ADJ12495517 · December 5, 2025

The petition was timely filed and the Appeals Board acted within the 60-day period required by Labor Code section 5909. The Board adopted the WCJ's report and found no basis to grant reconsideration on the merits, including failure to prove industrial causation for claimed injuries and no penalty due for alleged delays.

From the decision · page 1We have considered the allegations of the Petition for Reconsideration and the contents of the Report of the workers' compensation administrative law judge (WCJ) with respect thereto. Based on our review of the record, and for the reasons stated in the WCJ's Report, which we adopt and incorporate except as noted below, and for the reasons discussed below, we will deny reconsideration.

No evidence of unreasonable delay by defendant in medical treatment or permanent disability payment.

Favours Defendant prevailed

Supported denial of penalties for alleged delays.

From the decision · page 6As for medical delays, applicant made no specific claims and provided no specific evidence that her medical treatment was delayed. I have no evidence from the applicant of a specific treatment that was delayed, and the proof of said delay is her burden of proof. I therefore have no bases to impose a penalty on medical treatment. She did provide testimony that her surgery itself took a while to perform. She testified about it initially being authorized around October 8, 2019 and not actually being performed until September 9, 2021. (See MOH/SOE Part 2 of Trial, Pages 3-4, Lines 15-13). However, no further specifics were given about this and there is no corroborating documentary evidence of any such delay. The surgery was authorized by the defendant from the outset, so they never took any action to delay the actual performance of the surgery. The COVID pandemic caused a delay, so that already was not defendant's fault.

Petition for Reconsideration was timely filed and acted upon within 60 days by the Appeals Board.

Favours Defendant prevailed

Ensured procedural compliance and allowed merits review.

From the decision · page 2Here, according to Events, the case was transmitted to the Appeals Board on October 6, 2025 and 60 days from the date of transmission is December 5, 2025. This decision is issued by or on December 5, 2025, so that we have timely acted on the petition as required by section 5909(a).

Applicant failed to prove industrial causation for claimed thumb injuries.

Favours Defendant prevailed

Resulted in denial of injury acceptance for thumbs and denial of benefits related to those injuries.

From the decision · page 3We do not adopt or incorporate the section of the Report with the heading "3. Acceptance of Both Thumbs:" on page six. An "injury" is defined as an "injury or disease arising out of the employment" (Lab. Code, § 3208) which "results in lost time beyond the employee's work shift at the time of injury or which results in medical treatment beyond first aid...." (Lab. Code, § 5401.) Therefore, had applicant met her burden of proof to establish industrial causation for her thumbs, she would be entitled to a finding of industrial injury even if the symptoms had resolved after receiving medical treatment. Evidence that the thumbs had been "cured" by that medical treatment would go to the issue of disability. Nevertheless, we agree that applicant did not meet her burden of proof to establish industrial causation for the claimed injury to her thumbs.

Provided a ratable report used as basis for retroactive permanent disability payment; no penalty found for delay in payment based on this report.

From the decision · page 5Applicant has made a claim for penalties on several species of benefits. She testified about her complaints regarding delay of medical benefits. She testified about her carpal tunnel surgery, saying it originally was authorized around October 8, 2019 and not actually being performed until September 9, 2021. (See MOH/SOE Part 2 of Trial, Pages 3-4, Lines 15-13). I awarded her a 25% penalty on the SJDB Voucher, because I found it was not timely issued. There was a slight delay by defendant to issue retro PD to applicant. Retro PDA's were paid to applicant on 07/23/2022. The basis for that payment was the Dr. Sommer Med-Legal report, which was not served until 06/10/2022. I found no penalty for this delay, as I found it was not unreasonable.

Labor Code section 5909

Petition for reconsideration must be acted upon within 60 days of transmission to the Appeals Board.

The Board acted on the petition within the 60-day period, making the petition timely.

From the decision · page 1I. Preliminarily, we note that former Labor Code1 section 5909 provided that a petition for reconsideration was deemed denied unless the Appeals Board acted on the petition within 60 days from the date of filing. (Lab. Code, § 5909.) Effective July 2, 2024, section 5909 was amended to state in relevant part that: (a) A petition for reconsideration is deemed to have been denied by the appeals board unless it is acted upon within 60 days from the date a trial judge transmits a case to the appeals board.

Labor Code section 5705

Burden of proof on party holding affirmative of issue; employee must prove injury arising out of employment by preponderance of evidence.

Applicant failed to prove industrial causation for claimed thumb injuries.

From the decision · page 2II. In addition to the reasons given by the WCJ in the Report, we note that every party holding the affirmative of an issue bears the burden of proof. (Lab. Code, § 5705.) The employee bears the initial burden of proving injury arising out of and in the course of employment (AOE/COE) by a preponderance of the evidence. (Lab. Code, § 5705; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code,

Labor Code sections 3208 and 5401

Definition of injury requiring lost time beyond shift or medical treatment beyond first aid.

Applicant did not meet burden to establish industrial causation for thumb injuries, so no injury found.

From the decision · page 3We do not adopt or incorporate the section of the Report with the heading "3. Acceptance of Both Thumbs:" on page six. An "injury" is defined as an "injury or disease arising out of the employment" (Lab. Code, § 3208) which "results in lost time beyond the employee's work shift at the time of injury or which results in medical treatment beyond first aid...." (Lab. Code, § 5401.) Therefore, had applicant met her burden of proof to establish industrial causation for her thumbs, she would be entitled to a finding of industrial injury even if the symptoms had resolved after receiving medical treatment. Evidence that the thumbs had been "cured" by that medical treatment would go to the issue of disability. Nevertheless, we agree that applicant did not meet her burden of proof to establish industrial causation for the claimed injury to her thumbs.

Labor Code section 5814

Penalties under Labor Code section 5814 subject to two-year statute of limitations.

No penalty imposed for alleged medical or PD payment delays due to lack of evidence or statute of limitations.

From the decision · page 6As for medical delays, applicant made no specific claims and provided no specific evidence that her medical treatment was delayed. I have no evidence from the applicant of a specific treatment that was delayed, and the proof of said delay is her burden of proof. I therefore have no bases to impose a penalty on medical treatment. She did provide testimony that her surgery itself took a while to perform. She testified about it initially being authorized around October 8, 2019 and not actually being performed until September 9, 2021. (See MOH/SOE Part 2 of Trial, Pages 3-4, Lines 15-13). However, no further specifics were given about this and there is no corroborating documentary evidence of any such delay. The surgery was authorized by the defendant from the outset, so they never took any action to delay the actual performance of the surgery. The COVID pandemic caused a delay, so that already was not defendant's fault.

Applicant's testimony about surgery authorization and delay, but no corroborating documentary evidence of delay; COVID pandemic delay not defendant's fault.

From the decision · page 6As for medical delays, applicant made no specific claims and provided no specific evidence that her medical treatment was delayed. I have no evidence from the applicant of a specific treatment that was delayed, and the proof of said delay is her burden of proof. I therefore have no bases to impose a penalty on medical treatment. She did provide testimony that her surgery itself took a while to perform. She testified about it initially being authorized around October 8, 2019 and not actually being performed until September 9, 2021. (See MOH/SOE Part 2 of Trial, Pages 3-4, Lines 15-13). However, no further specifics were given about this and there is no corroborating documentary evidence of any such delay. The surgery was authorized by the defendant from the outset, so they never took any action to delay the actual performance of the surgery. The COVID pandemic caused a delay, so that already was not defendant's fault.