What the panel ordered
Petition for Reconsideration is granted; final decision after reconsideration is deferred pending further review.
Applicant seeks reconsideration of the Joint Findings of Fact, Award, and Order issued by the WCJ on August 5, 2024, which found no industrial injury to certain body parts except the right middle finger, and the WCJ's findings are under review.
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 WCJ's finding that the applicant did not sustain injury to certain body parts was challenged; the Appeals Board found the AME's medical reporting did not constitute substantial evidence and granted reconsideration for further review.
From the decision · page 5reporting of the AME in this case did not constitute substantial evidence, was inconsistent, based
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant testified she fell on August 22, 2015, landing on hands, knees, chest, and other body parts, feeling immediate pain.
Favours Applicant prevailed
Supports applicant's claim of injury to multiple body parts from the fall.
From the decision · page 5On August 22, 2015, she was facing the cookie section using a ladder to front face the products, when she turned to a customer to ask if he needed help. She stepped off of the ladder, folded it, and placed it to her right. As she turned she hit the tip of the ladder with her foot, causing her to fall forward. She landed on her hands, knees, and chest. She was not able to break the fall. She did put out her hands but still hit her chin and chest on the floor. The incident occurred at the end of the shopping aisle that was about five to six feet wide. She came to rest outside of the aisle. She felt immediate pain to her knees, hips, shoulders, neck, chin, hands, wrists, and elbows.
AME Feiwell's medical reporting was inconsistent and based on incorrect legal theory regarding aggravation vs exacerbation.
Favours Applicant prevailed
Undermines the WCJ's reliance on AME Feiwell's opinion as substantial evidence, supporting reconsideration.
From the decision · page 5reporting of the AME in this case did not constitute substantial evidence, was inconsistent, based
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.
Did not find permanent effects or injury (aggravation) to hands, elbows, knees, neck, or back from the fall; considered symptoms as exacerbations, not requiring further treatment beyond acute care.
The WCJ relied on AME Feiwell's opinion as substantial medical evidence that the applicant did not sustain permanent injury to the disputed body parts.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Zemke v. Workmen's Comp. Appeals Bd. (1968) 68 Cal.2d 794
A medical report based on an incorrect legal theory does not constitute evidence to deny compensation.
The Board found the AME's report was based on an incorrect legal theory regarding aggravation vs exacerbation and thus not substantial evidence.
From the decision · page 9Further, it is well established that a medical report predicated upon an incorrect legal theory does not constitute evidence to support a denial of compensation for an industrially caused disability." (Zemke v. Workmen's Comp. Appeals Bd. (1968) 68 Cal.2d 794 [33 Cal.Comp.Cases 358, 363].)
Labor Code sections 5903, 5952(d)
Decisions by the Appeals Board must be supported by substantial evidence.
The Board reviewed whether the WCJ's findings were supported by substantial medical evidence.
From the decision · page 9It 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.)
What proof carried it
The evidence the panel weighed, by kind.
Medical reporting of AME Feiwell was inconsistent and based on incorrect legal theory regarding aggravation vs exacerbation.
From the decision · page 5reporting of the AME in this case did not constitute substantial evidence, was inconsistent, based
Applicant's testimony describing the fall and immediate pain to multiple body parts.
From the decision · page 5On August 22, 2015, she was facing the cookie section using a ladder to front face the products, when she turned to a customer to ask if he needed help. She stepped off of the ladder, folded it, and placed it to her right. As she turned she hit the tip of the ladder with her foot, causing her to fall forward. She landed on her hands, knees, and chest. She was not able to break the fall. She did put out her hands but still hit her chin and chest on the floor. The incident occurred at the end of the shopping aisle that was about five to six feet wide. She came to rest outside of the aisle. She felt immediate pain to her knees, hips, shoulders, neck, chin, hands, wrists, and elbows.
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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.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
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