ADJ12062619 — California WCAB decision

What the panel ordered

The June 10, 2025 Findings & Order was rescinded and the matter was returned to the trial level for further proceedings.

Petition for reconsideration of the June 10, 2025 Findings & Order was granted, the Findings & Order was rescinded, and the matter was returned to the trial level for further proceedings consistent with the opinion.

Read the official decision →

This docket was decided more than once. Shown here is the latest released decision; we also hold November 25, 2024.

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.

Reconsideration / removalApplicant prevailed

The Appeals Board found that the WCJ erred in not admitting the subpoena evidence into the record, which was necessary for a proper decision on the merits. The Board granted reconsideration, rescinded the WCJ's Findings & Order, and returned the matter for further proceedings with a new WCJ.

From the decision · page 1Gemini Legal Services, Inc., (cost petitioner) seeks removal/reconsideration of the Findings and Order (F&O), issued by the workers' compensation administrative law judge (WCJ) on June 10, 2025, wherein the WCJ found in relevant part that cost petitioner did not meet its burden of proof and ordered that cost petitioner's petition for reimbursement/costs be denied.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

The subpoenas and related documentation were not admitted into evidence.

Favours Applicant prevailed

Without the subpoenas admitted as evidence, the WCJ's decision lacked a proper evidentiary basis and could not be reviewed on the merits.

From the decision · page 6Unfortunately, while documentation was attached to the petition for costs, that documentation, including the subpoenas, was never admitted into evidence. Thus, we are unable to consider the matter on the merits.

The WCJ's failure to admit evidence was an error of law.

Favours Applicant prevailed

This legal error required rescission of the Findings & Order and return of the matter for further proceedings.

From the decision · page 8As we explained in our previous Decision and above, if the evidence is not admitted into the record, then there is no basis for a WCJ's decision and no basis for our review, so that there is no choice but to rescind the decision. That is, the recission of the WCJ's previous decision was based on an error of law by the WCJ, not the failure by a party.

The WCJ's statements indicated an appearance of bias against the cost petitioner.

Favours Applicant prevailed

Due process concerns required reassignment to a new WCJ to avoid the appearance of bias.

From the decision · page 8Section 5311 provides that a party may seek to disqualify a WCJ upon any one or more of the grounds specified in Code of Civil Procedure section 641. (Lab. Code, § 5311; see also Code Civ. Proc., § 641.) Among the grounds for disqualification under section 641 are that the WCJ has demonstrated "[t]he existence of a state of mind... evincing enmity against or bias toward either party." (Code Civ. Proc., § 641(g)). "Due Process is violated where there is even an appearance of bias or unfairness in administrative hearings. (citations)" (Robbins v. Sharp Healthcare, et al. (2006) 71 Cal.Comp.Cases 1291, 1302 (Robbins).) An appearance of bias may be sufficient to require disqualification. The statements by the WCJ quoted above at the least raise the appearance of bias against cost petitioner insofar as the WCJ refers to cost petitioner having been `rescued' and given `another bite at the apple' by our prior decision.

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Lab. Code, §§ 3205.5, 5705.5; Lab. Code, §§ 4620, 4621, 4622(f); Colamonico v. Secure Transportation (2019) 84 Cal. Comp. Cases 1059 (Appeals Board en banc)

A cost petitioner holds the burden of proof to establish entitlement to payment for medical-legal expenses under Labor Code sections 3205.5, 5705.5, 4620, 4621, and 4622(f).

The Board applied these standards to determine that the cost petitioner must prove a contested claim existed at the time services were performed and that the expenses were reasonable and necessary.

From the decision · page 5III. On November 25, 2024 we issued our Decision in response to cost petitioner's first Petition for Reconsideration/Removal. As we discussed, a cost petitioner holds the burden of proof to establish all elements necessary to establish its entitlement to payment for a medical-legal expense. (See Lab. Code, § 3205.5, 5705.5; Torres v. AJC Sandblasting (2012) 77 Cal.Comp.Cases 1113, 1115 (Appeals Board en banc).) As we explained in our en banc decision in Colamonico v. Secure Transportation (2019) 84 Cal. Comp. Cases 1059 (Appeals Board en banc), section 4622 provides the framework for reimbursement of medical-legal expenses. Subsection (f) of the statute, however, specifically states that "[t]his section is not applicable unless there has been compliance with Sections 4620 and 4621." (Lab. Code, § 4622(f).) Thus, a lien claimant is required to establish that: 1) a contested claim existed at the time the expenses were incurred; 2) the expenses were incurred for the purpose of proving or disproving the contested claim; and 3) the expenses were reasonable and necessary at the time were incurred. (Lab.

Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473

Decisions must be based on admitted evidence in the record and supported by substantial evidence.

The Board emphasized that the WCJ's decision must be based on an adequate and complete record with admitted evidence.

From the decision · page 6Decisions 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).) Furthermore, decisions of 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 v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) An adequate and complete record is necessary to understand the basis for the WCJ's decision. (Lab. Code, § 5313; see also Cal. Code Regs., tit. 8, § 10787.) "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

Lab. Code, §§ 5900(a), 5902, 5903; Rymer v. Hagler (1989) 211 Cal.App.3d 1171; Safeway Stores, Inc. v. Workers' Comp. Appeals Bd. (Pointer) (1980) 104 Cal.App.3d 528

A petition for reconsideration may only be taken from a final order, decision, or award.

The Board found the WCJ's denial of the cost petition to be a final order subject to reconsideration.

From the decision · page 4II. A petition for reconsideration may properly be taken only from a "final" order, decision, or award. (Lab. Code, § 5900(a), 5902, 5903.) A "final" order has been defined as one that either "determines any substantive right or liability of those involved in the case" (Rymer v. Hagler (1989) 211 Cal.App.3d 1171, 1180; Safeway Stores, Inc. v. Workers' Comp. Appeals Bd. (Pointer) (1980) 104 Cal.App.3d 528, 534-535 [45 Cal.Comp.Cases 410]; Kaiser Foundation Hospitals v. Workers' Comp. Appeals Bd. (Kramer) (1978) 82 Cal.App.3d 39, 45 [43 Cal.Comp.Cases 661]) or determines a "threshold" issue that is fundamental to the claim for benefits (Maranian v. Workers' Comp. Appeals Bd. (2000) 81 Cal.App.4th 1068, 1070, 1075 [65 Cal.Comp.Cases 650]). Interlocutory procedural or evidentiary decisions, entered in the midst of the workers'

What proof carried it

The evidence the panel weighed, by kind.

expert methodologyfavours Applicant prevailed

The subpoenas and related documentation were not admitted into evidence, which prevented a proper merits decision.

From the decision · page 6Unfortunately, while documentation was attached to the petition for costs, that documentation, including the subpoenas, was never admitted into evidence. Thus, we are unable to consider the matter on the merits.

Other evidencefavours Applicant prevailed

The WCJ's failure to admit evidence was an error of law requiring rescission of the decision.

From the decision · page 8As we explained in our previous Decision and above, if the evidence is not admitted into the record, then there is no basis for a WCJ's decision and no basis for our review, so that there is no choice but to rescind the decision. That is, the recission of the WCJ's previous decision was based on an error of law by the WCJ, not the failure by a party.

Testimony and credibilityfavours Applicant prevailed

The WCJ's statements indicated an appearance of bias against the cost petitioner.

From the decision · page 8Section 5311 provides that a party may seek to disqualify a WCJ upon any one or more of the grounds specified in Code of Civil Procedure section 641. (Lab. Code, § 5311; see also Code Civ. Proc., § 641.) Among the grounds for disqualification under section 641 are that the WCJ has demonstrated "[t]he existence of a state of mind... evincing enmity against or bias toward either party." (Code Civ. Proc., § 641(g)). "Due Process is violated where there is even an appearance of bias or unfairness in administrative hearings. (citations)" (Robbins v. Sharp Healthcare, et al. (2006) 71 Cal.Comp.Cases 1291, 1302 (Robbins).) An appearance of bias may be sufficient to require disqualification. The statements by the WCJ quoted above at the least raise the appearance of bias against cost petitioner insofar as the WCJ refers to cost petitioner having been `rescued' and given `another bite at the apple' by our prior decision.

ADJ12062619 · September 12, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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