Psyche Symptoms Before Award Does Not Preclude Reopening
Sacramento, CA - Maureen Ford suffered injuries while employed by Communication Action Board of Santa Cruz.
On April 22, 2014, the parties filed joint Stipulations with Request for Award, for injury to "upper extremity" and "hand" on 8/19/11 (ADJ8177678) and for cumulative injury ending 9/26/11, to "upper extremity," "hand," "neck" and "back" (ADJ8177385), while employed as a landscape worker by Community Action Board, insured by State Compensation Insurance Fund.
Applicant reported psychological symptoms to her doctors prior to entering into the 2014 Stipulations with Request for Award. Neither physician expressed an opinion on causation of the psychological symptoms or whether they caused disability.
On 9/10/15, applicant filed a Petition to Reopen in both cases, alleging a change of condition, increase in PD, need for further medical treatment and different vocational factors. On 10/2/17, an Amended Application for Adjudication was filed in ADJ8177385, adding "psyche" as an additional injured body part. The cases went to trial on the issues of injury to the psyche, good cause to reopen per applicant's 9/13/15 Petition.
A 2018 report concluded, for the first time, that applicant met the requirements of Labor Code Sec. 3208.3, because she had a mental disorder per the DSM that was predominantly caused by the industrial injury in August of 2011.
The sole issue raised by defendant on reconsideration is that the WCJ erred in finding good cause to reopen the Award in Case No. ADJ8177385 for new and further psychiatric injury and disability where there was evidence of psychiatric injury at the time of the original Findings and Award. Defendant argues that, because the medical record documents that applicant expressed psychiatric symptoms prior to the April 22, 2014 Findings and Award, the psychiatric injury and disability found by the WCJ now is not "new and further."
In this case, there are only brief mentions of psychiatric symptoms in the medical record. There is no evidence of any psychiatric condition causing either disability or a need for treatment nor is there evidence of a formal diagnosis. Therefore, there is no substantial medical evidence establishing industrial causation for the psychiatric injury pursuant to section 3208.3(a).
The Board concluded that a psychiatric injury does not fall within the ambit of the workers' compensation system until it causes either disability or a need for medical treatment and it is diagnosed using the terminology and criteria of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.
In this case, the decision was said to be consistent the the outcomes in a number of Appeals Board panel decisions.