Judge Curtis A. Kin, Case Number: 22STCP03218, Date: 2023-12-07 Tentative Ruling

Petitioner John Nguyen petitions for a writ of mandate directing respondent Board of Fire and Police Commissioners for the City of Los Angeles to set aside its decision finding that his permanent incapacity to work is not connected to the discharge of his duties as a police officer and to find that his permanent incapacity is service connected.

Petitioner John Nguyen began working as police officer for the Los Angeles Police Department (“LAPD”) in March 2008. (AR 1, 93.) Petitioner became a member of Tier 5 of the Los Angeles Fire and Police Pension System (“LAFPP”). (AR 93.)

As part of the hiring process, petitioner submitted to a physical examination in December 2007. (AR 239-49.) Petitioner was 46 years of age and weighed 160 pounds. (AR 243, 245.) Petitioner reported a history of heart disease in his immediate family. (AR 240, 242.) Petitioner told the examining doctor that he was experiencing elevated cholesterol for two years and was taking 600 milligrams of gemfibrozil twice a day. (AR 241, 242.)

In 2009, petitioner was assigned to the Jail Division at LAPD. (AR 191.) Petitioner was next assigned to the West Valley Patrol Division as a patrol officer. (AR 196.) From 2011 to 2013, petitioner worked as a Gang Enforcement Officer. (AR 15, 201.)

One night in 2013, petitioner tried to make a pedestrian stop of a gang member, who immediately fled. (AR 15.) Petitioner chased after the gang member and grabbed the gang member’s jacket. (AR 15.) The gang member shot at petitioner but missed. (AR 15-16.) Petitioner reportedly feared for his life and relives the encounter every day. (AR 16, 96.)

Petitioner was reassigned to administrative jobs for the next five years. During 2013 and 2014 in the Personnel Division, Return to Work Section, petitioner “facilitate[d] reasonable accommodations, track[ed] employees who are sick, injured on duty, and employees who have temporary or permanent restrictions.” (AR 209.) During 2014 and 2015 in the Metropolitan Division – M Platoon-Administrative Division, petitioner completed various reports, “assisted with paperwork and logistics . . . accumulated and analyzed statistical data . . . [and] worked on various administrative projects as needed.” (AR 217.) From 2016 to 2018, petitioner was assigned to the Training Division of the Reserve Officer and Volunteer Unit, where petitioner provided administrative support, served as drill instructor for Reserve Academy classes, and coordinated training and other activities department wide. (AR 225, 229.) Petitioner also recruited and mentored potential Reserve candidates. (AR 225, 229.)

In March 2018, petitioner returned to uniformed patrol. (AR 233.) In addition to patrol duties, petitioner trained probationary police officers as a Field Training Officer. (AR 233.) Due to having responsibility for the training and safety of new police officers, petitioner found field training stressful. (AR 13.) Petitioner stopped working in April 2019. (AR 17.)

Starting in January 2012, during petitioner’s six weeks of annual vacation, he worked 8 to 15 hours per week as security for a private employer. (AR 25, 102.) Petitioner sat at a desk and signed employees in and out of a restricted area. (AR 25.) In 2017 and 2018, petitioner worked security for a different private employer for 40 hours per year. (AR 102.)

In November 2011, petitioner was referred to Behavioral Sciences Services (“BSS”) by his captain. (AR 251.) Petitioner’s son was abusing methamphetamine, and petitioner witnessed his son attempting suicide. (AR 251-53.) The psychologist recommended counseling and referred petitioner to someone who could help with the hospitalization of his son. (AR 253.)

On April 30, 2019, petitioner presented to the Emergency Department at Kaiser. (AR 296.) Petitioner reported experiencing chest tightness while walking with his wife one week prior, as well as since the previous night. (AR 296.) Rahaf Damlakhi, M.D. performed a history and physical. (AR 303.) Dr. Damlakhi noted that petitioner was “on Lipitor and aspirin daily.” (AR 303.) Petitioner had been prescribed Lipitor “to reduce risk of heart attacks and strokes.” (AR 303.) Dr. Damlakhi also noted that, while petitioner did not have a history of heart disease, petitioner had a “strong family history of heart disease . . . CAD [coronary artery

disease] in his father, mother and brother” and “hx [history] of stroke in his father.” (AR 303.)

On May 1 and 2, 2019, petitioner was examined by general and interventional cardiologists. (AR 306-22.) Petitioner underwent a nuclear stress test and was found to be ischemic. (AR 113, 312.) Petitioner’s laboratory test showed “significant elevation of cholesterol (249 mg) and serum triglycerides (570 mg)” (AR 135 [medical report by independent cardiologist], 311 [Kaiser record].) After performance of a heart catheterization, petitioner was diagnosed with “ACS [acute coronary syndrome] with Severe multi-vessel CAD with decreased flow in LAD [left anterior descending], mild LV [left ventricular] systolic dysfunction[.]” (AR 318.) Coronary artery disease “is caused by a build-up of fatty material within the walls of the arteries,” which “narrows the inside of the arteries, limiting the supply of oxygen-rich blood to the heart muscle.” (AR 68.)

On May 3, 2019, petitioner received triple coronary artery bypass graft surgery at Hoag Hospital. (AR 329, 421.) Petitioner tolerated the procedure well and was discharged on May 8, 2019. (AR 421.)

On January 31, 2020, petitioner filed an application for disability pension benefits. Petitioner claimed a disability of “hypertension/heart” beginning on April 29, 2019 that prevented him from working. (AR 94.) Petitioner asserted that the disability was service connected, claiming that the “day to day physical demands, stressful events, irregular eating habits, all caused my heart disabilities.”[1] (AR 94.)

In connection with petitioner’s application, four physicians examined petitioner. A summary of each physician’s medical report follows.

On April 21, 2021, cardiologist Marc L. Ladenheim, M.D. examined petitioner for one hour. (AR 112.) Dr. Ladenheim remarked that petitioner “has been on treatment for hypertension, which was diagnosed after his surgery and for high cholesterol, which was diagnosed a number of years ago.” (AR 113.) Petitioner’s “cholesterol pattern was characterized by high triglycerides, and elevated non-HDL cholesterol consistent with higher risk.” (AR 113.)

Dr. Ladenheim stated that petitioner’s hyperlipidemia poses a major risk factor for coronary artery disease. (AR 114.) The report also mentions that both of petitioner’s parents had history of coronary disease. (AR 114.) Petitioner’s brother “one time felt a bout of coronary artery disease, but apparently he is healthy.” (AR 114.)

Dr. Ladenheim opined: “[Petitioner’s] work environment with physical demands and psychologically stressful situations could have contributed to the development of his heart disease, but it is not likely the predominant cause.” (AR 114.) According to Dr. Ladenheim, petitioner may have inherited a genetic risk factor for heart disease based on the history of petitioners’ parents. (AR 115.)

Dr. Ladenheim found no possibility for petitioner to return to a full or restricted level of activity. (AR 115.) Noting petitioner’s complaints of atypical chest pain and shortness of breath, particularly with exertion, which were consistent with having had extensive surgery, Dr. Ladenheim opined: “Clearly, this applicant cannot return to his prior work environment with the extremely high physical and psychological demands of his job. He cannot be in a high intensity, anxiety provoking environment or situation requiring high level physical stress. He would be incapable of performing his duties. He does not have the physical or psychological well-being to perform his duties as a police officer. His symptoms cannot be controlled with a modified lifestyle or diet, over the counter medications, or prescription medication.” (AR 115.)

On April 21, 2021, cardiologist R. Nihal Goonetilleke, M.D. examined petitioner for one hour and reviewed petitioner’s medical records. (AR 134.) Dr. Goonetilleke noted that petitioner’s father underwent coronary bypass grafting in his 70s. (AR 136.) Petitioner’s mother underwent a coronary angioplasty with stenting in her 80s. (AR 136.) Petitioner did not know of any family history of hypercholesterolemia. (AR 136.) Dr. Goonetilleke noted that petitioner’s six siblings and three adult children were in good health without any documented coronary artery disease. (AR 136.)

According to Dr. Goonetilleke, petitioner was “clearly overweight,” as petitioner was five feet six inches and weighed 202 pounds. (AR 136.) Dr. Goonetilleke noted a diagnosis of “[p]ronounced dyslipidemia,” based on prior documentation of “markedly elevated total cholesterol and serum triglyceride levels.” (AR 135, 137.)

Dr. Goonetilleke opined, “The predominant source of his impairment can be related to a strong family history of coronary artery disease affecting both parents, the claimant's hypertension, dyslipidemia, and significant obesity.” (AR 138.)

On January 18, 2022, internal medicine physician Sean Leoni, M.D., prepared a report to rebut the reports of Dr. Ladenheim and Dr. Goonetilleke. (AR 104-10.) Dr. Leoni treated petitioner beginning in 2019 in connection with his workers’ compensation claim. (AR 483-85.) Petitioner told Dr. Leoni that his father had a coronary bypass graft at 74 years of age and that his mother had a stent placed at the age of 79. (AR 105.) None of petitioner’s siblings have cardiovascular issues. (AR 105.) Petitioner reported that he was taking Lipitor prior to the 2019 injury. (AR 105.)

Dr. Leoni disagreed with the reports of Dr. Ladenheim and Dr. Goonetilleke, attributing their opinions to their failure to consider the responsibilities of a police officer. (AR 108.) Opining that stress can increase the risk of heart attack, Dr. Leoni stated that “stress leaves the blood vessels tightly wound,” leaving “blood vessels…unable to respond properly to the change in blood demands (i.e. expanding and contracting to accommodate different amounts of blood flow).” (AR 109.)

Based on a review of petitioner’s job classification and job description, Dr. Leoni noted the stressors of petitioner’s job. (AR 108.) These stressors include “daily stress with suspects that at times involve getting into fights and altercations with armed felons, foot pursuits, and car chases on a daily basis.” (AR 104.) Petitioner was required to wear 25 pounds of heavy equipment, including a bulletproof vest and firearms. (AR 104.) Petitioner was also required to enter and exit vehicles while carrying equipment, including a helmet, extra magazines, and ballistic shields, that weighed as much as 40 pounds. (AR 104.) Petitioner climbed fences and walked up flights of stairs. (AR 104.) Petitioner’s shift was extended during unusual occurrences. (AR 104.) Petitioner lacked healthy eating choices at times and exercise during night shifts, according to Dr. Leoni. (AR 104.)

With respect to petitioner’s duties as a Field Training Officer, Dr. Leoni stated that mental stress resulted from “having an inexperienced rookie, sometimes 2 rookies, which created a lot of stress to be out in the field facing dangerous disturbance situations, daily interactions with dangerous individuals, persons with impaired mental status, drug users, and suicidal persons.” (AR 105.) Dr. Leoni described petitioner as having “maintained a constant extremely high level of alert and vigilant state of mind,” with petitioner being “unable to bring the level down” when he left work. (AR 105.)

With respect to family history of heart disease, Dr. Leoni opined: “For the family history to be contributory, the mother has to have had known coronary artery disease before the age 50 and the father has to have had known coronary artery disease before age of 55 to be considered a risk factor.” (AR 109.) While noting petitioner’s risk factor of hyperlipidemia, Dr. Leoni attributed petitioner’s disability to “his job as a police office [sic] for LAPD since 2008 through 2019.” (AR 109 [“[I]n my opinion this is predominant and convincing evidence that the job stressors that are outlined above have caused Mr. Nguyen’s disability”].)

On September 20, 2019, internal medicine physician L.V. Alonso examined petitioner for one and a half hours and prepared a report. (AR 487-88.) Dr. Alonso did not have petitioner’s medical records at the time he prepared the report. (AR 492.) During the examination, petitioner told Dr. Alonso that he experienced chest pain and shortness of breath but attributed the conditions to stress and did not give them much importance. (AR 489.)

Dr. Alonso set forth stressors at work that petitioner experienced, which are similar to the stressors set forth by Dr. Leoni. (Compare AR 488-89 with AR 104-05.) Dr. Alonso opined: “With reasonable medical probability, Mr. Nguyen’s heart condition is of industrial causation, due to repetitive stress, and strain associated with years of as a patrol, and field training officer.” (AR 493.) According to Dr. Alonso, the physiological responses from chronic stress, including an increase in blood pressure and heart contractility, have “adverse effects on the cardiovascular system, increasing risk of cardiovascular morbidity, and mortality.” (AR 494.) Dr. Alonso noted the “higher incidence of coronary artery disease in first responders has been well documented in the literature.” (AR 494.)

While Dr. Alonso noted petitioner’s mother’s history of coronary heart disease, he characterized petitioner’s heart condition as industrial in nature because none of petitioner’s siblings have heart disease. (AR 494.) Dr. Alonso invoked Labor Code § 3212 in asserting that petitioner’s “heart trouble” is presumed to be industrial and not subject to apportionment.[2] (AR 494.)

On November 15, 2019, having received petitioner’s medical records from 2007 to 2019, Dr. Alonso prepared a summary of the records. (AR 505-16.) A lab report from 2007 “revealed elevated cholesterol at 247, high triglyceride at 326, high LDL at 133, and borderline cholesterol/HDL at 5.0.” (AR 506; see also AR 508 [elevated levels of cholesterol and triglycerides in 2010].) Petitioner was diagnosed with hyperlipidemia in 2007. (AR 506.) In 2012, a lab result “revealed elevated cholesterol at 216, high triglycerides at 586, and high cholesterol/HDL at 6.8, and low HDL at 32.” (AR 510.) In 2014, petitioner’s treating physician noted that petitioner “had not been taking his cholesterol medication regularly.” (AR 512.) Petitioner’s cholesterol and lipid levels remained elevated through 2018. (AR 513.)

On May 29, 2020, Dr. Alonso reexamined petitioner for one hour. (AR 543-44.) Dr. Alonso reasserted that petitioner’s coronary artery disease is presumed industrial and not subject to apportionment. (AR 550.) With respect to petitioner’s hypertension, Dr. Alonso recommended an apportionment of 60% industrial, “due to repetitive stress and strain associated from years of work in active duty law enforcement,” and 40% nonindustrial, “due to familiar cardiovascular risk factors, and natural progression of essential hypertension, which is essentially a non-industrial condition.” (AR 550.)

On February 3, 2022, LAFPP staff recommended that petitioner “be granted a nonservice-connected disability pension of 40% for his hypertension/heart only, and due to the nature of his disability, no foreseeable purpose would be served in requiring periodic medical examinations.” (AR 61.)

On February 3, 2022, the Board of Fire and Police Pension Commissioners (“Board”) held a hearing on petitioner’s application for disability retirement. (AR 3.) Petitioner testified that he did not have any blood pressure or heart-related issues at the time he was hired. (AR 10-11.) Petitioner also testified to the aspects of the job that he found stressful, including being responsible for the safety of rookie police officers, the unpredictability of the events occurring upon responding to radio calls. (AR 12-16.) Petitioner also testified that he still has chest pain, shortness of breath, and fatigue. (AR 17-18.)

With respect to whether his brother has cardiovascular issues, he stated that his brother did not have any such issues. (AR 29-30.) Petitioner explained that, when he presented to Kaiser, he was sedated. (AR 30.) According to petitioner, his wife either provided the wrong information in a panic or miscommunicated because she speaks little English. (AR 30.)

Counsel for petitioner argued that petitioner qualified for a service-connected disability pension. (AR 33-35.) Counsel argued that Dr. Ladenheim and Dr. Goonetilleke did not assess or ask petitioner about his stress at work. (AR 30-31, 33-34.) Counsel also noted that petitioner’s parents had heart disease at a much later age than petitioner. (AR 33.)

The Board unanimously voted to grant petitioner a nonservice-connected disability pension of 50%. (AR 43-45.) The Board determined that the “discharge of [petitioner’s] duties was not the predominant cause of his impairment caused by his hypertension/heart pursuant to City of Los Angeles Administrative Code Section 4.2006(b).” (AR 2.) The Board’s determination was incorporated into the Findings of Fact issued on March 17, 2022. (AR 1-2.)

On August 30, 2022, petitioner filed a verified Petition for Writ of Mandate. On July 24, 2023, petitioner filed an opening brief. On August 23, 2023, respondents filed an opposition. On September 5, 2023, petitioner filed a reply. The Court has received the administrative record and the joint appendix.

Under CCP § 1094.5(b), the pertinent issues are whether the respondent has proceeded without jurisdiction, whether there was a fair trial, and whether there was a prejudicial abuse of discretion. An abuse of discretion is established if the agency has not proceeded in the manner required by law, the decision is not supported by the findings, or the findings are not supported by the evidence. (CCP § 1094.5(b).)

A disability pension benefit is a fundamental vested right. (See Strumsky v. San Diego County Employees Retirement Assn. (1974) 11 Cal.3d 28, 45 [service-connected death benefits to widow of police officer found to be fundamental vested right].) Accordingly, the Court exercises its independent judgment on the administrative findings. (See Wences v. City of Los Angeles (2§009) 177 Cal.App.4th 305, 314; Bixby v. Pierno (1971) 4 Cal.3d 130, 143.) Under the independent judgment test, “the trial court not only examines the administrative record for errors of law, but also exercises its independent judgment upon the evidence disclosed in a limited trial de novo.” (Bixby, 4 Cal.3d at 143.) The court must draw its own reasonable inferences from the evidence and make its own credibility determinations. (Morrison v. Housing Authority of the City of Los Angeles Board of Commissioners (2003) 107 Cal. App. 4th 860, 868.)

An agency is presumed to have regularly performed its official duties. (Evid. Code § 664.) “In exercising its independent judgment, a trial court must afford a strong presumption of correctness concerning the administrative findings, and the party challenging the administrative decision bears the burden of convincing the court that the administrative findings are contrary to the weight of the evidence.” (Fukuda v. City of Angels (1999) 20 Cal.4th 805, 817, internal quotations omitted.) A reviewing court “will not act as counsel for either party to an appeal and will not assume the task of initiating and prosecuting a search of the record for any purpose of discovering errors not pointed out in the briefs.” (Fox v. Erickson (1950) 99 Cal.App.2d 740, 742.) When an appellant challenges “‘the sufficiency of the evidence, all material evidence on the point must be set forth and not merely their own evidence.” (Toigo v. Town of Ross (1998) 70 Cal.App.4th 309, 317.)

“On questions of law arising in mandate proceedings, [the Court] exercise[s] independent judgment.’” (Christensen v. Lightbourne (2017) 15 Cal.App.5th 1239, 1251.) The interpretation of statute or regulation is a question of law. (See State Farm Mut. Auto. Ins. Co. v. Quackenbush (1999) 77 Cal.App.4th 65, 71.)

As a preliminary matter, respondent Board’s request to take judicial notice of Los Angeles Charter Code §§ 1102 and 1106 and Los Angeles Administrative Code (“LAAC”) § 4.2006 is GRANTED, pursuant to Evidence Code § 452(b).

Petitioner John Nguyen seeks a writ of mandate directing respondent Board of Fire and Police Pension Commissioners for the City of Los Angeles to (1) set aside its decision to grant him a nonservice-connected disability pension of 50% and (2) grant petitioner a service-connected disability pension and reconsider the percentage of his final compensation. (Pet. Prayer ¶ 1.)

Section 1102 of the Los Angeles City Charter created the Board of Fire and Police Pension Commissioners to manage and control the pension system for police officers. (RJN Ex. A.) Under section 1106(a)(1) of the City Charter, the Board has “sole and exclusive responsibility to administer its system . . . to provide benefits to system participants and their beneficiaries and to assure prompt delivery of those benefits and related services.” (Ibid.)

“The Board shall have the power to hear and determine all matters pertaining to the granting and denying of any such application or request for a disability pension.” (Id. at LAAC § 4.2006(c).) With respect to finding a service-connected disability for Tier 5 plan members like petitioner, LAAC § 4.2006(a) states: “A Tier 5 Plan Member’s incapacity is caused by the discharge of his or her duties if there is clear and convincing evidence that the discharge of the Plan Member’s duties is the predominant cause of the incapacity.” (RJN Ex. A.)

“Clear and convincing” evidence requires “a finding of high probability,” with evidence “so clear as to leave no substantial doubt” and “sufficiently strong to command the unhesitating assent of every reasonable mind.” (In re Angelia P. (1981) 28 Cal.3d 908, 919, internal quotations omitted.)

Upon reviewing the evidence, the Court finds that the weight of the evidence supports the Board’s conclusion that petitioner’s disability of “hypertension/heart” was not predominantly caused by the discharge of his duties and was accordingly nonservice connected.

After having examined petitioner and reviewed petitioner’s medical records, Dr. Ladenheim, a cardiologist, found that petitioner’s work environment, with its physical demands and psychologically stressful situations, was “not likely the predominant cause” of his heart disease. (AR 114.) Dr. Ladenheim acknowledged that the cause of petitioner’s heart disease is unclear. (AR 114-15.) Nevertheless, based on petitioner’s “significant lipid abnormality” and his parents’ history of coronary heart disease, Dr. Ladenheim opined that petitioner had “extensive asymptomatic artery disease” until he developed ischemic symptoms in April 2019 and had coronary bypass surgery on May 3, 2019. (AR 114-15.)

After having examined petitioner and reviewed petitioner’s medical records, Dr. Goonetilleke, a cardiologist, found that the “predominant source of [petitioner’s] impairment can be related to a strong family history of coronary artery disease affecting both parents, the claimant's hypertension, dyslipidemia, and significant obesity.” (AR 138.) Notwithstanding the dispute of whether petitioner’s brother had heart issues (compare AR 29-30 [petitioner denying brother had heart problems] with 114 [Dr. Ladenheim noting brother had a bout of coronary heart disease]), Dr. Goonetilleke noted that petitioners’ parents were treated for heart disease in their 70s and 80s. (AR 136.) Dr. Goonetilleke also noted the documentation of petitioner’s “markedly elevated total cholesterol and serum triglyceride levels” evidencing “[p]ronounced dyslipidemia” (AR 137.)

Petitioner’s lipid abnormality is acknowledged in Dr. Alonso’s summary of petitioner’s medical records, which evidenced a history of elevated cholesterol and triglyceride levels from 2007 to 2018. (AR 506, 508, 512, 513.) Petitioner was taking gemfibrozil prior to working for the LAPD. (AR 241.) Petitioner was prescribed Lipitor daily to reduce the risk of heart attack. (AR 105, 303.)

The reports of Dr. Ladenheim and Dr. Goonetilleke cast sufficient doubt on whether job-related stress was the predominant cause of petitioner’s coronary artery disease.

Petitioner argues that the reports of Dr. Ladenheim and Dr. Goonetilleke do not indicate that the physicians asked petitioner about the stresses of his job or considered the stressors of his job. That appears to be true. Dr. Ladenheim and Dr. Goonetilleke did not engage in an analysis of the aspects of petitioner’s job that could have caused stress, as Dr. Leoni did in his rebuttal report. (AR 104-05.) Dr. Ladenheim and Dr. Goonetilleke also did not discuss how stress could cause heart disease and hypertension, as Dr. Leoni and Dr. Alonso did in their reports. (AR 108-09 [Dr. Leoni], 493-94 [Dr. Alonso].)

Nevertheless, petitioner’s hyperlipidemia predated his employment with the LAPD. (AR 242, 507.) Further, petitioner’s family history with heart disease also predated his role as a police officer. (AR 115 [petitioner may have had genetic risk factor].) Both Dr. Ladenheim and Dr. Goonetilleke opined that family history and hyperlipidemia are factors or causes for heart disease. (AR 114, 138.) Given petitioner’s preexisting conditions or factors for heart disease, the Court does not find in its independent judgment review that there is clear and convincing evidence that job-related stress is the predominant cause of petitioner’s disability.

As for the reports of Dr. Leoni and Dr. Alonso, the Court notes that neither doctor is a cardiologist. Dr. Leoni is petitioner’s treating physician for his workers’ compensation claim. (AR 23-24, 483-85.) Dr. Alonso provided an independent medical examination for petitioner’s workers’ compensation claim. (AR 487-96.) While both doctors describe how stress could cause heart disease and while Dr. Leoni opined that family history does not explain petitioner’ s heart condition because his parents did not have known coronary artery disease in their 50s (AR 109), neither doctor provides any meaningful explanation of how petitioner’s preexisting condition of hyperlipidemia could not be the predominant cause of his heart disease.

The Court also notes that Dr. Alonso invoked Labor Code § 3212 in asserting that petitioner’s “heart trouble” is presumed to be industrial.[3] (AR 494.) Here, that Labor Code presumption is not incorporated into the Los Angeles Administrative Code. Importantly, a different standard applies in determining whether petitioner is entitled to a finding that his disability was service connected.

Apart from reliance on his doctors’ opinions, petitioner also suggests that the medical directive of one of the doctor’s on whom respondent relies actually supports petitioner’s claim, positing: “If Dr. Ladenheim restricts Mr. Nguyen from performing work in a ‘high physical and psychologically demanding position,’ wouldn’t that position also be the predominant cause of his admitted permanent incapacity?” (Reply at 7:10-12; see also Opening Br. at 12-13 [“[I]f the job is not a predominant factor, why is Dr. Ladenheim restricting Petitioner from physical and emotional demands of his job?”].) Petitioner’s supposition, however, does not necessarily and logically flow from Dr. Ladenheim’s medical advice. The fact that petitioner may not be able to return to work due to his disability does not necessarily mean that his work was the predominant cause of the disability, particularly, where, as here, the record indicates a preexisting, underlying condition of hyperlipidemia and family history.

At best, crediting the reports of the four physicians in the administrative record, petitioner’s condition was exacerbated by the stress of his duties as a police officer. But, when considering the record as a whole, the Court does not find clear and convincing evidence that petitioner’s duties as a police officer were the predominant cause of petitioner’s disability.

[1] Petitioner also asserted a back injury as a disability, but petitioner has not raised such injury in the petition, opening brief, or reply.

[2] It is undisputed that petitioner’s treatment was paid for by workers’ compensation. (AR 23.)

[3] Labor Code § 3212 states, in relevant part: “The…heart trouble…so developing or manifesting itself in those cases shall be presumed to arise out of and in the course of the employment. This presumption is disputable and may be controverted by other evidence…. The…heart trouble…so developing or manifesting itself in those cases shall in no case be attributed to any disease existing prior to that development or manifestation.”