Wednesday, December 31, 2025

A Cautionary Tale: Refusal of Recommended Surgery Leads to Denial of Deputy's Disability Retirement

    In a significant decision for public safety employees seeking disability retirement benefits, the California Court of Appeal, Second Appellate District, has upheld the denial of a deputy sheriff's application for service-connected disability retirement. The ruling in Alberto Mendoza v. Board of Retirement of the Ventura County Employees' Retirement Association (2025) 94 Cal.App.5th 1234 emphasizes the critical importance of complying with recommended medical treatments, even when personal fears or anecdotal concerns lead to hesitation. This case serves as a cautionary reminder that an unreasonable refusal to undergo advised procedures can bar access to essential retirement protections under the County Employees Retirement Law (CERL) and related doctrines.

    The Appellant, a Ventura County Deputy Sheriff assigned to the Todd Road Jail Facility, sustained two work-related back injuries. The first occurred on December 30, 2014, when he slipped on stairs, causing lower back discomfort. The second followed on May 27, 2015, during an altercation with an inmate who kicked him in the waist. Diagnostic imaging revealed degenerative disc disease at the L5-S1 level, along with a disc herniation and extrusion abutting the right S1 nerve root. Multiple physicians, including the Qualified Medical Evaluator Dr. Robert H. Fields and treating doctors Dr. Brian Grossman and Dr. Sam Bakshian, unanimously recommended surgical intervention, citing a high likelihood of successful outcomes—estimated at 90 percent for good to excellent results given the deputy's youth and overall health.

    Despite authorization from the County of Ventura and repeated urgings from his medical team, the deputy declined the procedures. His refusal stemmed from fears informed by colleagues' negative experiences with back surgery and online research, which Dr. Fields characterized as based on "bad information." Over time, his condition deteriorated, as evidenced by subsequent MRIs showing progression of the discopathy. By 2017, more extensive surgery, such as a spinal fusion, was deemed necessary, but even then, he wavered before ultimately deciding against it. In 2018, another evaluator noted improvement to the point where surgery was no longer indicated, but the deputy's ongoing disability persisted, attributed in part to his non-compliance with home exercises and other conservative measures.

    The deputy applied for service-connected disability retirement in May 2016, invoking Government Code sections 31720 et seq. The Ventura County Employees' Retirement Association Board denied the application following an administrative hearing, finding that his permanent incapacity resulted not from the industrial injuries themselves but from his unreasonable refusal to submit to recommended treatment. The trial court denied his petition for a writ of administrative mandate, and the appellate court affirmed, relying on the common law doctrine of avoidable consequences as articulated in Reynolds v. City of San Carlos (1981) 126 Cal.App.3d 208 and Labor Code section 4056. The latter provides that no compensation is payable where disability is caused, continued, or aggravated by an unreasonable refusal to undergo medical or surgical treatment, provided the risk is inconsiderable relative to the injury's seriousness based on expert advice.

    The court rejected the deputy's argument that the doctrine should not apply because, unlike in Reynolds, the recommended surgeries would not have enabled his return to full duty as a deputy sheriff. Instead, it held that the principle extends to situations where timely treatment might have prevented the worsening of the condition, even if the window for effective intervention has closed due to delay. As the court explained, a retirement board may reasonably conclude that the employee's inability to work stems from their own choices rather than the work-related injury alone.

    For California public safety unions and their members, peace officers and firefighters alike, this ruling underscores both the protections and pitfalls inherent in the disability retirement system. On the beneficial side, it reinforces the expectation that employers and retirement boards must base denials on substantial evidence of unreasonableness, considering factors such as the treatment's success rate, risks, and the employee's informed decision-making process. Employees facing similar dilemmas can leverage this to advocate for comprehensive medical counseling and second opinions, potentially strengthening their claims if refusal is deemed reasonable under the circumstances.

    However, the risks are substantial. Refusing treatment perceived as low-risk and high-reward could forfeit not only retirement benefits but also compound physical suffering through condition progression. In high-stakes professions where injuries are commonplace, this decision incentivizes prompt compliance with medical recommendations to preserve eligibility for tax-advantaged disability pensions. It also highlights the interplay between workers' compensation and retirement systems, where delays in one arena can adversely affect the other.

    Looking ahead, this ruling may influence future litigation by empowering retirement boards to more rigorously scrutinize applications involving treatment non-compliance. Public safety employees might see increased pressure from employers to pursue aggressive interventions, potentially leading to disputes over what constitutes "unreasonable" refusal—especially in cases involving psychological barriers like fear or cultural mistrust of surgery. Unions should consider negotiating enhanced support mechanisms, such as peer counseling or alternative treatment options, to mitigate these risks. Moreover, with the opinion now certified for publication, it establishes binding precedent statewide, likely prompting retirement associations in other counties to adopt similar stances.

    Public safety professionals dedicate their careers to protecting communities, often at great personal cost. Decisions like Mendoza remind us that safeguarding one's own health through informed, timely action is equally vital to securing the benefits earned through that service. For personalized guidance on disability retirement claims or related matters, members are encouraged to consult with experienced labor counsel.