ADJ7873659 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted; matter set for status conference; final decision after reconsideration deferred

Petition for Reconsideration granted by the Appeals Board panel, matter referred for status conference, final decision deferred

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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 granted the petition for reconsideration because the WCJ's decision lacked sufficient findings and the record needed further development, and because the petition was timely filed despite defective service.

The facts that decided it

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

The WCJ's Findings of Fact and Order did not make findings on whether there was a contested claim or whether services were reasonable and necessary under Labor Code sections 4620 and 4621.

Favours Applicant prevailed

This lack of findings meant the WCJ's decision was unsupported and required reconsideration.

The rules the panel named

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

Labor Code sections 5903, 5952(d); Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159

Decisions by the Appeals Board must be supported by substantial evidence.

The Appeals Board reviewed the record and found the WCJ's decision lacked sufficient findings and evidence to support the denial of lien claimant's medical-legal entitlement.

From the decision · page 3II. We also highlight the following legal principles that may be relevant to our review of this matter: It 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 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) "The term `substantial evidence' means evidence which, if true, has probative force on the issues. It is more than a mere scintilla, and means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion...It must be reasonable in nature, credible, and of solid value." (Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, 164 [48 Cal.Comp.Cases 566], emphasis removed and citations omitted.) Decisions 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).) An adequate and complete record is necessary to understand the basis

Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473 (Appeals Board en banc)

The Appeals Board must base decisions on admitted evidence in the record and ensure the record is complete and adequately developed.

The Appeals Board noted the WCJ's decision did not clearly set forth reasons or evidence relied upon, requiring further development of the record.

McClune v. Workers' Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117; Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396

The Appeals Board has a constitutional mandate to ensure substantial justice and must further develop the record where evidence is insufficient.

The Appeals Board emphasized its duty to develop the record further when the existing record is insufficient to support the WCJ's decision.

From the decision · page 4The WCJ and the Appeals Board have a duty to further develop the record where there is insufficient evidence on an issue. (McClune v. Workers' Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261].) The Appeals Board has a constitutional mandate to "ensure substantial justice in all cases." (Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396, 403 [65 Cal.Comp.Cases 264].) The Board may not leave matters undeveloped where it is clear that additional discovery is needed. (Id. at p. 404.)

ADJ7873659 · October 17, 2023

What the panel ordered

What was disputed, and how it came out

The facts that decided it

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The rules the panel named

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