AOE/COE — was the injury industrial

What the Appeals Board did with this

Newest released decisions that turned on this issue. Each quotes the passage it turned on and links to the official PDF. Litigated tail — not a win rate, not a settlement value.

• ADJ18656111 · 2026-06-26 · Bakersfield District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of the Findings of Fact issued on March 3, 2026, wherein the workers' compensation administrative law judge ("WCJ") found that defendant did not prove that decedent's death was proximately caused by intoxication. Defendant asserts that the WCJ erred because the evidence supports the opinion of the Qualified Medical Examiner ("QME") that intoxication was a proximate or substantial cause of the injury.

  The Appeals Board agreed with the WCJ that defendant did not prove by a preponderance of the evidence that decedent's intoxication was a proximate or substantial cause of the injury, due to lack of concrete evidence and reliance on speculative assumptions in the QME report.

  Official decision · page 1 →
• ADJ13582881 · 2026-06-26 · Long Beach District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Award of March 16, 2026, wherein it was found that while employed as an assistant manager applicant sustained industrial injury in the form of a hernia and to the low back, causing the need for further medical treatment. Industrial injury to the hernia had been accepted by the defendant, but injury to the low back was contested. All other issues including date of injury, temporary disability, and permanent disability were deferred.

  The Appeals Board found substantial evidence supporting industrial injury to the low back based on the entire medical record and credible applicant testimony, favoring the treating physician's opinions over the PQME Dr. Shah's contrary opinion.

  Official decision · page 1 →
• ADJ18031412 · 2026-06-26 · San Diego District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.1Lien claimant Medland Medical seeks reconsideration of the Findings and Order issued by the workers' compensation administrative law judge (WCJ) on April 6, 2026. Therein, the WCJ found that, while employed as a Machine Operator/Packer, applicant claims to have sustained injury arising out of and occurring in the course of employment (AOE/COE) to her bilateral arms, bilateral hands, back, bilateral hips, and bilateral legs. The WCJ further found that the case in chief settled via Compromise and Release with an Order Approving issuing October 14, 2025; that lien claimant did not meet the burden of proof on the injury AOE/COE, such that the lien is disallowed in its entirety. Based on these findings, the WCJ ordered that lien claimant's lien be disallowed in its entirety.

  The lien claimant failed to meet the burden of proof by a preponderance of the evidence to establish injury AOE/COE based on the medical record and evidentiary record submitted. The ultimate conclusion of industrial causation was deferred to the Trier of Fact, and the WCJ found no sufficient evidence to support the lien claimant's claim.

  Official decision · page 1 →
• ADJ14972494 · 2026-06-23 · Van Nuys District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of the February 3, 2026 Findings of Fact, Award and Order (F&A) issued by the workers' compensation administrative law judge (WCJ), wherein the WCJ found that while employed by defendant as a chief negotiator for the nurses' union, from February 4, 2005 to July 13, 2021, applicant sustained injury arising out of and occurring in the course of employment to her "internal" and eyes/vision, and claimed injury to various parts.

  The WCJ's finding of industrial injury to the eyes/vision is supported by substantial medical evidence including the ophthalmology QME Dr. Sami's opinion, the internal medicine AME Dr. Grodan's deferral to Dr. Sami, credible applicant testimony, and contemporaneous treating records. The Report on Reconsideration supplies the reasoning required under Labor Code section 5313, curing any deficiency in the original Opinion on Decision.

  Official decision · page 1 →
• ADJ8387927 · 2026-06-19 · San Francisco District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.1Applicant, in pro per, seeks reconsideration of the Opinion and Decision After Reconsideration (ODAR) issued on March 3, 2026, by the Workers' Compensation Appeals Board (WCAB), wherein we affirmed the May 24, 2022 Findings of Fact & Award finding that there was no evidence of preexisting labor disabling impairment for the allergic rhinitis, irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD) and dermatitis (in the form of a rash).

  Applicant failed to provide substantial medical evidence of preexisting labor disabling impairment for the listed conditions prior to the November 4, 2010 injury, including new medical reports which did not cure the evidentiary defect.

  Official decision · page 1 →
• ADJ11186589 · 2026-06-18 · Los Angeles District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.1Lien claimant Ameri Chiropractic (lien claimant) seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Order (F&O) of May 10, 2021, wherein it was found that applicant did not sustain injury arising out of and in the course of employment (AOE/COE) to the neck, arm, wrist, and back pursuant to the prior Findings & Order of April 12, 2019; that lien claimant is not entitled to any payments pursuant to Labor Code1 section 5402(c) as it failed to establish when the claim form was supplied to the employer by applicant or when the employer had knowledge of the injury alleged herein from any other source; that the services provided by lien claimant were self-procured medical expenses and defendant is not liable for reimbursement of those expenses; that lien claimant failed to establish any basis for reimbursement of the lien claim; and there is no basis to award costs to defendant or impose sanctions on lien claimant.

  The WCJ and the Board found no injury arising out of and in the course of employment based on the evidence and prior Findings and Order.

  Official decision · page 1 →
• ADJ14589712 · 2026-06-12 · San Francisco District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.6Based upon our review of Dr. Stoller's reports, including the medical legal report dated December 12, 2024, Dr. Stoller reviewed medical records, took an accurate and adequate history of the injury, thoroughly examined the applicant, and explained how and why the industrial work exposure caused applicant's complaints. As such, we find that Dr. Stoller's reporting constitutes substantial medical evidence of injury AOE/COE to the lumbar spine. As explained by Dr. Stoller, applicant sustained a 6% WPI to the lumbar spine under DRE category II due to loss of range of motion and pain as well as the injury's effects on applicant's activities and daily living (ADLs) including issues with standing and sitting. (Joint Exhibit 104 p. 27.) Applicant noted that he can tolerate sitting for sixty (60) minutes, standing and walking for two (2) hours, and lifting up to thirty (30) pounds. (Id. at p. 2.) Applicant also noted significant pain when walking up and down stairs and driving more than two hours. (Ibid.) We note that in his report dated August 1, 2025, Dr. Stoller confirmed that causation was due to the cumulative injury ending on October 25, 2018. (Joint Exhibit 105.)

  Dr. Stoller's reports were found to constitute substantial medical evidence supporting injury AOE/COE to the lumbar spine, including detailed examination, history, and explanation of causation.

  Official decision · page 6 →
• ADJ10175755 · 2026-06-02 · San Jose District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.4III DISCUSSION Standard to qualify for SIBTF benefits under Labor Code § 4751 To be eligible for Subsequent Injuries Benefits Trust Fund (SIBTF) under Labor Code Section 4751, applicant must demonstrate that (1) he had pre-existing permanent partial disability; (2) the permanent disability from the subsequent industrial injury either (a) produces 35 percent disability or more or (b) 5 percent disability or more to an "opposite and corresponding member, (3) the combined pre-existing and subsequent permanent partial disability is greater than the subsequent permanent partial disability alone; and (4) the combined pre-existing and subsequent permanent partial disability is equal to 70 percent or more.

  Applicant failed to establish pre-existing partial permanent disability to the left shoulder prior to the subsequent industrial injury as required by Labor Code Section 4751 and relevant case law; medical evidence and testimony were insufficient and not corroborated.

  Official decision · page 4 →