What the panel ordered
Petition for Reconsideration denied; prior ODAR granting reconsideration and finding injury AOE/COE to left knee on September 30, 2023, upheld.
Defendant seeks reconsideration of the August 29, 2025 WCAB Opinion and Order Granting Petition for Reconsideration and Decision After Reconsideration (ODAR), which rescinded the May 20, 2025 WCJ decision denying injury AOE/COE and substituted findings that applicant sustained industrial injury to his left knee on September 30, 2023.
This docket was decided more than once. Shown here is the latest released decision; we also hold August 29, 2025.
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 WCAB found that the QME's medical-legal determination, supported by medical records and applicant's unchallenged trial testimony, constituted substantial evidence establishing injury AOE/COE to the left knee on September 30, 2023, by a preponderance of the evidence.
From the decision · page 4the WCJ's concerns regarding the lack of contemporaneous reporting as to the alleged mechanism of injury, but following a review of the entire record, determined that "the QME's medical-legal determination as supported in the medical record and applicant's unchallenged trial testimony supports a finding of industrial injury, to a preponderance of the evidence." (Id. at p. 11.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
QME Dr. Retodo concluded applicant sustained a specific industrial injury to the left knee on September 30, 2023, based on clinical evaluation and medical record review.
Favours Applicant prevailed
This medical opinion provided substantial evidence supporting the finding of injury AOE/COE.
From the decision · page 2The parties have selected Albert Retodo, M.D., as the Qualified Medical Evaluator (QME) in orthopedic medicine. On March 7, 2024, Dr. Retodo evaluated applicant and issued a report dated April 15, 2024 in which he noted that applicant had a symptomatic history of gout. Nonetheless, the QME determined that applicant sustained a "[s]pecific industrial injury to the left knee, dated [September 30, 2023], strain/sprain injury, with [April 12, 2024] MRI evidence of lateral patellar tilt and subluxation with patellofemoral degenerative change and chondral thinning and moderately large joint effusion and small popliteal cyst with distal patellar tendinosis." (Ex. 1, Report of Albert Retodo, M.D., dated April 15, 2024.)
Applicant's unchallenged trial testimony described the injury mechanism and timing consistent with the QME's findings.
Favours Applicant prevailed
The WCAB credited this testimony over the WCJ's contrary credibility finding, supporting injury causation.
From the decision · page 4the WCJ's concerns regarding the lack of contemporaneous reporting as to the alleged mechanism of injury, but following a review of the entire record, determined that "the QME's medical-legal determination as supported in the medical record and applicant's unchallenged trial testimony supports a finding of industrial injury, to a preponderance of the evidence." (Id. at p. 11.)
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.
Concluded applicant sustained a specific industrial injury to the left knee on September 30, 2023, supported by MRI evidence and medical record review, to a reasonable medical probability.
The QME's conclusion was reasonably explicated, consistent across multiple reports, and stated to a reasonable medical probability, supporting industrial injury causation.
From the decision · page 2The parties have selected Albert Retodo, M.D., as the Qualified Medical Evaluator (QME) in orthopedic medicine. On March 7, 2024, Dr. Retodo evaluated applicant and issued a report dated April 15, 2024 in which he noted that applicant had a symptomatic history of gout. Nonetheless, the QME determined that applicant sustained a "[s]pecific industrial injury to the left knee, dated [September 30, 2023], strain/sprain injury, with [April 12, 2024] MRI evidence of lateral patellar tilt and subluxation with patellofemoral degenerative change and chondral thinning and moderately large joint effusion and small popliteal cyst with distal patellar tendinosis." (Ex. 1, Report of Albert Retodo, M.D., dated April 15, 2024.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 3202.5
Injury arising out of and in the course of employment must be established by a preponderance of the evidence.
Applicant met burden by preponderance of evidence including QME report and trial testimony.
From the decision · page 6It is well established that decisions by 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, 319 [35 Cal.Comp.Cases 500, 505]); LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Bd. en banc).) Applicant bears the burden of proving injury AOE/COE by a preponderance of the evidence. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a); 3202.5.)
Labor Code section 4060
Qualified Medical Evaluator (QME) reports must be based on reasonable medical probability and supported by pertinent facts and adequate examination.
QME Dr. Retodo's reports met these criteria and were relied upon by the WCAB.
From the decision · page 6It is well established that decisions by 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, 319 [35 Cal.Comp.Cases 500, 505]); LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Bd. en banc).) Applicant bears the burden of proving injury AOE/COE by a preponderance of the evidence. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a); 3202.5.)
Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312
Medical opinion must not be speculative and must set forth reasoning in support of conclusions to constitute substantial evidence.
The QME's opinion was found to be substantial evidence despite defendant's credibility challenges.
From the decision · page 6It is well established that decisions by 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, 319 [35 Cal.Comp.Cases 500, 505]); LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Bd. en banc).) Applicant bears the burden of proving injury AOE/COE by a preponderance of the evidence. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a); 3202.5.)
What proof carried it
The evidence the panel weighed, by kind.
Applicant's unchallenged trial testimony describing injury mechanism and timing
From the decision · page 4the WCJ's concerns regarding the lack of contemporaneous reporting as to the alleged mechanism of injury, but following a review of the entire record, determined that "the QME's medical-legal determination as supported in the medical record and applicant's unchallenged trial testimony supports a finding of industrial injury, to a preponderance of the evidence." (Id. at p. 11.)
QME's medical-legal determination supported by extensive medical records and diagnostic imaging
From the decision · page 4the WCJ's concerns regarding the lack of contemporaneous reporting as to the alleged mechanism of injury, but following a review of the entire record, determined that "the QME's medical-legal determination as supported in the medical record and applicant's unchallenged trial testimony supports a finding of industrial injury, to a preponderance of the evidence." (Id. at p. 11.)
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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.
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