ADJ17259034 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted; final decision deferred pending further review of merits and entire record.

Lien claimant Medland Medical petitioned for reconsideration of the WCJ's April 4, 2024 Findings, Award and Order denying injury AOE/COE and disallowing most medical treatment dates; WCAB granted reconsideration and deferred final decision pending further review.

Read the official decision →

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.

AOE/COERemandedneck · hand · trunk · back · unclassified

The WCJ initially found no injury AOE/COE based on lack of applicant testimony and medical evidence; the WCAB granted reconsideration to further review the merits and evidence including the medical-legal report of Dr. Omid Haghighinia D.C.

The facts that decided it

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

Applicant did not testify and did not provide substantial medical evidence to establish injury AOE/COE.

Favours Defendant prevailed

This led the WCJ to find no injury and deny lien claimant's recovery initially.

What proof carried it

The evidence the panel weighed, by kind.

Testimony and credibilityfavours Defendant prevailed

Applicant did not testify at trial nor provide substantial medical evidence to establish injury AOE/COE; lien claimant did not meet burden of proof initially.

From the decision · page 2*** Lien claimant steps into the shoes of the Applicant, and has the burden to prove injury arising out of and occurring in the course of employment. Applicant did not testify at trial nor provide substantial medical evidence to establish an injury AOE/COE. Lien claimant did not meet its burden of proof and it is found Applicant did not sustain injury arising out of and occurring in the course of employment. *** When an Applicant alleges an industrial injury, and the allegation is disputed by the employer, a medical-legal evaluation is often sought in order to resolve the dispute. Whether or not the court finds injury AOE/COE, medical-legal costs can be deemed reasonable and necessary, and therefore, payable. Lien claimant's initial report of 4/19/23 is being characterized as a medical-legal evaluation. (Opinion, pp. 1-2).

Medical recordsfavours Applicant prevailed

No evidence was presented to rebut Dr. Omid Haghighinia D.C.'s medical-legal report; defendants did not file an answer to petition.

From the decision · page 3that proves injury out of and in the course of employment on a contested claim that was denied in full. There has been no evidence provided by the defendants to rebut the medical-legal report of Omid Haghighinia D.C. There has been no evidence obtained to show that a false history had been taken by Dr. Haghighinia, D.C., a licensed physician, who is himself a certified Qualified Medical Examiner. The defendant had the right to dispute this report and obtain evidence, and their remedy was to obtain Panel QME to resolve the continued dispute. They had the right to depose the applicant, depose other witnesses, or provide their investigation reports showing what evidence they relied upon to deny the applicant's case; no other evidence was sought or presented to refute the Applicant statements provided to Dr. Haghighinia D.C.

ADJ17259034 · June 24, 2024

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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What the panel did with the medical opinions

The rules the panel named

What proof carried it

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