What the panel ordered
The Appeals Board granted defendant's Petition for Reconsideration and deferred issuance of a final decision after reconsideration pending further review of the merits and the entire record.
Defendant filed a Petition for Reconsideration of the WCJ's October 23, 2024 Findings and Award. The WCJ issued a Report and Recommendation to deny reconsideration. The Appeals Board granted reconsideration and deferred final decision pending further review.
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The Appeals Board found the record was not properly developed with substantial medical evidence to support the WCJ's finding of total permanent disability due to brain injury and psychiatric dysfunction, warranting reconsideration.
From the decision · page 1Defendant seeks reconsideration of the October 23, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained injury to her cervical and lumbar spine, left hand, head, ears and psyche and injury in the form of blackouts, while employed as an Associate Director of Transportation on May 18, 2015. The WCJ further found applicant is totally permanently disabled because of her injury on a psychiatric basis.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The medical evidence was incomplete, stale, and no longer germane, or based on inaccurate history or speculation.
Favours Defendant prevailed
This lack of substantial medical evidence led the Appeals Board to grant reconsideration to further study the factual and legal issues.
From the decision · page 4Based on our review, we are not persuaded that the record is properly developed. Where the medical evidence or opinion on an issue is incomplete, stale, and no longer germane, or is based on an inaccurate history, or speculation, it does not constitute substantial evidence. (Place v. Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372 [35 Cal.Comp.Cases 525]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).)
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Provided permanent and stationary date and reports supporting injury to head and blackouts.
Referenced in the WCJ's findings and the vocational report as part of the injury evidence.
From the decision · page 3This matter involves an injury sustained by applicant, (hereinafter Applicant) while employed by the Defendant, University of California Irvine (hereinafter Defendant) on May 18, 2015. She was employed as an Associate Director of Transportation when she was involved in a motor vehicle accident which resulted in industrial injuries to her cervical spine, lumbar spine and left hand pursuant to Dr. Smith's report of 8/28/2018, (Ex. EE). She also sustained an injury to her psyche on an industrial basis pursuant to Dr. Friedman's report of 7/23/2020, as reported by Paul Broadus's Vocational Report of 12/11/2023, (Ex. 1) and by Dr. Lissaur in his report of 2/14/2022, (Ex. EE). These body parts were accepted by the Defendant. Additionally, after trial the undersigned found that Applicant sustained an injury to her head, blackouts and her ears (pursuant to Dr. Furst's report of 7/7/2023, (Ex. BB)) and Dr. Nudleman's report dated 8/28/2018, as found in Paul Broadus's report (Ex. 1).
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code sections 5903, 5952(d); Braewood Convalescent Hosp. v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604
Decisions by the Appeals Board must be supported by substantial evidence, which means evidence that a reasonable mind might accept as adequate to support a conclusion.
The Appeals Board reviewed the record and found the medical evidence insufficient to support the WCJ's findings, requiring reconsideration.
From the decision · page 4It is well established that decisions by the Appeals Board must be supported by substantial evidence. (Lab. Code, § 5903, 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274 [39 Cal. Comp. Cases 310]; Garza, supra; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal. Comp. Cases 16].) "The term `substantial evidence' means evidence which, if true, has probative force on the issues. It is more than a mere scintilla, and means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion... It must be reasonable in nature, credible, and of solid value." (Braewood Convalescent Hosp. v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, 164 [48 Cal.Comp.Cases 566], emphasis removed and citations omitted.) To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).)
What proof carried it
The evidence the panel weighed, by kind.
Medical evidence was incomplete, stale, and no longer germane, lacking substantial evidence to support total permanent disability.
From the decision · page 4Based on our review, we are not persuaded that the record is properly developed. Where the medical evidence or opinion on an issue is incomplete, stale, and no longer germane, or is based on an inaccurate history, or speculation, it does not constitute substantial evidence. (Place v. Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372 [35 Cal.Comp.Cases 525]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).)
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
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