders, bilateral arms, bilateral wrists, and bilateral hands. Previously, on April 27, 2020, defendant issued a notice of denial of claim, based upon the affirmative defense of the filing a claim post-termination or layoff as set forth in section 3600(a)(10). The parties proceeded with discovery and retained Dr. Lockwood as the chiropractic PQME. Dr. Lockwood initially evaluated applicant on July 2, 2020, and issued medical reports dated August 1, 2020, October 26, 2020, January 27, 2021, May 12, 2021, August 16, 2021, and March 19, 2022. Dr. Lockwood was also deposed on December 6, 2021. (Exhibits A1-A7.) In his August 1, 2020 report, Dr. Lockwood noted by way of history that applicant had a January 28, 2010 specific injury and a prior cumulative injury with applicant’s previous employer, Earthbound Farms. (Exhibit A6, p.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 3202.5
Preponderance of the evidence to establish industrial causation for injury AOE/COE.
Applicant must show employment was a contributing cause of injury.
From the decision · page 6AOE/COE. It is well established that when an employee claims injury AOE/COE, it is the employee who carries the burden of proof in establishing industrial causation and they must show that employment was a contributing cause. (South Coast Framing v. Workers’ Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297- 298, 302; §§ 5705; 3600.) Pursuant to section 3202.5, the evidentiary burden of proof is to be met by a preponderance of the evidence. However, “[t]hat 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].) Substantial medical evidence is used to establish industrial causation. “The term ‘substantial evidence’ means evidence which, if true, has probative force on the issues.
Braewood Convalescent Hospital v. Workers’ Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159
Substantial medical evidence must be reasonable, credible, and of solid value to support injury AOE/COE.
Medical opinion must be based on adequate facts and reasoning to be substantial evidence.
From the decision · page 6It is more than a mere scintilla, and means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion…It must be reasonable in nature, credible, and of solid value.” (Braewood Convalescent Hospital v. Workers’ Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, 164 [48 Cal.Comp.Cases 566], emphasis removed and citations omitted.) Pursuant to E.L. Yeager v. Workers’ Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th922, 928 [71 Cal.Comp.Cases 1687], “[a] medical opinion is not substantial evidence if it is based on facts no longer germane, on inadequate medical histories or examinations, on incorrect legal theories, or on surmise, speculation, conjecture, or guess.
What proof carried it
The evidence the panel weighed, by kind.
Applicant’s testimony about job duties and injury symptoms, though initially found not credible by WCJ, was considered in light of medical evidence and Dr. Lockwood’s thorough review.
From the decision · page 7(Rodarte) (2004) 119 Cal.App.4th 998 [69 Cal.Comp.Cases 579].) Moreover, based on our review of the evidentiary record, including the PQME reports of Dr. Lockwood, we observe that Dr. Lockwood’s opinions are grounded not only in the reported history of the injury, but also comprehensive physical examinations of applicant, and thorough review of extensive medical records, numbering more than 2,500 pages. Ultimately, even after review of records pertaining to applicant’s prior injuries with Earthbound Farms, Dr. Lockwood continued to find injury AOE/COE. Defendant contends that Dr. Lockwood relied primarily upon applicant’s inaccurate depiction of her job duties, but in his March 19, 2022 report, Dr. Lockwood noted review of applicant’s actual job description. (Exhibit A1, p. 2.) Thus, despite being given the opportunity to reverse his opinions, he continually opted to find injury. Ultimately, in reviewing Dr. Lockwood’s reports, we find his opinions to be well-reasoned and not based upon surmise, speculation, conjecture, or guess. We thus conclude that Dr. Lockwood’s opinions constitute substantial medical evidence on the issue of injury AOE/COE to the cervical spine, lumbar spine, bilateral shoulders, and bilateral wrists. We also find, for the
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