ADJ18926429 · April 27, 2026

The WCJ found insufficient substantial medical evidence on causation and ordered further development of the record with supplemental QME reporting; the Appeals Board upheld this and denied reconsideration.

From the decision · page 2Applicant claimed injury to her bilateral wrists, bilateral hands, back, knees, arms, and shoulders, while employed as a customer service representative/billing representative by defendant TalentBurst, Inc. from June 6, 2022 to December 26, 2023. Defendant denies injury AOE/COE.

Dr. Donald Kim personally reviewed the medical records, interviewed the applicant, and performed the physical examination, ensuring the accuracy of his reports.

Favours Applicant prevailed

This supported the WCJ's finding of no ghostwriting and justified ordering supplemental reporting rather than excluding the QME reports.

The medical reports submitted by the parties were found inaccurate, inconsistent, or incomplete on causation, requiring further evidentiary development.

Favours neutral

This led to the WCJ ordering supplemental QME reporting to address causation and clerical errors.

From the decision · page 1Defendant seeks reconsideration of the January 26, 2026 Findings of Fact and Order (F&O), wherein the workers' compensation administrative law judge (WCJ) found that applicant was employed as a customer service representative/billing representative from June 6, 2022, through December 26, 2023 by defendant. The WCJ found, in relevant part, that there was no "ghostwriting" involved in the reporting of Qualified Medical Evaluator (QME) Donald Kim, M.D., but that the medical opinions submitted by the parties were inaccurate, inconsistent and/or incomplete on the issue of causation of applicant's alleged injuries. The WCJ determined that because there was insufficient evidence in the record upon which to base a determination, the evidentiary record required development. The WCJ ordered the parties to submit additional trial records to the QME and to obtain supplemental reporting correcting all clerical errors and addressing the issue of causation.

The reports of PTP Dr. Furman were excluded due to non-compliance with procedural rules and section 4628.

Favours Defendant prevailed

This exclusion affected the evidentiary record and the determination of substantial medical evidence on causation.

From the decision · page 3The WCJ's Opinion on Decision explained that the reports of PTP Dr. Furman were signed by persons other than Dr. Furman, and that insofar as the reports lacked confirmation that the signatory to each report was the examining physician, the reports did not comply with Workers' Compensation Appeals Board (WCAB) Rule 10682, subd. (b)(15) (Cal. Code Regs., tit. 8, § 10682(b)(15)) or with section 4628. Accordingly, the WCJ declined to admit the body of PTP reporting into evidence.

Dr. Kim personally interviewed the applicant, performed the physical examination, reviewed the history and medical records, and dictated the report reflecting his professional observations, conclusions, and recommendations. The WCJ found no ghostwriting and that procedural inadequacies were clerical, not substantive.

The WCJ and Appeals Board found Dr. Kim's reports did not constitute substantial medical evidence but ordered supplemental reporting to address causation and clerical errors.

Dr. Furman's reports were signed by persons other than himself and lacked confirmation that the signatory was the examining physician, thus not complying with WCAB Rule 10682 and Labor Code section 4628. The WCJ declined to admit these reports into evidence.

The WCJ excluded Dr. Furman's reports due to non-compliance with procedural rules and section 4628.

From the decision · page 3The WCJ's Opinion on Decision explained that the reports of PTP Dr. Furman were signed by persons other than Dr. Furman, and that insofar as the reports lacked confirmation that the signatory to each report was the examining physician, the reports did not comply with Workers' Compensation Appeals Board (WCAB) Rule 10682, subd. (b)(15) (Cal. Code Regs., tit. 8, § 10682(b)(15)) or with section 4628. Accordingly, the WCJ declined to admit the body of PTP reporting into evidence.

Labor Code

Labor Code section 4628

Applied to assess the admissibility and procedural compliance of QME and PTP medical reports.

From the decision · page 1Defendant contends that the reporting of the QME violates Labor Code1 section 4628, that such violation precludes returning to the QME for supplemental reporting, and that applicant has not met his burden of establishing injury arising out of and in the course of employment (AOE/COE).

Applicant was a credible witness; defendant's rebuttal testimony either confirmed or did not refute applicant's testimony.

From the decision · page 3The WCJ carefully reviewed the summaries of evidence adduced over multiple days of trial and concluded that applicant was a credible witness, and that the rebuttal testimony and evidence provided by the defendant either confirmed the applicant's testimony or did not refute the applicant's testimony. (Id. at p. 18.) However, given the lack of substantial medical evidence admitted in the record, the WCJ determined that the evidentiary record required development. The WCJ discussed the issue of whether to return to the QME for supplemental reporting, and observed that "[a] review of Dr. Kim's reporting and his subsequent deposition shows that there was no ghostwriting involved... As such, the procedural inadequacies of Dr. Kim's reporting are clerical and not substantive." (Id. at p. 19.) The WCJ concluded that "returning to Dr. Kim to have him provide additional reporting, taking into consideration an updated history and mechanism of injury, would not frustrate the Legislature's purpose in enacting section 4628." (Ibid.)