AME Dr. David Reiss's causation analysis attributing 65% of psychiatric injury causation to actual events of employment including reporting to non-medical supervisors and letter of expectation
Favours Applicant prevailed
The AME's agreed medical opinion was relied upon by the WCJ and WCAB as the primary medical evidence establishing causation and predominance of actual events of employment.
From the decision · page 3The parties selected David Reiss, M.D. as the Agreed Medical Examiner (AME) in
psychiatry. Dr. Reiss identified multiple psychiatric diagnoses, with industrial factors identified as
the predominant cause of psychiatric injury. (Ex. 1, report of AME David Reiss, M.D., dated
February 5, 2013, at p. 17.) The determination of whether there was good faith personnel action
was deferred to the trier of fact. (Ibid.) Over the next four years, the parties requested multiple
supplemental reports from Dr. Reiss in an attempt to elucidate the issue of whether good faith
personnel action was a substantial cause of alleged psychiatric injury. On March 25, 2016, AME
Dr. Reiss issued a report wherein he assigned 5% causation to applicant's usual and customary
duties, 15% to perceived discrimination, and 5% to preexisting factors. (Ex. 6, report of David
Reiss, M.D., dated March 25, 2016, p. 6.) Dr. Reiss felt that the remaining 75% causation arose
out of the administrative actions of applicant's employer. (Ibid.) In a supplemental report of
April 14, 2017, Dr. Reiss provided the following causation attribution:
Defendant failed to prove that administrative appointments of other individuals to Chief of Mental Health were lawful, nondiscriminatory, good faith personnel actions
Favours Applicant prevailed
Without proof that these were personnel actions, the good faith personnel action defense failed, supporting applicant's claim for compensation.
From the decision · page 10We emphasize that each case must be decided on its own merits, and that this decision is
limited to facts at bar. (County of Butte v. Workers Compensation Appeals Bd. (Purcell), supra,
65 Cal. Comp. Cases 1053, 1057], "what constitutes a personnel action depends on the subject
matter and factual setting for each case.") However, on the facts before us we conclude that the
employer's administrative appointments of persons other than applicant were not personnel actions
as contemplated by section 3208.3(h). Because defendant has not established the administrative
appointments of other individuals to the position of Chief of Mental Health were personnel actions
within the meaning of section 3208.3(h), we agree with the WCJ that defendant has not met its
burden of proving that lawful, nondiscriminatory good faith personnel action was a substantial
cause of the claimed injury.