ADJ14559862 — California WCAB decision

What the panel ordered

Defendant's Petition for Reconsideration is granted; final decision after reconsideration is deferred pending further review of merits and entire record.

Defendant sought reconsideration of the WCJ's August 25, 2025 Findings of Fact and Orders regarding injury arising out of employment and lien claims; WCJ issued a Report and Recommendation to deny reconsideration; WCAB granted defendant's Petition for Reconsideration and deferred final decision pending further review.

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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.

AOE/COEDefendant prevailedlow back

The WCJ found injury AOE/COE based on substantive medical evidence from Dr. Marina Russman, but the WCAB panel found the record not properly developed and granted reconsideration for further review.

From the decision · page 1Defendant seeks reconsideration of the August 25, 2025 Findings of Fact and Orders issued by the workers' compensation administrative law judge (WCJ). Therein, the WCJ found that applicant sustained injury arising out of and in the course of employment (AOE/COE) to his low back, while employed as a dishwasher on October 27, 2019. The WCJ further found that the normal workers' compensation issues were resolved by a compromise and release on July 20, 2022; that lien claimant FMR Interventional Quality Pain Management, APC provided medical care; that lien claimant Joyce Altman Interpreters provided Spanish interpreting services for the care at FMR; and that the WCJ does not have jurisdiction to adjudicate the lien claims herein pending UR procedures. Based on these finding, the WCJ ordered defendant to perform retrospective UR services on the services provided by FMR and Joyce Altman within the time limits set forth in Cal. Code of Regs. § 9792.9.1.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Dr. Marina Russman's medical-legal report was based on a credible history, physical exam, and reasonable conclusions, meeting substantive medical evidence standards.

Favours Applicant prevailed

Supported the WCJ's finding of injury arising out of employment (AOE/COE).

From the decision · page 4reported symptoms in his back, right hip and right leg that he ascribed to his work. The employer sent him "to the doctor." He continued to work. He received no notices regarding a claim form or any rights. He self-procured treatment at a "clinica" where he was prescribed meds. His attorney referred him to the lien claimant FMR Interventional Medical Group. By that time, he had apparently changed employers. Dr. Marina Russman took him off of work. The claim was denied (Ex.C). His job duties were described in detail by Dr. Russman.

No medical records were provided to contradict Dr. Russman's opinion despite passage of time and treatment.

Favours Applicant prevailed

Lack of contradictory evidence failed to undermine the credibility of the injury finding.

From the decision · page 5No medical records were provided to Dr. Russman despite the passage of eight months of treatment and the passage of three years before the lien trial took place. No records were placed into evidence by Defendant that would raise any doubts as to the substantive nature of the opinion voiced by the doctor. Hence the lack of any records fails to dispel the credibility of the report. ___________________________

Defendant alleged bias by Dr. Russman but no evidence was presented to support this claim.

Favours Applicant prevailed

Absence of evidence of bias upheld the credibility of the medical opinion.

From the decision · page 5Lastly, there is no evidence that Dr. Russman was biased. It is obvious that had she found no injury then no treatment under WC law could be had. Nonetheless the original report of 6/14/2021 is a medical-legal report that would be payable regardless of the doctor's findings.

The record was found by the WCAB panel to be not properly developed and requiring further review.

Favours Defendant prevailed

Led to granting of reconsideration and deferral of final decision, favoring defendant's position.

From the decision · page 7Based on our review, we are not persuaded that the record is properly developed. Where the evidence or opinion on an issue is incomplete, stale, and no longer germane, or is based on an inaccurate history, or speculation, it does not constitute substantial evidence. (Place v. Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 372 [35 Cal.Comp.Cases 525]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).) Here, we are not persuaded that there is substantial evidence to support the WCJ's decision.

ADJ14559862 · November 4, 2025

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