ADJ1991445 — California WCAB decision

What the panel ordered

Findings and Order issued by WCJ on 5/10/22 denying Petition for Reconsideration to set aside the OACR dated 2/28/02 is affirmed.

Petition for Reconsideration to set aside the Order Approving Compromise & Release (OACR) dated 2/28/02 was denied by WCJ on 5/10/22; Applicant sought reconsideration which was granted to study the issues further; this decision affirms the WCJ's denial of the petition.

Read the official decision →

This docket was decided more than once. Shown here is the latest released decision; we also hold October 12, 2021.

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.

Other disputed issueDefendant prevailed

Applicant failed to provide substantial medical evidence of incompetence at the time of signing the C&R and did not meet the stringent test for extrinsic fraud or mistake to set aside the OACR; the settlement was approved with legal representation and after a long passage of time; thus, the petition was denied.

The facts that decided it

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

No substantial medical evidence that Applicant was incompetent at time of signing C&R in 2002.

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.

QMERelied upon

Diagnosed paranoid schizophrenia, PTSD, borderline personality disorder; found severe disability when psychotic symptoms emerge; apportioned disability entirely to non-industrial conditions; did not state Applicant was incapable of handling affairs.

Medical evidence required to establish incompetence; Dr. Marusak's report did not find Applicant incapable of handling affairs.

From the decision · page 6Dr. Marusak diagnosed her with paranoid schizophrenia and post traumatic stress disorder on p. 19 of his report, and borderline personality disorder on p. 20. On p. 21, he writes "She is able to function quite well from time to time, but generally finds herself in bizarre and inappropriate interpersonal relationships." He wrote on p. 22 that "A minimal pre-condition of her returning to the workplace would be ongoing psychopharmacologic management on a monthly basis." Further down that page, he writes "There is severe, indeed profound, disability when psychotic, delusional symptoms emerge." He listed her factors of disability on p. 22 as non- industrial delusions, paranoia, and anxiety. On p. 23, he discussed how the Applicant would have "difficulty functioning in any kind of interpersonal environment due to her psychosis." But he also said she could likely continue working "with a modicum of interpersonal involvement." He apportioned her disability on p. 23 entirely to non-industrial paranoid schizophrenia and borderline personality disorder. Not once does the doctor say that she was incapable of handling her affairs.

QMERelied upon

Agreed generally with Dr. Marusak; noted Applicant required intensive psychiatric treatment and had paranoid psychosis in 1998; no evidence incompetence persisted until 2002 settlement.

Medical evidence required to establish incompetence; no evidence incompetence persisted to settlement date.

From the decision · page 6Dr. Maloff wrote on p. 6 of his report, more than a year after Dr. Marusak's report, that he was generally in agreement with Dr. Marusak, although he found it unlikely that Applicant was suffering from borderline personality disorder. He concluded by saying that the Applicant "does indeed require intensive psychiatric treatment and as of last week had been admitted to Charter Oak Hospital in the Intensive Treatment Unit due to paranoid psychosis." This report was written on 2/19/98, which was about four years prior to the Applicant's OAC&R. The court believes the fact that Applicant was admitted to the hospital for paranoid psychosis in February 1998 could tend to show the Applicant was incompetent at that particular time. But there is no evidence in the record indicating this incompetence persisted until her case settled four years later.

ADJ1991445 · January 24, 2024

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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What the panel did with the medical opinions

The rules the panel named

What proof carried it

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