Authorities as the decision cited them, with how this panel applied each one.
Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc)
A medical opinion must be framed in terms of reasonable medical probability, not speculative, based on pertinent facts and adequate examination, and set forth reasoning in support of conclusions.
The WCJ's finding lacked substantial medical evidence as required by this standard, leading to rescission of the Findings and Order.
From the decision · page 4II.
To constitute substantial evidence "... a medical opinion must be framed in terms of
reasonable medical probability, it must not be speculative, it must be based on pertinent facts and
on an adequate examination and history, and it must set forth reasoning in support of its
conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en
banc).)
The 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.) The preferred
procedure is to allow supplementation of the medical record by the physicians who have already
reported in the case. (McDuffie v.
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 Board found the record needed further development due to insufficient evidence on internal complaints.
From the decision · page 4II.
To constitute substantial evidence "... a medical opinion must be framed in terms of
reasonable medical probability, it must not be speculative, it must be based on pertinent facts and
on an adequate examination and history, and it must set forth reasoning in support of its
conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en
banc).)
The 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.) The preferred
procedure is to allow supplementation of the medical record by the physicians who have already
reported in the case. (McDuffie v.
Labor Code section 5410
Section 5410 limits the time period to institute proceedings for new and further disability within five years from date of injury.
The WCJ initially barred internal injury complaints under this statute, but the Board found the evidence insufficient to support the bar.
From the decision · page 1Applicant seeks reconsideration of the "Findings and Order" (F&O) issued on February
20, 2026, by the workers' compensation administrative law judge (WCJ). The WCJ found, in
pertinent part, that applicant's internal injury complaints are barred by Labor Code1 section 5410
because applicant failed to obtain substantial medical evidence establishing internal injury within
five years from his date of injury.