Boursalian: A Missing Psychiatric Evaluation Required Further Proceedings

If you are pursuing a work-related psychiatric injury claim, being told your medical evidence is inadequate can feel especially discouraging when you have been waiting for the evaluator who is supposed to examine you. A missed evaluation can leave the central medical question unanswered. The hearing record needs to show what evaluation was requested, why it did not happen and which issues still require a doctor’s opinion.

That problem was central in Boursalian v. Stanford University, No. ADJ14002457 (WCAB Dec. 2, 2024). The selected psychiatrist had retired, the worker requested a new panel and she told the judge she was still awaiting an evaluation. The Workers’ Compensation Appeals Board rescinded the decision rejecting her psychiatric injury claim and returned it for further proceedings and appropriate development of the record.

The selected evaluator retired before the claim was decided

Maral Boursalian worked as an administrative associate. She brought separate claims involving her back and her psychiatric condition. The back claim was settled by a compromise and release approved on February 1, 2024. The psychiatric claim, covering alleged work injury from March 3, 2016 through October 30, 2019, remained disputed.

A psychiatry QME panel had issued in December 2021. After the parties struck names from the panel, Dr. Allan Sidle remained. In December 2023, Boursalian requested a new panel because he had retired as a QME.

The evaluation history in Boursalian matters because it identifies a specific obstacle to obtaining the medical evidence. At the May and July 2024 trial proceedings, Boursalian was representing herself. She maintained that the case was not ready for trial because she was awaiting a QME evaluation that had not been authorized.

The employer disputed her diligence and raised limitations and post-termination defenses. The trial judge found that the submitted medical exhibits were not substantial evidence supporting industrial psychiatric injury and found that she had not sustained such an injury. Boursalian sought reconsideration, arguing that the case had been decided without the QME opinion she needed.

The judge and the doctor answer different questions

Psychiatric injury claims require a connection between actual workplace events and the medical condition. Describing distressing events and proving their medical effect are related but distinct tasks.

The causation analysis in Boursalian applied Rolda v. Pitney Bowes, Inc., 66 Cal.Comp.Cases 241, 247 (WCAB en banc 2001). The judge determines whether the alleged events were actual events of employment. Competent medical evidence is needed to determine whether those events predominantly caused the psychiatric injury.

Under the ordinary rule in Labor Code section 3208.3(b)(1), actual employment events must predominate over all causes combined. The Board explained that standard as a work-related share greater than 50 percent of the causal factors. The current statute has a different substantial-cause standard for qualifying violent-act injuries under subdivision (b)(2); the predominant-cause standard was the one discussed in this decision.

For a worker preparing the medical history, this means identifying the actual events and supplying relevant treatment and other records, including information about other possible causes. The evaluator needs a basis to explain the work connection. A description of how difficult the experience felt cannot substitute for that medical explanation.

An inadequate report called for a developed medical record

The trial judge had found Boursalian’s submitted medical exhibits insufficient. The Board then addressed the missing evaluation. It relied on Insurance Company of North America v. Workers’ Comp. Appeals Bd. (Kemp), 122 Cal.App.3d 905, 911–912 (1981), for the need to use expert medical opinion when deciding a medical issue, including psychiatric compensability.

As an unrepresented employee, Boursalian needed a QME evaluation to address compensability and any permanent impairment. The medical-evaluation discussion in Boursalian connected that need to the requested panel, the selected doctor’s retirement and her statement that the replacement evaluation remained unauthorized at trial.

The current section 4060 provides different medical-legal evaluation procedures depending on whether the worker has an attorney. Its unrepresented-worker provisions address evaluations needed to determine disputed compensability. A separate provision, section 4061(i), addresses readiness for proceedings on disputed permanent impairment and limitations. Identify the actual medical question before choosing the procedure.

The Board also examined the judge’s responsibility to develop an inadequate record. Citing Kuykendall v. Workers’ Comp. Appeals Bd., 79 Cal.App.4th 396, 403–404 (2000), and other record-development authorities, it explained that the system’s obligation to provide substantial justice required further development where additional discovery was clearly needed.

The record-development reasoning in Boursalian tied that duty to an insufficiently supported threshold issue. It also emphasized a decision based on admitted evidence, with findings and reasons specific enough to explain the result. The missing medical evaluation and the adequacy of the decision record therefore had to be addressed together.

The claim returned for further proceedings

The order in Boursalian granted reconsideration, rescinded the August 26, 2024 findings and order, and returned the case to the trial level. The Board recommended that the judge consider appropriate further development of the psychiatric injury record.

For Boursalian, the immediate result was another opportunity to develop the evidence and obtain a properly supported decision. Compensability still required adjudication on that developed record. Her requested relief on reconsideration concerned the missing evaluation and the premature decision; the returned proceedings were the next step toward resolving the claim.

That distinction matters when reviewing your own case. Identify whether the immediate problem is access to the required evaluation, the adequacy of an existing report, the facts of the employment events or the judge’s explanation of the evidence. Each requires a specific response supported by the record.

Show exactly what prevented the evaluation

Keep the original panel, the parties’ selections, communications about the evaluator’s availability or retirement, the replacement request and all responses. Compare those records with the hearing minutes and the issues the judge was asked to decide.

For the psychiatric evaluation itself, prepare a dated account of the work events and the records that support it. Include relevant treatment history and information the doctor needs to evaluate all potential causes. Ask which medical questions remain unanswered and how the proposed examination or supplemental report would address them.

If a hearing is approaching, raise the missing evaluation and readiness issue promptly, with the documents showing what has happened. Boursalian illustrates the importance of a concrete medical-evidence gap and the effort to obtain the evaluation. Our Hamilton analysis explains the related need for a clear record of issues and admitted evidence.