Opinion
NOT TO BE PUBLISHED
APPEAL from an order of the Superior Court of San Diego County No. 37-2007- 00073294-CU-WM-CTL, Joan M. Lewis, Judge.
HALLER, J.
The City of San Diego (City) denied city employee Steven Gold's request for an industrial leave benefit after he injured his back on the job. The benefit is not available if the work-related injury is an aggravation of a nonservice-connected injury. The City determined Gold's injury fell within this category of excluded injuries. After the City's denial was affirmed in administrative proceedings, Gold petitioned for a writ of mandate in superior court. The trial court granted the petition and ordered the City to grant Gold's request for the industrial leave benefit. The City appeals. We affirm. We hold the City improperly denied the benefit based on the fact that Gold had not previously filed a written report documenting his preexisting injury as work related. The applicable City regulations do not require a prior written report to qualify a preexisting injury as service connected for purposes of the industrial leave benefit.
FACTUAL AND PROCEDURAL BACKGROUND
Overview
In 1992, Gold injured his back while attending a work-related computer training program at an off-site building. According to Gold, he verbally told his supervisor about this injury shortly after it occurred. However, he did not submit a written report and did not file a workers' compensation claim for the injury. Instead, he obtained compensation from the third party responsible for managing the off-site building. In 1994, Gold underwent back surgery because of the 1992 injury. Several years later, in 2005, Gold reinjured his back while at work and needed further surgery. Gold's physicians determined that his 2005 injury had aggravated a back condition that had arisen from his 1992 injury and the ensuing 1994 surgery. Gold requested that he be provided the industrial leave benefit for the 2005 injury.
The City denied Gold's request for the benefit. The City did not refute Gold's claim that the preexisting 1992 injury was suffered while he was on the job, but rather maintained that the 1992 injury did not qualify as a service-connected injury because Gold never submitted a written report to the City documenting the 1992 injury as work related.
After an administrative hearing, the hearing officer affirmed the City's denial based on the absence of a written report for the 1992 injury. In a mandamus proceeding challenging the administrative ruling, the trial court granted writ relief based on its conclusion that the City was equitably estopped from relying on the absence of a written report for the preexisting injury. The trial court reasoned that Gold had verbally reported the injury in 1992 to his supervisor, and the supervisor did not inform Gold about the written reporting requirement and the supervisor failed to file a written report.
After obtaining supplemental briefing from the parties, we conclude that the relevant city regulations contain no written reporting requirement to establish a preexisting injury as service connected. Although the city regulations set forth reporting requirements for a current work-relatedinjury when an employee is seeking workers' compensation or industrial leave benefits, they contain no reporting requirement to qualify a preexisting injury as work related.
Because there is no regulation mandating a written report for the 1992 injury to qualify it as service connected, the administrative ruling characterizing the 1992 injury as nonservice connected based on the absence of a written report was legally erroneous. We also conclude there is no need to remand the matter for further proceedings to determine whether Gold is entitled to the industrial leave benefit. The record reveals that the factual predicates necessary to establish Gold's eligibility for the industrial leave benefit were resolved in the proceedings below. Specifically, the record shows that Gold's 1992 injury occurred during a work-related activity; his 1994 surgery resulted from the 1992 injury; and his deteriorating back condition was not congenital but resulted from the 1994 surgery incurred because of the 1992 injury. Accordingly, Gold's 2005 work-related injury was an aggravation of a preexisting, service-connected injury that qualified for the industrial leave benefit.
The City raises several additional arguments to support its position that we should reverse the trial court's order, including that the doctrines of laches or unclean hands bar Gold's request for the benefit. We reject these arguments. The trial court correctly ordered the City to grant Gold's request for the industrial leave benefit.
Background
Gold has been employed by the City as a deputy city attorney since 1988. In September 1992, he injured his back while attending a work-related computer training program at an off-site building. The injury occurred when an elevator door closed on him because the "electric eye" was turned off. Gold did not file a claim for workers' compensation, but received compensation from the third party responsible for the elevator malfunction.
The 1992 injury created disk herniation at the L5-S1 level of Gold's spine. Due to continuing pain from the 1992 injury, in 1994 Gold underwent lumbar fusion surgery at the L5-S1 level which was paid for by the third party. Gold recovered from the surgery and continued to work for the City.
On July 6, 2005, Gold lifted a heavy box at work and reinjured his back. He filed a workers' compensation claim, which the City approved. Gold's examining physicians (Drs. Carl Maguire and Bruce van Dam) determined that he had stenosis and degenerative spondylolisthesis at the L4-5 level; that this condition was an "[a]ccelerated adjacent segment disease"; and that the condition was aggravated by the recent 2005 on-the-job injury. The doctors recommended extension of the fusion surgery to the L4-5 level. Gold filed a request to receive the industrial leave benefit for the 2005 injury.
Administrative Proceeding
On February 27, 2006, the City denied Gold's request for the industrial leave benefit. The City stated in its denial letter that Gold's July 2005 injury was an aggravation of a nonservice connected injury and hence he did not qualify for the industrial leave benefit. Gold requested an administrative hearing to review the denial.
At an administrative hearing held on April 13, 2006, the City did not refute Gold's claim that the 1992 injury was incurred at the work-related computer training, but argued that Gold never submitted a written report to the City about the 1992 injury. Gold acknowledged that he did not submit a written report for the 1992 injury, but stated that the injury was incurred while he was on the job at the computer training program, and that current and past City employees could corroborate this fact.
The administrative proceedings were not recorded, nor does it appear that the parties submitted written legal arguments to the hearing officer. Our summation of the parties' positions is based on the statements in the hearing officer's decision and the documents submitted by the parties at the administrative hearing.
To support its denial, the City also relied on its interpretation of the reports of Gold's medical doctors, which referred to a "degenerative" condition and which the City construed as meaning his back condition was congenital. To refute this, Gold submitted a clarifying medical report from Dr. van Dam stating that his current condition at the L4-5 level was not a congenital condition but was a consequence of the 1994 fusion and the aggravation caused by the July 2005 lifting injury. Dr. van Dam explained that the 1994 spinal fusion resulted in a total lack of motion at L5-S1; which then transferred abnormal loading to the adjacent motion segment at L4-5; which over time caused the disk and facet joints at L4-5 to undergo accelerated breakdown or degeneration; and which resulted in the current condition (stenosis and spondylolisthesis) to his back at the L4-5 level.
Dr. van Dam's supplemental report was submitted after the administrative hearing, but was accepted and considered by the hearing officer.
In a May 8, 2006 decision, the administrative hearing officer affirmed the City's denial of the benefit. The hearing officer noted that the City "did not dispute that the 1992 injury may have been service-connected, but affirmed the injury was never reported as such." The hearing officer cited a city administrative regulation requiring an employee to document an injury in writing by submitting an "Employee-Employer Report of Occupational Injury or Illness" (the Employee-Employer Report). The hearing officer concluded that because no such report had been filed, the "1992 injury and resultant 1994 fusion are not recognized as service-connected or industrial, and [the] 2005 injury would be an aggravation of a nonservice-connected medical condition."
The hearing officer also noted the City's interpretation of the medical reports as indicating the preexisting condition was congenital, but did not rely on this when affirming the denial of Gold's claim. Rather, the hearing officer stated he had reviewed Dr. van Dam's supplemental medical report, and quoted the statement in the report explaining the condition was not congenital.
Writ of Mandate Proceeding
In August 2007, Gold filed a petition for writ of mandate under Code of Civil Procedure section 1094.5, challenging the City's denial of his request for the industrial leave benefit. At the mandamus proceeding, Gold asserted the City should be estopped from denying his request based on his failure to submit a written report for the 1992 injury. To support this position, Gold claimed he had verbally reported his 1992 injury to his supervisor at the time that it occurred; his supervisor never informed him of any written reporting requirement; and his supervisor did not comply with his own obligation under the City's regulations to ensure that a written report is submitted.
In opposition, the City asserted the hearing officer properly rejected Gold's claim because Gold never filed a written report for the 1992 injury. The City also argued it should not be estopped from denying the claim based on Gold's supervisor's alleged conduct, noting that Gold was an attorney himself and was represented by counsel during his personal injury lawsuit against the owner of the building where the 1992 injury occurred. Further, the City requested that the court apply the equitable doctrines of estoppel, laches, and unclean hands in favor of the City.
The City questioned whether the estoppel issue was properly before the trial court, but nevertheless addressed the issue on the merits and also raised its own equitable defenses.
The trial court granted Gold's writ petition. As did the hearing officer, the court noted that the City's position that the 1992 injury was not service connected was "not based on how or where the 1992 injury occurred but, rather, on the fact that [Gold] never submitted a written report documenting the injury as service-connected." The court concluded the City was estopped from asserting the absence of a written report as a defense given that Gold promptly notified his supervisor of his work-related injury in 1992, and the supervisor failed to inform Gold of the need to submit a written report and/or the supervisor did not comply with his own obligations to report the incident. The court ordered the City to set aside its denial of the industrial leave benefit, and remanded the matter to the City to determine the amount of industrial leave benefits owed to Gold.
During the oral arguments before the trial court, the court also rejected the City's assertion that the hearing officer had found Gold's preexisting back condition was congenital. The court stated that when read in context it was clear the hearing officer's decision was based solely on the failure to submit a written report.
DISCUSSION
I. No Written Reporting Requirement to Qualify Preexisting Injury as Service Connected
It is clear from the record that the hearing officer and the trial court assumed that under the City's regulations, a preexisting injury must have been reported in writing to the City to qualify as a service-connected injury for the industrial leave benefit. We solicited and obtained supplementary letter briefs from the parties to address whether this reporting requirement actually exists in the City's regulations. Although recognizing there is no regulation expressly imposing a written reporting requirement for preexisting injuries, the City contends a written report must be filed to qualify any injury as service connected. We reject this interpretation of the regulations, and conclude there is no written reporting requirement to qualify a preexisting injury as service connected.
On appeal from administrative mandamus proceedings, we review legal issues de novo. (Jenron Corp. v. Department of Social Services (1997) 54 Cal.App.4th 1429, 1434; Roze v. Department of Motor Vehicles (2006) 141 Cal.App.4th 1176, 1184.) An agency's interpretation of the law is not binding, although we may give deference to its interpretation as appropriate under the circumstances. (Santa Clara Valley Transportation Authority v. Rea (2006)140 Cal.App.4th 1303, 1314; Sacramento Children's Home v. State Dept. of Social Services (2000) 81 Cal.App.4th 786, 792-793.) When an issue concerns a pure question of law, we may consider it for the first time on appeal even though it was not raised in the proceedings below. (Gilliland v. Medical Board (2001) 89 Cal.App.4th 208, 219.)
The relevant city administrative regulations cited by the parties and reviewed in the proceedings below are Administrative Regulation 63.00 (A.R. 63) governing the industrial leave benefit for city employees, and Administrative Regulation 62.00 (A.R. 62) governing workers' compensation benefits for city employees. A.R. 63 states that its purpose is to "establish regulations and guidelines regarding the City of San Diego's Industrial Leave Program." (A.R. 63, § 1.) A.R. 62 states that its purpose is to "define the City's self-administered program for meeting its Worker's Compensation liabilities in compliance with the Worker's Compensation provisions of Division 4 of the California Labor Code; to establish procedures for reporting occupational injuries and illnesses of City employees." (A.R. 62, § 1.1.)
Under A.R. 63, the industrial leave benefit provides injured city employees (in lieu of workers' compensation temporary disability) a one-year leave benefit based on their full pay. (A.R. 63, §§ 1, 4.1, 4.3(A), (B), (F)(1).) A.R. 63 sets forth the eligibility requirements for receipt of industrial leave, including that (1) the "employee is unable to perform his or her assigned duties due to job related injury or illness and is entitled to Workers' Compensation Temporary Disability," and (2) the "employee reported the injury or illness to his or her supervisor within 24 hours of the incident" (with an exception for extenuating circumstances). (A.R. 63, § 4.2(A) & (B).) Additionally, for the injured employee to be eligible for industrial leave, the disability must not result from "an aggravation nor recurrence of: [¶]... [a] pre-employment, and/or nonservice-connected medical condition or disability (either physical and/or mental), even if such condition is aggravated by on-the-job experience." (A.R. 63, § 4.2(G)(1).)
The eligibility provision of A.R. 63 states: "4.2 Eligibility for Industrial Leave [¶] Employees shall be eligible for industrial leave benefits subject to the following provisions: [¶] A. The employee is unable to perform his or her assigned duties due to job related injury or illness and is entitled to Workers' Compensation Temporary Disability under the provisions of Division 4 of the California Labor Code. [¶] B. The employee reported the injury or illness to his or her supervisor within 24 hours of the incident, except under extenuating circumstances. Extenuating circumstances under which an employee may report an injury beyond the 24 hour limit shall include but not be limited to a report at the time the employee realized the injury is disabling and the medical evidence is consistent with the claim." (A.R. 63, § 4.2(A) & (B).)
The provision of A.R. 63 concerning a preexisting injury states: "4.2. Eligibility for Industrial Leave [¶] Employees shall be eligible for industrial leave benefits subject to the following provisions: [¶]... [¶] G. The disability did not result from an aggravation nor recurrence of: [¶] 1. A pre-employment and/or nonservice-connected medical condition or disability (either physical and/or mental), even if such condition is aggravated by on-the-job experience. It is the intent that industrial leave will not be approved when competent medical authority determines the disability to be a result of an aggravation of, or caused by, a pre-employment or non-industrial medical condition." (A.R. 63, § 4.2(G)(1).)
In a section denominated "Procedure," A.R. 63 delineates the employee's responsibilities to report the job-related injury to his or her supervisor within 24 hours, and to fill out required forms. (A.R. 63, §§ 5.1, 5.2, 5.3.) The employee's initial report may be made verbally, but must be followed by completion of the necessary forms "as soon as possible." (A.R. 63, § 5.1.) Likewise, A.R. 63 sets forth the employer's responsibility to investigate the accident and fill out required forms, stating that the supervisor must investigate the accident within 24 hours after it is reported, complete certain forms (including the Employee-Employer Report), and ensure that the employee completes certain forms (including the employee portion of the Employee-Employer Report). (A.R. 63, § 5.10.)
A.R. 63 states: "PROCEDURE [¶] Responsibilities.... [¶] 5.1 Each employee is responsible for reporting the job related injury or illness to his or her supervisor within 24 hours of the incident, except under extenuating circumstances. The initial report should be made to the employee[']s immediate supervisor, or if unavailable, to the next supervisor in the chain of command. The initial report may be made verbally, but must be followed by completion as soon as possible of the necessary forms outlined below." (A.R. 63, §§ 5, 5.1.)
A.R. 63, section 5.10 states: "Each supervisor must thoroughly investigate each accident with[in] 24 hours after it is reported and complete the applicable 'Employee Injury Investigative Report.' The supervisor must also fill out RM-1532A, the Employee-Employer Report of Occupational Injury or Illness, and make sure the employee completes the employee portion of both that form and the Request for Leave of absence form. All required forms must be promptly forwarded to the appointing authority for processing."
Governing workers' compensation benefits, A.R. 62 sets forth reporting requirements similar to those in A.R. 63, requiring the injured employee to complete the Employee-Employer Report form "within 24 hours of the injury or as soon as the employee is physically able to do so." (A.R. 62, § 5 (1).) Further, the employee's supervisor must investigate the disability; review, comment upon, and sign the Employee-Employer Report form; and complete a supervisor's report form. (A.R. 62, § 5 (4).)
A.R. 62 states: "PROCEDURE. [¶] Responsibility.... [¶] Injured Employee 1. Completes and signs 'Employee-Employer Report of Occupational Injury or Illness' (Form ES-1531A) within 24 hours of the injury or as soon as the employee is physically able to do so. [¶] 2. Retains one copy and gives original and three copies to immediate supervisor." (A.R. 62, §§ 5, 5(1), 5(2).) In addition to requiring completion of the Employee-Employer Report, A.R. 62 requires the employee to complete a "Request for Leave of Absence for On-the-Job Disability" in cases of absence. (A.R. 62, § 5(3).)
A.R. 62, section 5(4) states: "Department/Division Supervisor reviews, comments upon and signs ES-1531A [the Employee-Employer Report form]; investigates circumstances of disability and completes 'Supervisor's Accident Investigation Report' (ES-1531B)."
In short, A.R. 63 and A.R. 62 require an employee to submit written forms reporting a current job-related injury in order to obtain industrial leave or workers' compensation benefits. Further, A.R. 63 precludes an employee who suffers a work-related injury from obtaining the industrial leave benefit if the injury was caused by an aggravation of a nonservice-connected medical condition. Thus, when an employee suffers an industrial injury that consists of an aggravation of a preexisting condition, the industrial leave benefit will apply only if the preexisting condition arose because of a work-related activity.
However, there is nothing in A.R. 63 or A.R. 62 which provides that when an employee suffers an on-the-job aggravation of a preexisting, work-related medical condition, the preexisting condition qualifies as service connected only if the employee filed a written report with the City concerning the preexisting injury. A.R. 63, which governs the industrial leave benefit, merely requires that the employee comply with the reporting requirements for the current injury, and that the current injury not be an aggravation of a nonservice-connected medical condition. Although the submission of a written report to the employer concerning the preexisting injury can serve as evidentiary proof that the preexisting condition was job-related, there is nothing in the administrative regulations stating that such a written report is a prerequisite to qualifying the preexisting injury as job related.
We note that the introductory paragraph of A.R. 62, governing workers' compensation benefits, states that the purpose of the regulation is "to establish procedures for reporting occupational injuries and illnesses of City employees." (A.R. 62, § 1.1.) This provision, although broad in scope, cannot reasonably be construed as imposing a written reporting requirement to establish a preexisting injury as service connected for the industrial leave benefit. A.R. 63, governing the industrial leave benefit, contains its own reporting requirements which are distinct from the reporting requirements in A.R. 62. Further, the reporting requirements set forth in both A.R. 62 and A.R. 63 contemplate employee claims for benefits for current injuries. There is nothing in these regulations suggesting that the reporting requirements for current injuries are meant to be superimposed as reporting requirements necessary to qualify a preexisting injury as service connected.
Further, there is no basis for inserting a reporting requirement for preexisting injuries into the regulations by implication. Unless the result would frustrate the purpose of a statute or lead to absurd results, statutory language should be interpreted according to its plain meaning and without adding terms as to which the statute is silent. (See Atlantic Richfield Co. v. Workers' Comp. Appeals Bd. (1982) 31 Cal.3d 715, 726; California School Employees Assn. v. Governing Bd. of South Orange County Community College Dist. (2004) 124 Cal.App.4th 574, 584.) There is nothing to suggest that without a written reporting requirement for preexisting injuries the purpose of the industrial leave benefit will be frustrated or absurdity will ensue. To the contrary, providing the industrial leave benefit to an employee who in fact suffers an on-the-job aggravation of a preexisting, work-related injury (regardless of whether the latter was documented in a written report) comports with the intent of the industrial leave benefit to provide augmented financial support to employees who sustain service-connected injuries.
For example, there may be instances where an employee fails to submit a written report for what appears to be a minor work-related injury, and then years later, through on-the-job cumulative trauma or reinjury, the original injury escalates into a serious health condition. Significantly, an employee who seeks the leave benefit because of a current job-related injury that consists of an aggravation of a preexisting, job-related injury, is not seeking leave benefits for the past injury but only for the current injury. Absent a regulation alerting an employee that the failure to submit a written report precludes subsequent characterization of the injury as work-related, there is no reason why the employee's failure to submit a written report for the past injury should deprive the employee of the leave benefit for the current, properly-reported injury. Of course, the employee will be required to prove that the past injury was suffered on the job. As noted, a written report concerning the preexisting injury provides proof that the injury was service connected, but the absence of a written report does not necessarily mean the preexisting injury was not, in actuality, service connected.
In sum, there is no legal basis to support the City's denial of Gold's request for industrial leave based merely on Gold's failure to submit a written report for the 1992 injury. A.R. 63 and A.R. 62 require that an employee submit forms to report a current injury for purposes of obtaining industrial leave or workers' compensation benefits. However, there is nothing in A.R. 63 or A.R. 62 which requires that an employee must have submitted a written report concerning a preexisting injury to qualify that preexisting condition as service-connected. A.R. 63 merely requires that the preexisting injury was, in fact, service related.
We conclude that because there is no regulation imposing a written reporting requirement to qualify a preexisting injury as service connected, the City cannot properly deny the industrial leave benefit based on the absence of a written report. The hearing officer's affirmance of the City's denial of the benefit premised on the absence of a written report for the 1992 injury was legally erroneous.
II. The Record Shows the Preexisting Condition Was Service Connected
Both the hearing officer's and the trial court's resolution of Gold's eligibility for the industrial leave benefit was premised on the incorrect assumption that there was a written reporting requirement to qualify a preexisting injury as service connected. Although in some circumstances this would necessitate a remand of the matter for further proceedings on the issue of eligibility, no remand is required here because the record shows the factual predicates necessary to qualify Gold for the benefit were resolved in the proceedings below in Gold's favor.
In the proceedings below, the trial court and the parties assumed that the industrial leave benefit did not concern a fundamental vested right and hence that the substantial evidence (rather than the independent judgment) standard applied at the mandate proceedings before the trial court. When the substantial evidence standard applies, both the trial court and the appellate court review the factual findings in the administrative decision for substantial evidence. (SP Star Enterprises, Inc. v. City of Los Angeles (2009) 173 Cal.App.4th 459, 468-469.) In contrast, when the independent judgment standard applies, the trial court reweighs the evidence in the administrative record, and on appeal we review the trial court's factual findings for substantial evidence. (Ibid.) On our own motion, we raised the question of whether the industrial leave benefit was a fundamental vested right (see Dickey v. Retirement Board (1976) 16 Cal.3d 745), and we received supplemental briefing from the parties on this issue. As will become apparent in our discussion that follows, under the particular posture of this case we have now concluded it is not necessary for us to determine whether the leave benefit is a fundamental vested right.
There is no dispute that Gold suffered an on-the-job injury in 2005 and that he complied with the reporting requirements for the 2005 injury. Further, there is no dispute that Gold's 2005 injury was an aggravation of a preexisting back condition. Under A.R. 63, Gold is entitled to the industrial leave benefit for the 2005 injury only if his preexisting back condition was, in fact, service connected. (A.R. 63, § 4.2, (G) (1).) Gold's preexisting back condition arose from the 1992 back injury, the 1994 back fusion surgery which he underwent to address pain from the 1992 back injury, and the development of a deteriorating back condition. As we shall discuss, the record shows that all of these contributors to his back condition were service connected. That is, the record establishes (1) that the 1992 injury occurred during a work-related activity, (2) the 1994 surgery was incurred because of the 1992 work-related back injury, and (3) the deteriorating back condition was not a congenital condition but was the result of the 1994 surgery necessitated by the 1992 injury.
At the administrative hearing, Gold declared that he suffered the 1992 injury while he was at job-related computer training, and he indicated that he could, if necessary, obtain corroborating statements from other city employees. The record shows the City did not refute Gold's claim that the 1992 injury was service connected. In his written decision, the hearing officer stated that the City "did not dispute that the 1992 injury may have been service-connected, but affirmed the injury was never reported as such." Further, the hearing officer made no express or implied adverse credibility finding concerning Gold's description of the circumstances of the 1992 injury, but instead relied solely on Gold's failure to submit a written report concerning the 1992 injury.
The trial court's construction of the record was essentially the same as the hearing officer's on this point. The trial court's decision states that the City's characterization of the 1992 injury as nonservice connected was "not based on how or where the 1992 injury occurred but, rather, on the fact that [Gold] never submitted a written report documenting the injury as service-connected."
If the City wanted to dispute Gold's claim that the 1992 injury was service connected, it was required to present its evidence on this point at the administrative hearing. (Windigo Mills v. Unemployment Ins. Appeals Bd. (1979) 92 Cal.App.3d 586, 595; Bohn v. Watson (1954) 130 Cal.App.2d 24, 37.) In the absence of contrary evidence from the City, the record establishes that Gold's 1992 injury was incurred during a work-related activity.
On appeal, the City contends the 1992 injury should not be characterized as work related because of a statement made by Gold's physician in conjunction with Gold's application for disability income at the time of his 1994 surgery. In December 1994, Gold filled out an application for "Long-Term Disability Income" benefits from the City to receive compensation for loss of income related to the surgery. In a statement from his attending physician supporting this application, the physician classified his condition as unrelated to employment. The City asserts that this statement supports that the 1992 injury did not occur during a work-related activity. We are not persuaded. Gold's description of the 1992 injury as occurring during a work-related computer training activity sets forth the specific circumstances of the injury, and the City provided no information to counter this description. Further, Gold claimed that he made a verbal report to his supervisor about the 1992 injury, and the City likewise did not refute this claim. The physician's conclusory statement characterizing Gold's condition as unrelated to employment provides no factual information describing how the 1992 injury occurred, and the statement is insufficient to refute the specific description provided by Gold.
Gold's claim that he made a verbal report to his supervisor does not appear in the administrative record provided to us on appeal. However, it appears undisputed that he made this claim at the administrative proceeding.
The record also shows that the 1994 back surgery was service connected in that it was incurred as a result of the 1992 work-related injury. There is nothing in the record to suggest that Gold underwent the surgery because he suffered from a back condition unrelated to the 1992 work-related injury.
Finally, the record shows that Gold's deteriorating back condition was not a congenital condition. Dr. van Dam's supplemental medical report expressly stated the condition was not congenital and explained that the condition arose from the 1994 fusion surgery. Dr. Maguire's medical report contains no statement indicating the condition was congenital. In his written decision, the hearing officer noted the City's congenital argument; quoted from Dr. van Dam's supplemental report stating the condition was not congenital; and then concluded the City's denial was proper because Gold failed to submit a written report. At the mandamus hearing, the trial court rejected the City's contention that the hearing officer had found the condition was congenital, and the court itself made no finding that the condition was congenital. At the administrative proceeding, the City's assertion that the injury was congenital was based on the examining physicians' characterization of the injury as "degenerative." Degenerative does not mean congenital, and there is nothing in the medical reports stating the injury was congenital. (See Webster's Collegiate Dict. (10th ed. 2002), pp. 242, 303 [congenital means existing at birth; degenerative means deteriorating]; Stedman's Medical Dict. (27th ed. 2000) pp. 398, 467-468 [same].) It is clear from the record that both the hearing officer and the trial court understood that there was no evidentiary support for the City's assertion that the deteriorating back condition was congenital rather than related to the 1992 work-related injury and ensuing 1994 back surgery.
In its reply brief, the City states that the hearing officer's written decision noted "that there was evidence in the medical reports... that [Gold's] 2005 injury and disability was due to an aggravation of a congenital (spinal stenosis) and degenerative condition (spondylothesis)." (Italics added.) This is a misstatement of the record. The hearing officer's decision does not refer to the stenosis as congenital, nor do the medical reports.
The record establishes that Gold is eligible for the industrial leave benefit because his preexisting back condition was service connected. Accordingly, there is no need to remand the matter for a determination of this issue.
III. Additional Arguments Raised by the City
The City raises several additional arguments to support its position that we should reverse the trial court's order, including: (1) the trial court agreed that the substantial evidence standard applied, but the court, in effect, erroneously applied an independent judgment standard when reviewing the hearing officer's decision; (2) equitable estoppel should not be applied to preclude the City from relying on Gold's failure to submit a written report; and (3) Gold should be barred from the industrial leave benefit under the doctrines of laches and unclean hands.
The first two arguments do not raise any issues affecting our resolution of this appeal. As set forth above, both the hearing officer and the trial court correctly assessed that the City did not refute Gold's claim that the 1992 injury was work related, and both the hearing officer and the trial court properly declined to adopt the City's unsupported contention that Gold's deteriorating back condition was congenital. Given the agreement between the trial court and the hearing officer on these pivotal points, the trial court's conclusions would be the same regardless of whether it applied the substantial evidence or independent judgment standard to review the hearing officer's decision. Likewise, once the written reporting requirement is eliminated, our evaluation of the case on appeal is not affected by the standard of review issue because the record establishes Gold's entitlement to the industrial leave benefit under both the hearing officer's and trial court's decisions. (See fn. 10, ante.) Further, we need not evaluate whether the trial court could properly find the City was estopped from relying on the absence of a written report given that a written reporting requirement for a preexisting injury does not exist.
In its third argument, the City asserts that based on Gold's lengthy delay in formally reporting the 1992 injury as work-related, and the characterization of the injury as unrelated to employment in the physician's statement accompanying Gold's 1994 disability income application, we should apply the equitable doctrines of laches and unclean hands to bar Gold from receiving the industrial leave benefit. These factual issues are not properly before us because the record does not show they were presented at the administrative hearing. As a general rule, review of an administrative decision is confined to matters in the administrative record. (Pomona Valley Hospital Medical Center v. Superior Court (1997) 55 Cal.App.4th 93, 101; Jenron Corp. v. Department of Social Services, supra, 54 Cal.App.4th at p. 1437; Fukuda v. City of Angels (1999) 20 Cal.4th 805, 812, 817.) The parties are required to present all existing evidence at the administrative hearing. (Windigo Mills v. Unemployment Ins. Appeals Bd., supra, 92 Cal.App.3d at p. 595; Bohn v. Watson, supra, 130 Cal.App.2d at p. 37.)
On this record, there is nothing to indicate that the City raised the equitable defenses of laches or unclean hands at the administrative hearing as an alternative basis to support the denial of the industrial leave benefit. In his written decision, the hearing officer referred only to Gold's failure to submit a written report concerning his 1992 injury. The hearing officer did not suggest that the absence of a written report or other factors created an equitable ground for denying the benefits. Nor is there anything in the administrative record suggesting that the City raised the equitable defenses at the administrative hearing but the hearing officer did not reach them because of his determination in the City's favor on another ground.
Although new matters may be raised at mandamus proceedings if they could not have been presented at the administrative hearing (Code Civ. Proc., § 1094.5, subd. (e); Pomona Valley Hospital Medical Center v. Superior Court, supra, 55 Cal.App.4th at p. 101), the trial court did not rule that the issues of laches or unclean hands fell within this category. Further, although the City raised laches and unclean hands in its pleadings before the trial court and discussed these issues in its oral arguments to the trial court, the trial court made no findings concerning these defenses. (See In re Marriage of Freeman (1996) 45 Cal.App.4th 1437, 1450-1451 [party has duty to request that trial court make ruling on issue].) Examination of laches and unclean hands is typically fact-intensive and requires findings and inferences drawn from all the circumstances of the case. (See Miller v. Eisenhower Medical Center (1980) 27 Cal.3d 614, 624; Dickson, Carlson & Campillo v. Pole (2000) 83 Cal.App.4th 436, 447.) This is not a case where the issues can be resolved for the first time on appeal as a matter of law because only one inference can reasonably be drawn from undisputed facts. (See Platt Pacific, Inc. v. Andelson (1993) 6 Cal.4th 307, 319.)
Nevertheless, the City asserts we should reach the laches and unclean hands issues because the trial court considered and relied on equitable considerations when making its equitable estoppel finding in favor of Gold. The trial court's equitable estoppel ruling concerned the City's denial of the benefit based on a written reporting requirement, and did not address the equities independent of a written reporting requirement. In any event, assuming arguendo the trial court implicitly considered equitable issues apart from a written reporting requirement, and that these issues could properly be considered by the trial court for the first time at the mandamus proceedings, the record supports the trial court's conclusion that the equities favored Gold rather than the City.
As stated, the hearing officer's decision contains no express or implied ruling on the City's equitable defenses, and there is no showing the City raised the equitable defenses at the administrative ruling. Nevertheless, we are acceding to the City's request that we consider these equitable issues when reviewing the trial court's ruling. Under these circumstances, we need not decide whether the administrative decision was entitled to deference (see fn. 10, ante), and we apply the substantial evidence standard to any implied ruling by the trial court rejecting these defenses.
The defense of laches may be applied when a party unreasonably delayed and the delay caused prejudice to the opposing party. (Bono v. Clark (2002) 103 Cal.App.4th 1409, 1419-1420.) The defense of unclean hands may be applied when a party engages in inequitable conduct in connection with the matter in controversy. (Dickson, Carlson & Campillo v. Pole, supra, 83 Cal.App.4th at p. 446.) When deciding whether to apply these equitable defenses, the trial court considers the overall balance of competing equities between the parties. (Cortez v. Purolator Air Filtration Products Co. (2000) 23 Cal.4th 163, 180; Dickson, Carlson & Campillo v. Pole, supra, 83 Cal.App.4th at p. 446.) On appeal, we defer to the trial court's ruling on equitable defenses unless it is unsupported by the record or an abuse of discretion. (Miller v. Eisenhower Medical Center, supra, 27 Cal.3d at p. 624; Dickson, Carlson & Campillo v. Pole, supra, 83 Cal.App.4th at p. 447.)
Under the City's equitable arguments, Gold could arguably be denied the industrial leave benefit even though he had no obligation to file a written report for the preexisting injury and even though he was otherwise eligible for the benefit, if his conduct (i.e., his failure to file a written report and his submission of a physician's statement characterizing his condition as unrelated to employment) created equitable circumstances in favor of the City. However, on this record, the trial court could reasonably conclude that on balance the equities favored Gold.
The equitable considerations in Gold's favor included (1) Gold's unrefuted claims that the 1992 injury was in fact suffered on the job and that Gold verbally told his supervisor about the injury in 1992, and (2) the City's regulation governing the industrial leave benefit which states that the supervisor should fill out the Employee-Employer Report form and "make sure the employee completes the employee portion" of that form (A.R. 63, § 5.10; see fn. 7, ante). Notably, A.R. 63, section 5.10 refers to the supervisor's duties to investigate and submit written reports "with[in] 24 hours after [the accident] is reported" (italics added), with no suggestion that the supervisor is not authorized to submit a written report unless the employee has first submitted a written report. The trial court could consider that because the City—through its supervisor—was on notice of the 1992 injury, and because the supervisor was equally capable of submitting a written report, it would be unfair to penalize Gold for any repercussions on the City arising from the absence of a written report. Similarly, Gold's advisement to his supervisor about the 1992 injury supports a finding that Gold did not attempt to mislead the City when his physician characterized the injury as unrelated to employment in the 1994 disability income application.
In its briefing on appeal, the City notes the 13-year span between the 1992 injury and the 2005 reinjury when Gold characterized the 1992 injury as work related. Based on this lengthy passage of time, the City contends it was prejudiced in its ability to submit evidence from the 1992 supervisor at the administrative hearing to refute Gold's claim of a verbal report. The City never made this argument to the trial court. Instead, when the trial court noted that there was no declaration from the supervisor and queried whether the City had refuted Gold's claim that he had verbally reported the injury, the City merely acknowledged it had made no such refutation. The City never suggested to the trial court that the supervisor was unavailable due to the passage of time. Under these circumstances, the City cannot properly advance this theory for the first time on appeal. (Bogacki v. Board of Supervisors (1971) 5 Cal.3d 771, 780.) The City has not carried its burden to show the trial court could not reasonably reject the defenses of laches and unclean hands.
Because there is no requirement that a preexisting injury be documented in a written report to qualify it as service connected, and based on the showing that Gold's 2005 injury was an aggravation of a preexisting back condition that was work related and not the result of a congenital condition, Gold is entitled to the industrial leave benefit. Accordingly, the trial court properly granted Gold's petition for writ of mandate.
DISPOSITION
The order granting the petition for writ of mandate is affirmed. The City to pay Gold's costs on appeal.
WE CONCUR: McCONNELL, P. J., O'ROURKE, J.
A.R. 63 requires that the employee complete (1) the "Medical Status Report for Occupational Injury or Illness" (Form RM-1634) for injuries that result in absence from work, and (2) the "Employee Claim for Workers' Compensation Benefits" (Form RM-1642). (A.R. 63, §§ 5.2, 5.3.) If the employee is physically unable to fill out the Medical Status Report form, A.R. 63 provides that the employee's supervisor must complete and submit the form for the employee. (A.R. 63, § 5.2.)