ADJ20322653 · October 16, 2026

The WCAB found the WCJ's decision lacked substantial evidence and that the PQME's causation opinion was incomplete, requiring further proceedings to properly assess causation and compensability under Labor Code section 3208.3.

From the decision · page 14Section 3208.3 requires as a condition of compensation that an injured worker prove by a preponderance of the evidence that actual events of employment predominantly caused the psychological injury. (Lab. Code, § 3208.3(b)(1).) This requires the WCJ to determine whether actual events of employment occurred, and it requires a psychologist or psychiatrist to determine whether actual events of employment were a predominant cause of an injury to the psyche. (Rolda v. Pitney Bowes, Inc. (2001) 66 Cal.Comp.Cases 241, 245 (Appeals Board en banc).) The phrase “predominant as to all causes” means that “the work-related cause has greater than a 50 percent share of the entire set of causal factors.” (Dep't of Corr. v. Workers' Comp. Appeals Bd. (Garcia) (1999) 76 Cal.App.4th 810, 816 [64 Cal.Comp.Cases 1356].) In order to

Applicant did not receive the WCJ's Findings and Order in the mail and had to obtain a copy from the WCAB office.

Favours Applicant prevailed

This procedural defect justified granting reconsideration and rescinding the WCJ's decision.

From the decision · page 1Applicant seeks reconsideration of the June 9, 2026 Findings and Order (F&O) issued by a workers’ compensation administrative law judge (WCJ), wherein the WCJ found that applicant failed to establish that she sustained a compensable psychiatric injury arising out of and in the course of her employment as a custodian through December 27, 2024. Applicant’s Petition for Reconsideration alleges that “Rafel Alex & Abraham attack[ed] me every day so I could lose my job. They would have meetings in Spanish so I couldn’t understand. I submitted all the evidence to the Judge.” (Petition dated August 3, 2026, page 1.) The Petition, which is verified, further states that applicant never received the WCJ’s order in the mail, and that she had to go to the WCAB office to get a copy of the F&O. (Ibid.) Defendant has filed an Answer, and the WCJ has prepared a Report and Recommendation on Petition for Reconsideration (Report) recommending that we deny reconsideration. We have considered the Petition for Reconsideration, defendant’s Answer, and the contents of the Report, and we have reviewed the record in this matter. Based upon our review of the record, we will grant applicant’s Petition for Reconsideration, rescind the F&O, and return the matter to the trial level for further proceedings consistent with this decision.

The PQME's supplemental reports failed to assign causation percentages to all causes of the psychiatric injury as required by Rolda.

Favours Applicant prevailed

This incomplete medical opinion undermined the substantial evidence basis for the WCJ's decision and required remand for further proceedings.

From the decision · page 18she assign new causation percentages to any other cause as required by Rolda. Dr. Allen concluded only that there was “insubstantial evidence” to support her pervious finding that actual events of applicant’s employment met the 51% threshold for causation of psychiatric injury under section 3208.3, without any attempt to attribute the disorder to one or more causes as required. The PQME cannot logically determine that industrial causes of injury are 50 percent or less as to all causes without first accounting for all causes of injury within a reasonable degree of medical probability. Dr. Allen’s modified opinions are incomplete and therefore fail to constitute substantial medical evidence. The PQME replaced what was a complete assessment of causation (100 percent to reported fear for safety at work due to unlocked doors) with an incomplete causation opinion that failed to identify and assign percentages of causation to any other causes of applicant’s Unspecified Anxiety Disorder. Further, Dr.

Diagnosed Unspecified Anxiety Disorder attributed 100% to work stress if doors were unlocked as described by applicant, 0% to personnel actions; later reports incomplete and failed to assign causation percentages to other causes, undermining substantial evidence.

The PQME's initial causation opinion was complete and supported compensability, but later supplemental reports were incomplete and failed to assign causation percentages as required by Rolda, undermining the WCJ's decision.

From the decision · page 18she assign new causation percentages to any other cause as required by Rolda. Dr. Allen concluded only that there was “insubstantial evidence” to support her pervious finding that actual events of applicant’s employment met the 51% threshold for causation of psychiatric injury under section 3208.3, without any attempt to attribute the disorder to one or more causes as required. The PQME cannot logically determine that industrial causes of injury are 50 percent or less as to all causes without first accounting for all causes of injury within a reasonable degree of medical probability. Dr. Allen’s modified opinions are incomplete and therefore fail to constitute substantial medical evidence. The PQME replaced what was a complete assessment of causation (100 percent to reported fear for safety at work due to unlocked doors) with an incomplete causation opinion that failed to identify and assign percentages of causation to any other causes of applicant’s Unspecified Anxiety Disorder. Further, Dr.

Labor Code section 3208.3

Labor Code section 3208.3 requires proof that actual events of employment predominantly caused the psychiatric injury, with a greater than 50% share of causation.

The WCJ must determine whether actual events occurred and a psychiatrist must determine if those events predominantly caused the injury.

From the decision · page 14Section 3208.3 requires as a condition of compensation that an injured worker prove by a preponderance of the evidence that actual events of employment predominantly caused the psychological injury. (Lab. Code, § 3208.3(b)(1).) This requires the WCJ to determine whether actual events of employment occurred, and it requires a psychologist or psychiatrist to determine whether actual events of employment were a predominant cause of an injury to the psyche. (Rolda v. Pitney Bowes, Inc. (2001) 66 Cal.Comp.Cases 241, 245 (Appeals Board en banc).) The phrase “predominant as to all causes” means that “the work-related cause has greater than a 50 percent share of the entire set of causal factors.” (Dep't of Corr. v. Workers' Comp. Appeals Bd. (Garcia) (1999) 76 Cal.App.4th 810, 816 [64 Cal.Comp.Cases 1356].) In order to

Labor Code section 3208.3(h)

The good faith personnel action defense bars compensation if the injury was substantially caused by lawful, nondiscriminatory personnel actions, defined as at least 35-40% of causation.

The WCJ must determine if personnel actions occurred and if they were a substantial cause of injury.

From the decision · page 15apply this standard, the evaluating physician must take a history of all events alleged to have contributed to the psychiatric injury, then render an opinion as to causation in terms of first whether the employment events were a predominant, or greater than fifty percent, cause of the injury. (Rolda, supra, 66 Cal.Comp.Cases at p. 245.) Section 3208.3 also provides a defense barring compensation for a psychiatric injury if the injury was substantially caused by a lawful, nondiscriminatory, good faith personnel action. (Lab. Code, § 3208.3(h).) The statute expressly assigns the burden of proof on this issue to a defendant who raises the defense. In order to determine whether the good faith personnel action defense bars compensation, the WCJ must determine whether any “personnel action” occurred, and if so, whether it was lawful, nondiscriminatory, and in good faith. The defense also requires a psychologist or psychiatrist to determine whether such personnel action was a “substantial cause” of an injury to the psyche, which is defined by section 3208.3 as “at least 35 to 40 percent of the causation from all sources combined.” (Lab. Code, § 3208.3(b)(3); Rolda, supra, 66 Cal.Comp.Cases at p. 246.) As we noted in our en banc decision in Rolda, supra, and also in significant panel decisions 3 Larch v. Contra Costa County (1998) 63 Cal.Comp.Cases 831, 833–839 and Stockman v.

Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604

Medical opinions must be based on reasonable medical probability, pertinent facts, adequate examination and history, and set forth reasoning to constitute substantial evidence.

The Appeals Board must judge the weight and credibility of medical opinions based on their factual basis.

From the decision · page 16(Bolton) (1983) 34 Cal.3d 159 [48 Cal.Comp.Cases 566].) 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).) “Medical reports and opinions are not substantial evidence if they are known to be erroneous, or if they are based on facts no longer germane, on inadequate medical histories and examinations, or on incorrect legal theories. Medical opinion also fails to support the Board’s findings if it is based on surmise, speculation, conjecture or guess.” (Hegglin v. Workmen's Comp. Appeals Bd.

Applicant's testimony found less than convincing; surveillance video showed no evidence of doors being unlocked by others; no facts supported harassment claims; consistent testimony from supervisors about job performance issues.

From the decision · page 9the applicant's description of problems causing psychiatric injury. Multiple individuals at her employment, including her supervisor, gave descriptions of problems pertaining to her job performance and inappropriate behavior in response to criticism and direction. Their descriptions are consistent with one another. There were no facts to support her contentions of harassment by her supervisor or others at her job site. There is insubstantial evidence to support that work stress, CT 12/27/2024, met the 51% threshold for causation of psychiatric injury. Defense Exhibit D, 8/1/2025 report of QME Dr. Allen at pg. 2 – 3 The court notes several aspects of applicant’s testimony that were of particular concern. First, and most concerning, was that, although convinced that someone was following behind her and unlocking doors she had previously locked, having reviewed the surveillance video, no evidence of this was evident. This video was viewed by the applicant in the presence of a union representative and management. Applicant contends that the video had been altered, however, the court finds this to be completely implausible. No one altered the video, and