ADJ18421273 · March 3, 2026

The WCJ's permanent disability ratings and injury scope findings were based on incomplete medical evidence, particularly regarding left shoulder, elbows, knees, and internal medicine claims, requiring further development of the medical record.

From the decision · page 1Applicant seeks reconsideration of two decisions issued concurrently by a workers' compensation administrative law judge (WCJ). In a Findings and Award of October 30, 2025 in case ADJ18421273, it was found that while employed as a water system technician on December 28, 2020, applicant sustained industrial injury to his right shoulder, causing permanent disability of 11% and the need for further medical treatment. In a Findings and Award of October 30, 2025 in cased ADJ18421294, it was found that while employed as a water system technician during a cumulative period ending July 7, 2021, applicant sustained industrial injury to his cervical and lumbar spine causing permanent disability of 23% and the need for further medical treatment, but that there was no cumulative injury to the shoulders, elbows, knees, or in the forms of hypertension or diabetes.

Dr. Watkins' reports did not clarify industrial causation for left shoulder, elbows, knees injuries, listing left arm shoulder bursitis without causation discussion.

Favours Applicant prevailed

This lack of clarity required further development of the medical record and reconsideration of permanent disability and injury scope findings.

From the decision · page 3Turning to the merits, the WCJ relied upon the opinions of panel qualified medical evaluator orthopedist Robert Watkins III, M.D. with regard to industrial injury and permanent disability with regard to applicant's orthopedic claims. Accordingly, it was found that applicant's right shoulder injury and disability was attributable to the specific injury, the cervical and lumbar spine injuries were attributable to a cumulative injury, and that there were no further injuries to any other body part. Dr. Watkins issued reports dated January 30, 2024, April 19, 2024, June 27, 2024, and November 27, 2024. We note that while Dr. Watkins evaluated applicant's left shoulder, elbows and knees, and appears to have not attributed any permanent impairment to these body parts, he never expressly states that there was no industrial injury to these body parts. In fact, we note that Dr. Watkins lists "left arm shoulder bursitis" among applicant's diagnoses (January 30, 2024 report at p. 45), but does not discuss industrial causation (or lack of it) in his reporting. The record must be further developed for Dr. Watkins to clarify whether industrial injury to these other body parts caused disability or the need for medical treatment.

Found right shoulder injury and disability attributable to specific injury; cervical and lumbar spine injuries attributable to cumulative injury; did not expressly state no industrial injury to left shoulder, elbows, knees; listed left arm shoulder bursitis but did not discuss industrial causation.

From the decision · page 3Turning to the merits, the WCJ relied upon the opinions of panel qualified medical evaluator orthopedist Robert Watkins III, M.D. with regard to industrial injury and permanent disability with regard to applicant's orthopedic claims. Accordingly, it was found that applicant's right shoulder injury and disability was attributable to the specific injury, the cervical and lumbar spine injuries were attributable to a cumulative injury, and that there were no further injuries to any other body part. Dr. Watkins issued reports dated January 30, 2024, April 19, 2024, June 27, 2024, and November 27, 2024. We note that while Dr. Watkins evaluated applicant's left shoulder, elbows and knees, and appears to have not attributed any permanent impairment to these body parts, he never expressly states that there was no industrial injury to these body parts. In fact, we note that Dr. Watkins lists "left arm shoulder bursitis" among applicant's diagnoses (January 30, 2024 report at p. 45), but does not discuss industrial causation (or lack of it) in his reporting. The record must be further developed for Dr. Watkins to clarify whether industrial injury to these other body parts caused disability or the need for medical treatment.

Concluded internal medicine conditions (hypertension, diabetes, colon polyp) preexisted specific injury and could not have been caused by it; further opinion needed on cumulative injury contribution.

From the decision · page 3With regard to applicant's "internal medicine" complaints such as hypertension, diabetes, and gastrointestinal issues, panel qualified medical evaluator internist Stanley J. Majcher, M.D. concluded that applicant's injuries could not have been caused by the December 28, 2020 specific injury because these issues preexisted the specific injury by many years. As Dr. Majcher writes in his June 3, 2024 report, "Based on the voluminous new set of medical records, kindly note the applicant's internal medical conditions, including hypertension, diabetes, and colon polyp have been noted prior to his industrial injury. Based on the information in the new set of medical records, the applicant's hypertension and diabetes had been detected prior to his industrial specific injury." (June 3, 2024 report at p. 19.) However, as Dr. Machjer himself wrote in his initial February 19, 2024 report, applicant began working for the employer in 1988, over 30 years prior to the specific injury, and claimed industrial injury to these "internal medicine" conditions as a result of the cumulative injury (Minutes of Hearing and Summary of Evidence of October 23, 2025 trial at p. 3.) Accordingly, Dr. Machjer must opine whether any work exposure over this cumulative period contributed to disability or the need for medical treatment.

Labor Code section 5909

Labor Code section 5909(a) requires the Appeals Board to act on a petition for reconsideration within 60 days of transmission of the case to the Appeals Board.

The decision was issued on the 60th day after transmission, thus timely acting on the petition.

From the decision · page 2Preliminarily, we note that former Labor Code section 5909 provided that a petition for reconsideration was deemed denied unless the Appeals Board acted on the petition within 60 days from the date of filing. (Lab. Code, § 5909.) Effective July 2, 2024, Labor Code section 5909 was amended to state in relevant part that:

Dr. Watkins did not expressly state no industrial injury to left shoulder, elbows, knees; listed left arm shoulder bursitis but did not discuss causation

From the decision · page 3Turning to the merits, the WCJ relied upon the opinions of panel qualified medical evaluator orthopedist Robert Watkins III, M.D. with regard to industrial injury and permanent disability with regard to applicant's orthopedic claims. Accordingly, it was found that applicant's right shoulder injury and disability was attributable to the specific injury, the cervical and lumbar spine injuries were attributable to a cumulative injury, and that there were no further injuries to any other body part. Dr. Watkins issued reports dated January 30, 2024, April 19, 2024, June 27, 2024, and November 27, 2024. We note that while Dr. Watkins evaluated applicant's left shoulder, elbows and knees, and appears to have not attributed any permanent impairment to these body parts, he never expressly states that there was no industrial injury to these body parts. In fact, we note that Dr. Watkins lists "left arm shoulder bursitis" among applicant's diagnoses (January 30, 2024 report at p. 45), but does not discuss industrial causation (or lack of it) in his reporting. The record must be further developed for Dr. Watkins to clarify whether industrial injury to these other body parts caused disability or the need for medical treatment.