ADJ19474979 · October 16, 2026

The WCJ and WCAB found that the applicant did not meet the burden to prove her psychiatric injury was predominantly caused by employment events, relying on the substantial medical evidence of AME Dr. Piciucco who opined only 40% industrial causation, below the required 51%. Applicant's contrary medical evidence was not substantial. The good faith personnel action defense was not reached due to lack of predominant causation.

From the decision · page 3Applicant seeks reconsideration of the Findings and Order (F&O), issued by the workers’ compensation administrative law judge (WCJ) on July 15, 2026, wherein the WCJ found in part that applicant did not meet her burden to prove that her injury was a compensable psychiatric industrially related injury. 1 0F

Dr. Piciucco opined only 40% of psychiatric injury was caused by employment events, below the 51% threshold for compensability.

Favours Defendant prevailed

This finding meant the applicant did not meet the burden to prove compensable psychiatric injury, leading to denial of the petition.

From the decision · page 4BACKGROUND We will briefly review the relevant facts. Applicant claimed injury to psyche while employed by defendant as a customer service representative, during the period from June 18, 2009 to March 1, 2024. On July 9, 2025, Dr. Piciucco reevaluated applicant. (Joint Exhibit Y.) On Axis I, applicant was diagnosed with 1) Rule out delusional disorder, persecutory type; 2) Depressive disorder, unspecified; and 3) Anxiety disorder, unspecified. (Id. at p. 2.) On Axis II, applicant was diagnosed with paranoid personality disorder. (Id.) Concerning causation, Dr. Piciucco opined: It is my opinion with reasonable medical probability that the applicant’s psychiatric disturbances, as outlined, are not predominantly caused by the consequences of alleged suffered employment distress as detailed within the description of injury sections. It is my opinion with reasonable medical probability that the applicant’s psychiatric disturbances are predominantly caused by her pre-existing nonindustrial paranoid personality disorder which has led to her perception of having been chronically maltreated, retaliated against, harmed, and exploited during the course of several years of employment.

Applicant's psychiatric disturbances predominantly caused (60%) by nonindustrial paranoid personality disorder; 40% caused by employment events; personnel actions constituted a substantial cause (35-40%) but legality deferred to trier of fact; applicant permanent and stationary as of 7/9/2025; no apportionment indicated due to lack of predominant industrial causation.

Dr. Piciucco's reports were found substantial medical evidence and persuasive by the WCJ and WCAB, framing opinions in reasonable medical probability and based on adequate examination and history.

From the decision · page 4BACKGROUND We will briefly review the relevant facts. Applicant claimed injury to psyche while employed by defendant as a customer service representative, during the period from June 18, 2009 to March 1, 2024. On July 9, 2025, Dr. Piciucco reevaluated applicant. (Joint Exhibit Y.) On Axis I, applicant was diagnosed with 1) Rule out delusional disorder, persecutory type; 2) Depressive disorder, unspecified; and 3) Anxiety disorder, unspecified. (Id. at p. 2.) On Axis II, applicant was diagnosed with paranoid personality disorder. (Id.) Concerning causation, Dr. Piciucco opined: It is my opinion with reasonable medical probability that the applicant’s psychiatric disturbances, as outlined, are not predominantly caused by the consequences of alleged suffered employment distress as detailed within the description of injury sections. It is my opinion with reasonable medical probability that the applicant’s psychiatric disturbances are predominantly caused by her pre-existing nonindustrial paranoid personality disorder which has led to her perception of having been chronically maltreated, retaliated against, harmed, and exploited during the course of several years of employment.

Opined injury met AOE/COE standards but did not review medical records; report not substantial medical evidence.

Report not substantial medical evidence due to lack of medical records review; outweighed by Dr. Piciucco's reports.

From the decision · page 7Applicant submitted reporting from Dr. Ferguson who opined that injury met the AOE/COE standards however Dr. Ferguson did not review any medical records. [Applicant’s Exhibit 9.] The reporting was not substantial medical evidence and Dr. Piciucco’s reporting was more persuasive. Although applicant did submit medical reporting which showed evidence of some industrial stressors, there was no substantial medical evidence that her psychiatric injury was predominantly caused by her employment. Applicant’s psychiatric injury is therefore found to be nonindustrial in nature.

Power v. Workers’ Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114]

The Appeals Board will follow the opinions of the AME unless good cause exists to find the opinion unpersuasive.

Applied to give weight to Dr. Piciucco's opinion as AME.

From the decision · page 8Workers’ Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].) The Appeals Board will follow the opinions of the AME unless good cause exists to find the opinion unpersuasive. (Id.) We find no good cause to find the opinion of Dr. Piciucco unpersuasive. Next, in order to establish that a psychological injury is compensable, an injured worker must show by a preponderance of the evidence that actual events of employment predominantly caused the psychological injury. 3 (Lab. Code, § 3208.3(b)(1).) 2F

Labor Code section 3208.3(b)(1)

To establish compensability of psychiatric injury, injured worker must show by preponderance of evidence that actual employment events predominantly caused the injury (greater than 50%).

Applied to determine burden of proof for psychiatric injury causation.

From the decision · page 8Workers’ Comp. Appeals Bd. (1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].) The Appeals Board will follow the opinions of the AME unless good cause exists to find the opinion unpersuasive. (Id.) We find no good cause to find the opinion of Dr. Piciucco unpersuasive. Next, in order to establish that a psychological injury is compensable, an injured worker must show by a preponderance of the evidence that actual events of employment predominantly caused the psychological injury. 3 (Lab. Code, § 3208.3(b)(1).) 2F

San Francisco Unified School Dist. v. Workers’ Comp. Appeals Bd. (Cardozo) (2013) 190 Cal.App.4th 1, 9

When a psychiatric injury is alleged and the good faith personnel action defense is raised, the WCJ must evaluate the defense according to a multilevel analysis (Rolda analysis).

Explained the multilevel analysis for good faith personnel action defense.

From the decision · page 9and the other documentary and testimonial evidence of record, the WCJ must make the following determinations: First, the [WCJ] must determine whether the alleged psychiatric injury involves actual events of employment and, if so, whether competent medical evidence establishes the required percentage of industrial causation. If these first two conditions are met, the [WCJ] must then decide whether any of the actual employment events were personnel actions. If so, the [WCJ] must next determine whether the personnel action or actions were lawful, nondiscriminatory, and made in good faith. Finally, if all these criteria are met, competent medical evidence is necessary as to causation; that is, whether or not the personnel action or actions are a substantial cause, accounting for at least to 40 percent of the psychiatric injury as defined by section 3208.3(b)(3).

Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc)

A medical opinion must be framed in terms of reasonable medical probability, not speculative, based on pertinent facts and adequate examination and history, and set forth reasoning in support of conclusions.

Applied to evaluate Dr. Piciucco's reports as substantial medical evidence.

From the decision · page 8In addition to the analyses offered by the WCJ, we offer the following. To constitute substantial evidence “… a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions.” (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) Dr. Piciucco’s reporting is framed in terms of reasonable medical probability, is not speculative, is based on pertinent facts and on an adequate examination and history, and sets forth reasoning in support of its conclusions. As the WCJ observed, applicant presented no alternative, substantial medical evidence finding industrial psychiatric injury. Furthermore, the parties presumably choose an AME because of the AME’s expertise and neutrality. (Power v.

Applicant's testimony of retaliation and management problems

From the decision · page 6II. In her Opinion on Decision, the WCJ offered the following: Applicant alleges a psychiatric injury occurring during the period of 6/18/2009 through 3/1/2024 while working as a customer service representative for Employment Development Department. In order for a psychiatric injury to be compensable the injury must arise out [of] employment, occur during the course of employment and Labor Code Section 3208.3 mandates that it be at least 51% industrially related. Generally speaking, applicant testified to issues with retaliation from coworkers and problems with management.

Psychiatric testing and history relied upon by Dr. Piciucco

From the decision · page 7Dr. Piciucco’s reporting is substantial medical evidence. He opined that applicant’s psychiatric injury was not predominantly caused by work events, opining that only 40% of her injury was due to industrially related reasons. He relied upon applicant’s personality disorder diagnosis, the results of the psychological testing administered, the history given by the applicant and the records reviewed.