California WCABDecision and order

ADJ10755277 · May 26, 2026

Rescinded WCJ's Findings and Order; returned to trial level for further proceedings

Issues decided: 2
Medical opinions weighed: 3
Authorities named: 3
District office: Salinas

What the panel ordered

Rescinded WCJ's Findings and Order; returned to trial level for further proceedingsp. 2

Petition for Reconsideration of WCJ's Findings and Order denying Petition to Reopen

Read the official decision →

This docket was decided more than once. Shown here is the latest released decision; we also hold May 20, 2024.

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.

Reopening / new and further disabilityRemandedsleep · rib

Record insufficient to determine whether sleep disturbance was original industrial injury or whether rib injury constitutes new and further disability; due process requires further development of record

From the decision · page 2Reconsideration, we will rescind the WCJ’s March 7, 2024 F&O and return the matter to the trial level for further proceedings consistent with this decision.

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The rules the panel named

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

Nicky Blair's Restaurant v. Workers' Comp. Appeals Bd. (1980) 109 Cal.App.3d 941

New and further disability under Lab. Code § 5410 requires demonstrable change in employee's condition within five years of injury

Applied to determine whether rib injury and sleep-related disability constitute new and further disability

From the decision · page 4The court in Nicky Blair’s Restaurant v. Workers’ Comp. Appeals Bd. (1980) 109 Cal.App.3th 941 [45 Cal.Comp.Cases 876] found that, under section 5410, “[the] term ‘new and further disability’ has been defined to mean disability which results from some demonstrable change in an employee’s condition.” ( Id. at p.

E.L. Yeager v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922

Substantial evidence requires expert medical opinion framed in terms of reasonable medical probability, based on accurate history and examination, with reasoning to support conclusions

Applied to find PTP and psychiatric nurse reports insufficient

From the decision · page 6Workers’ Comp. Appeals Bd. (1970) 1 Cal.3d. 627 [35 Cal.Comp.Cases 16].) To be substantial evidence, expert medical opinion must be framed in terms of reasonable medical probability, be based on an accurate history and an examination, and must set forth reasoning to support the expert conclusions reached. ( E.L. Yeager v. Workers’ Comp.

Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389

WCAB has duty to develop record where insufficient evidence exists to determine issues raised for trial

Applied to remand for further development of record regarding sleep and rib injuries

From the decision · page 6“[I]n order to ensure reliance on substantial evidence, and a complete adjudication of the issues consistent with due process,” the WCJ and the Appeals Board both have a duty to develop the record further where there is an absence of, or insufficient evidence to determine the issues raised for trial. ( Tyler v. Workers’ Comp. Appeals Bd.

ADJ10755277 · May 26, 2026

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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