What the panel ordered
Petition for Reconsideration granted; final decision deferred pending further review
Petition for Reconsideration granted; final decision deferred 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 WCJ's findings that Dr. Williams' reports were not substantial evidence and ordering the parties to agree on an AME were preliminarily found to lack sufficient support, leading to granting reconsideration and deferring final decision for further review.
From the decision · page 5... Here, there are numerous issues with Dr. Williams' reporting. First, it appears he only reviewed medical reports at the time he performed his initial evaluation in May of 2020, and in fact, some of those reports were viewed on applicant's phone. (Exhibit 15 at p. 4.) Further, the few records he reviewed only addressed the thoracic spine, and the most recent report was dated December of 2018. (Id. at pp. 4-5.) Aside from some x-rays, it is unclear whether applicant received any medical treatment to his knee or lumbar spine.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Dr. Williams' medical reports were found to be conclusory, unsupported, and confusing, lacking substantial evidence.
Favours Applicant prevailed
This led to the preliminary rejection of his reports and the granting of reconsideration.
From the decision · page 5... Here, there are numerous issues with Dr. Williams' reporting. First, it appears he only reviewed medical reports at the time he performed his initial evaluation in May of 2020, and in fact, some of those reports were viewed on applicant's phone. (Exhibit 15 at p. 4.) Further, the few records he reviewed only addressed the thoracic spine, and the most recent report was dated December of 2018. (Id. at pp. 4-5.) Aside from some x-rays, it is unclear whether applicant received any medical treatment to his knee or lumbar spine.
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.
Reports were found to lack substantial evidence due to incomplete review of medical records, unexplained changes in impairment ratings, unsupported apportionment, and failure to address non-industrial conditions.
The WCJ found Dr. Williams' reports to be conclusory, unsupported, and confusing, thus not substantial evidence.
From the decision · page 5... Here, there are numerous issues with Dr. Williams' reporting. First, it appears he only reviewed medical reports at the time he performed his initial evaluation in May of 2020, and in fact, some of those reports were viewed on applicant's phone. (Exhibit 15 at p. 4.) Further, the few records he reviewed only addressed the thoracic spine, and the most recent report was dated December of 2018. (Id. at pp. 4-5.) Aside from some x-rays, it is unclear whether applicant received any medical treatment to his knee or lumbar spine.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, 5952(d)
Decisions by the Appeals Board must be supported by substantial evidence.
The WCJ's findings were preliminarily found to lack substantial evidence, leading to reconsideration.
From the decision · page 6It is well established that decisions by the Appeals Board must be supported by substantial evidence. (Lab. Code, § 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274, 281 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 317 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 635 [35 Cal.Comp.Cases 16].)
Lab. Code, 5701
An Independent Medical Evaluator shall be appointed per section 5701 unless parties agree on an AME.
The WCJ ordered the parties to meet and confer about an AME or an IME appointment per section 5701.
From the decision · page 1The WCJ further found that, while employed by defendant as a vineyard worker during the period ending July 19, 2017, applicant sustained an injury AOE/CO to his low back. (ADJ14019876). In both cases, the WCJ found that Exhibit 18 was not admissible, and issued an Order and Notice of Intent (NIT) that the parties are to meet and confer about the use of an Agreed Medical Evaluator (AME) to address both claims. The NIT advised that an Independent Medical Evaluator (IME) shall be appointed per Lab. Code Section 57011 unless "the parties provide notification that they have selected an agreed medical evaluator to address both claims." All other issues were deferred. (FA&O, pp. 1-2.)
What proof carried it
The evidence the panel weighed, by kind.
Dr. Williams' reports were conclusory, unsupported, and confusing, lacking substantial evidence to support the award.
From the decision · page 5... Here, there are numerous issues with Dr. Williams' reporting. First, it appears he only reviewed medical reports at the time he performed his initial evaluation in May of 2020, and in fact, some of those reports were viewed on applicant's phone. (Exhibit 15 at p. 4.) Further, the few records he reviewed only addressed the thoracic spine, and the most recent report was dated December of 2018. (Id. at pp. 4-5.) Aside from some x-rays, it is unclear whether applicant received any medical treatment to his knee or lumbar spine.
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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.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
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