California Court of Appeals, First District, Fourth Division
JOSE A. DUARTE, Plaintiff and Appellant,
STATE TEACHERS’ RETIREMENT SYSTEM et al., Defendants and Respondents.
Alameda County Superior Court No. RG 09-490024 Hon. Evelio Grillo Judge.
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Law Offices of Jivaka Candappa and Jivaka Candappa for Plaintiff and Appellant.
Kamala D. Harris, Attorney General, Julie Weng-Gutierrez, Assistant Attorney General, Karin S. Schwartz and Charles J. Antonen, Deputy Attorneys General, for Defendants and Respondents.
Jose A. Duarte (Duarte) appeals from the trial court’s denial of his petition for writ of administrative mandamus, through which he asserts that his application to the State Teachers’ Retirement System (CalSTRS) for disability retirement benefits has been improperly denied. After hearing, an administrative law judge (ALJ) upheld CalSTRS’s denial of Duarte’s application for benefits, concluding that CalSTRS had no choice but to deny Duarte’s application once he refused to complete the independent medical evaluation (IME) ordered by CalSTRS pursuant to section 24103, subdivision (b), of the Education Code. The trial court subsequently affirmed the decision of the ALJ. Duarte asserts on appeal that the trial court erred in concluding that he was ineligible for disability benefits under section 24101, subdivisions (a) and (c). He additionally argues that the doctrine of collateral estoppel bars CalSTRS from relitigating the issue of his disability because several other state agencies have already found him to be disabled. Because we conclude that Duarte cannot overcome his refusal to attend the IME ordered by CalSTRS in this case, we affirm.
A. Duarte’s Employment and Disability History
Duarte became a contributing member of the CalSTRS defined benefit program on September 1, 1993, when he began teaching in the Stockton
Unified School District (SUSD). Duarte taught in Stockton through June 30, 1995, earning 2.023 years of creditable service for purposes of CalSTRS benefit calculations. Thereafter, the SUSD authorized unpaid personal leave for Duarte for the 1995-1996 school year and unpaid educational leave for each of the 1996-1997 and 1997-1998 school years. During his time away from teaching, Duarte spent one season working for California's Department of Forestry and Fire Protection as a firefighter. In addition, he reportedly attended law school but, after failing to pass the bar, was working as a paralegal. On December 3, 2003, Duarte returned to teaching in the Oakland Unified School District (OUSD). On his second day of employment—December 4, 2003—he was assaulted by two students after he denied them entry into his classroom due to their disruptive behavior. Specifically, Duarte sustained an injury to his shoulder when one of the students knocked him backwards in order to get past him through the classroom door. According to Duarte, the other student threatened him several times, making statements such as “I’m gonna put a cap in your ass.” As Duarte tried to complete the day’s lesson, a number of students continued to mock him. Duarte has not returned to teaching since this incident.
In January 2004, Duarte’s treating psychologist, Dr. Sloman, opined that he was suffering from a posttraumatic stress disorder (PTSD) and was “totally disabled with respect to working as a teacher." Specifically, Dr. Sloman stated: “His anxiety, due to reminders of the original trauma, would be so high he could not function.” Dr. Sloman indicated in April 2005 that her original diagnosis had not changed. In March 2007, although she had last seen Duarte in November 2005, Dr. Sloman continued to diagnose him as suffering from PTSD and also reported that Duarte had difficulty focusing, impaired concentration when trying to complete whet appear to be simple tasks, and an inability to understand and remember simple directions. She did not expect his condition to improve. Duarte’s treating psychiatrist, Dr. Goldstein, stated in December 2004 that Duarte was suffering from significant intermittent depression and indicated that he had previously been diagnosed with this condition by a psychiatrist at Kaiser Hospital. In October 2005, after seeing Duarte for almost a year, Dr. Goldstein’s stated diagnosis was PTSD with significant depression. He further indicated that, due to this condition, Duarte “has a definite lack of concentration, impaired energy, nightmares/flashbacks, memory loss, and anxiety.” Moreover, “[d]ue to the daily stress and anxiety associated with this condition, ” Duarte was reported
to be “unable to complete average daily tasks and is unable to make deadlines, appointments and other routine tasks required of him.”
In March 2004, Duarte filed a worker’s compensation claim with the Worker’s Compensation Appeals Board in Oakland against the OUSD and the State Department of Education, which at the time managed and supervised the OUSD. During the processing of this claim, Duarte was evaluated by four different doctors. For instance, Dr. Matan—an orthopedic surgeon and qualified medical evaluator (QME)—concluded that Duarte has “disability precluding heavy or repetitive use of his left shoulder” and is “specifically precluded from doing significant work at or above shoulder height.” According to Dr. Matan, Duarte is physically able to work as a teacher, but probably not as a firefighter. Another orthopedist and QME, Dr. Barber, confirmed “a level of permanent disability which precludes constant work at or above shoulder level on the left.”
In addition, Duarte attended a psychiatric evaluation with psychiatrist Donald Stanford in December 2005. During that evaluation, Duarte indicated that he had been treated psychiatrically for stress for a short time in 1995 when he was working for the SUSD. Records indicate that he was also treated for stress in 1998. Duarte additionally reported multiple learning problems involving reading that he has had throughout his life, along with issues related to short-term memory. Dr. Stanford concluded that Duarte’s cognitive complaints appeared to be exaggerated and that reported problems with concentration and clear thinking were “not clinically evident.” Further, he saw no new cognitive problems as a result of Duarte’s OUSD injury. Dr. Stanford additionally opined that Duarte’s PTSD symptoms had “resolved for the most part, ” although he would likely become anxious again if he were to resume his work as a teacher. In summary, Dr. Stanford concluded that Duarte had a period of “temporary psychiatric disability” as a result of the December 2003 incident, but that it had resolved by August 2004, other than a preclusion from returning to teaching. Other longstanding psychiatric and cognitive problems were unrelated to the OUSD injury.
Finally, Duarte received a psychiatric evaluation from Dr. Richard Lieberman in November 2005. Duarte reported longstanding issues with dyslexia and “short-term memory trouble with details and words” to Dr. Leiberman. Dr. Lieberman diagnosed Duarte with PTSD, resolving. He concluded that Duarte was psychiatrically totally and temporarily disabled from the date of the assault until the date of his evaluation. He recommended that Duarte not return to work as a “Spanish teacher for the Unified School District, ” but indicated that vocational rehabilitation would be appropriate. Ultimately, Duarte entered into a stipulated settlement of his worker’s compensation claims on January 26, 2007. The executed settlement documents indicate a “serious dispute” regarding the scope of Duarte’s disability.
In October 2006, Duarte applied for social security disability benefits. State Department of Social Services (CalDSS) is charged with making disability determinations in California on behalf of the Social Security Administration (SSA), based on federal law. (See 42 U.S.C. § 421.) As part of this process, CalDSS sent Duarte to be examined by an orthopedist, Dr. Pon, and a psychologist, Dr. Felix. Dr. Pon concluded in March 2007 that Duarte should avoid reaching over the left shoulder level and should be limited to only occasionally climbing ladders, crawling, lifting 20 pounds, and reaching using his left shoulder. Dr. Felix completed a psychological evaluation of Duarte that same month. Based on this evaluation, Dr. Felix concluded that Duarte “appears to be impaired in his ability to return to teaching.” Specifically, Dr. Felix opined as follows: “[Duarte] would have difficulty in any situation involving the execution of even simple tasks in a consistent manner. He would be able to interact appropriately with co-workers, supervisors, and the public. It is possible that over time [Duarte] may overcome some of his slowness, terror, and emotional numbness.”
Ultimately, CalDSS determined on April 13, 2007, that Duarte was disabled from the date of the December 2003 incident. He became eligible for monthly disability benefits as of December 2005. According to Duarte, no hearing was ever held during this process, although he submitted a declaration to CalDSS and the SSA and was asked “ ‘Is that the truth and the whole truth?’ ” during one phone call from “one of the people from the Social Security Administration.” Further, CalDSS did not issue a determination letter stating its reasons for approving his claim.
Duarte also had two student loans through the University of California (UC) totaling approximately $10, 000 which he requested be forgiven due to his total and permanent disability. One loan was an institutional loan issued and funded by the UC, itself, while the other was a federally-funded loan issued under the federal Perkins Loan program. A representative of the UC testified at the administrative hearing in this matter regarding the process for loan forgiveness with respect to both student loans, stating that first the borrower “submits whatever medical documentation they would like” for consideration. Thereafter, the documentation is evaluated by medical staff at the relevant UC campus. “So, in the case of this U.C. Irvine loan that was evaluated by the medical staff at the Irvine campus, I’m not going to say that it’s a comprehensive evaluation, but we do want to make at least a determination that the documentation appears, to our eyes, to be reasonable.” For the
institutional loan, the recommendation of medical staff after this informal review is conclusive. Indeed, there is no formal hearing, and no “formulated approach” or written standard to aid in a finding of disability. With respect to the federal loan, once the UC makes a preliminary finding of disability, it releases its interest in the loan and forwards it to the U.S. Department of Education for a final determination based on federal standards. After application of this stated process in the present case, Duarte’s institutional loan was cancelled on the basis of total and permanent disability. His federal loan was released by the UC and forwarded to the U.S. Department of Education on the basis of ...