ADJ19640948 — California WCAB decision

What the panel ordered

Petition for Reconsideration granted, March 4, 2026 Joint Findings of Fact and Orders rescinded, matter returned to WCJ for further proceedings

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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.

Jurisdiction / venueApplicant prevailed

Applicant was denied the opportunity to cross-examine PQME Dr. Schmitz on a significant supplemental report, which denied her a fair trial and due process, warranting reconsideration and further proceedings.

From the decision · page 71. Parties to a workers' compensation proceeding retain the fundamental right to due process and a fair hearing under both the California and United States Constitutions. (Rucker v. Workers' Comp. Appeals Bd. (2000) 82 Cal.App.4th 151, 157-158 [65 Cal.Comp.Cases 805].) A fair hearing is "one of `the rudiments of fair play' assured to every litigant...." (Id. at p. 158.) As stated by the Supreme Court of California in Carstens v. Pillsbury (1916) 172 Cal. 572, "the commission...must find facts and declare and enforce rights and liabilities, -- in short, it acts as a court, and it must observe the mandate of the constitution of the United States that this cannot be done except after due process of law." (Id. at p. 577.) A fair hearing includes, but is not limited to, the opportunity to offer evidence in rebuttal. (See Gangwish v. Workers' Comp. Appeals Bd. (2001) 89 Cal.App.4th 1284, 1295 [66 Cal.Comp.Cases 584].) Indeed: Although the California Constitution states that a goal of workers' compensation proceedings is to "accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character...." (Cal. Const., art. XIV, § 4), the right to due process is paramount to the goal of conducting workers' compensation proceedings expeditiously. We therefore conclude that denial of a fair trial to a [party] is reversible per se.

The facts that decided it

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

Applicant was not allowed to cross-examine PQME Dr. Schmitz on a significant supplemental report issued shortly before trial.

Favours Applicant prevailed

Denied opportunity to rebut expert evidence, violating due process and fair trial rights, leading to grant of reconsideration.

From the decision · page 8On March 4, 2026, FF&O issued denying injury. As noted above, at trial the WCJ admitted Joint Exhibit 7, the supplemental report of PQME Dr. Schmitz. This report was signed just twelve days before trial on December 31, 2026. This report was significant as it reviewed ten scientific reports, a PQME deposition and was forty- three-pages long. Within nine days of the report being signed applicant scheduled the PQME's deposition. On these facts, because the WCJ ordered submission, applicant was not afforded the opportunity to offer evidence in rebuttal to Joint Exhibit 7. (Gangwish, supra, p. 1295.) The opportunity to provide rebuttal evidence is foundational to a fair trial. Here, applicant was denied a fair trial and, as such, we will rescind the FF&O and return these cases to the trial level for further discovery consistent with this opinion. (Pinkney, supra, 806.)

PQME Dr. Schmitz's reports did not consider the cumulative injury claim and may have applied incorrect legal standards for causation.

Favours Applicant prevailed

Medical opinions lacked substantial evidence to support denial of injury claims, undermining the FF&O findings.

From the decision · page 9It appears from this record that PQME Dr. Schmitz was not aware of applicant's claim for cumulative injury. None of his reports appear to reference a claim of cumulative injury generally nor specifically the case ADJ19640948. This is concerning because a report based on "inadequate medical histories" or "incorrect legal theories" may well be found to not be substantial evidence. (Hegglin, supra, p. 169.) It is even more difficult to understand how such reporting can be the basis for the finding of no injury in the cumulative claim ADJ19640948 when that claim was apparently not considered by the PQME.4

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.

QMERejected · cardiology

Found no injuries to heart or venous system caused by Moderna COVID-19 vaccine; supplemental report issued after review of scientific reports and deposition; report lacked consideration of cumulative injury claim and may have applied incorrect legal standards.

Report did not consider cumulative injury claim and may have applied wrong legal standard for causation; relied on incomplete history and did not address applicant's injury history impact on opinions.

From the decision · page 8On the final day of trial held January 12, 2026, the WCJ admitted Joint Exhibit 7, the forty- three-page supplemental report from PQME Dr. Schmitz, dated November 17, 2025, (but signed on December 31, 2025). The report was issued after review of "10 scientific reports and a second deposition from the psychiatric QME, Dr. Judith Keins." (Joint Exhibit 7, PQME Dr. Schmitz, pp. 2, 43.) PQME Dr. Schmitz found "It is not within a reasonable degree of medical probability that the applicant suffered any injuries to her heart or venous system as a consequence of her receipt of the Moderna COVID-19 vaccine." (Joint Exhibit 7, PQME Dr. Schmitz, p. 35, emphasis in original.) Also admitted was applicant's Exhibit 10, a notice of deposition dated January 9, 2026, scheduling PQME Dr. Schmitz deposition for March 16, 2016. (Applicant Exhibit 10, p. 1.) The WCJ ordered the cases submitted January 26, 2026.

QMERejected · psychiatry

Evaluated cumulative injury claim; concluded no industrial psychiatric injury; report lacked demonstration of understanding of relevant law and improperly usurped trier of fact's role in causation determination.

Report was conclusory and did not apply relevant law properly; failed to provide sufficient reasoning for conclusion of no industrial psychiatric injury.

From the decision · page 11Although PQME Dr. Keins ultimately finds applicant has not sustained an industrial psychiatric injury, we are unable to determine from her reporting how she applied the relevant law to arrive at this conclusion.

The rules the panel named

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

Rucker v. Workers' Comp. Appeals Bd. (2000) 82 Cal.App.4th 151

Due process rights to a fair hearing under California and United States Constitutions.

Denial of opportunity to cross-examine expert witness violates due process and warrants reconsideration.

From the decision · page 71. Parties to a workers' compensation proceeding retain the fundamental right to due process and a fair hearing under both the California and United States Constitutions. (Rucker v. Workers' Comp. Appeals Bd. (2000) 82 Cal.App.4th 151, 157-158 [65 Cal.Comp.Cases 805].) A fair hearing is "one of `the rudiments of fair play' assured to every litigant...." (Id. at p. 158.) As stated by the Supreme Court of California in Carstens v. Pillsbury (1916) 172 Cal. 572, "the commission...must find facts and declare and enforce rights and liabilities, -- in short, it acts as a court, and it must observe the mandate of the constitution of the United States that this cannot be done except after due process of law." (Id. at p. 577.) A fair hearing includes, but is not limited to, the opportunity to offer evidence in rebuttal. (See Gangwish v. Workers' Comp. Appeals Bd. (2001) 89 Cal.App.4th 1284, 1295 [66 Cal.Comp.Cases 584].) Indeed: Although the California Constitution states that a goal of workers' compensation proceedings is to "accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character...." (Cal. Const., art. XIV, § 4), the right to due process is paramount to the goal of conducting workers' compensation proceedings expeditiously. We therefore conclude that denial of a fair trial to a [party] is reversible per se.

Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162

Expert medical opinions must be substantial evidence, based on adequate medical histories and correct legal theories, and provide reasoning for conclusions.

Medical opinions lacking adequate reasoning or based on incorrect legal theories are not substantial evidence and cannot support findings.

From the decision · page 9examinations, or on incorrect legal theories. Medical opinion also fails to support the Board's findings if it is based on surmise, speculation, conjecture or guess." (Hegglin v. Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93].

ADJ19640948 · May 19, 2026

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