What the panel ordered
Petition for Reconsideration is granted. Final decision after reconsideration is deferred pending further review of the merits and entire record.
Applicant seeks reconsideration of the January 19, 2024 Findings and Award, Orders. The WCJ found admitted industrial injury to the low back with 27% permanent disability but deferred causation, permanent disability, apportionment, and future medical care for bilateral hips pending further record development. The WCJ ordered a psychology QME panel and deferred the internal medicine QME panel issue. The WCJ denied due process denial claims. The Appeals Board grants reconsideration and defers final decision pending further review.
This docket was decided more than once. Shown here is the latest released decision; we also hold December 29, 2023.
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 that the record was incomplete and inconsistent, and that the WCJ's decision did not adequately address all issues, warranting reconsideration and further development of the record.
From the decision · page 1Applicant seeks reconsideration of the January 19, 2024 Findings and Award, Orders wherein the workers' compensation administrative law judge (WCJ) found that applicant sustained admitted industrial injury to the low back while employed as a laborer on October 29, 2014 causing 27% permanent disability. The WCJ further found that the issue of causation, permanent disability, apportionment, and future medical care for the bilateral hips are deferred pending further development of the record; that there is good cause to order a panel of Qualified Medical Evaluators (QME) in the specialty of psychology; that the issue of applicant's right to an internal medicine QME panel is deferred pending the psychology QME evaluation; and that applicant was not denied due process by proceeding with Trial. Applicant also filed supplemental pleading on March 18, 2024 which we accept pursuant to our authority. (Cal. Code Regs., tit. 8, § 10964.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The record was incomplete and inconsistent, with disagreement about issues framed for trial and deferred issues not properly addressed by the WCJ.
Favours Applicant prevailed
This lack of clarity and completeness prevented meaningful review and justified granting reconsideration and deferring final decision.
From the decision · page 3We are unable to perform meaningful review and note the following inconsistencies in the record. There is apparent disagreement about the issues that were framed for trial. Applicant asserts that only the issues raised in his February 21, 2023 Declaration of Readiness to Proceed should have been set for trial and that he did not agree to the issues listed by defendant. However, the partial transcript of proceedings contains the following exchange:
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473; McClune v. Workers' Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117; Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396
Decisions of the Appeals Board must be based on admitted evidence in the record; the record must be adequate and complete to understand the basis for the WCJ's decision; the WCJ must set forth reasons and evidence relied on for each issue; the WCJ and Appeals Board have a duty to further develop the record where evidence is insufficient; the Appeals Board has a constitutional mandate to ensure substantial justice in all cases.
The Appeals Board preliminarily reviewed the record and found it incomplete and inconsistent, indicating further development of the record is appropriate.
From the decision · page 2I. We highlight the following legal principles that may be relevant to our review of this matter: Decisions of the Appeals Board "must be based on admitted evidence in the record." (Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Board en banc).) An adequate and complete record is necessary to understand the basis for the WCJ's decision. (Lab. Code, § 5313.) "It is the responsibility of the parties and the WCJ to ensure that the record is complete when a case is submitted for decision on the record. At a minimum, the record must contain, in properly organized form, the issues submitted for decision, the admissions and stipulations of the parties, and admitted evidence." (Hamilton, supra, 66 Cal.Comp.Cases at p. 475.) The WCJ's decision must "set[] forth clearly and concisely the reasons for the decision made on each issue, and the evidence relied on," so that "the parties, and the Board if reconsideration is sought, [can] ascertain the basis for the decision[.]... For the opinion on decision to be meaningful, the WCJ must refer with specificity to an adequate and completely developed record." (Id.
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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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