ADJ21492524 — California WCAB decision

What the panel ordered

Findings and Orders of December 12, 2025, and Finding and Order Re: Second QME Panel rescinded; panel 7875837 stricken as untimely; all other issues deferred; matter returned to trial level for further proceedings.

Petition for reconsideration of Findings and Orders issued December 12, 2025, granted; matter returned to trial level 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.

QME/AME processApplicant prevailedhead · neck · arm · wrist · hands · fingers · back · hips · shoulders · knees · nervous system · psyche · high cholesterol

The WCJ found panel 7875837 was untimely requested and thus invalid, a finding not disputed by parties; however, the WCJ's findings on subsequent replacement requests lacked sufficient evidence and were rescinded, with the matter returned for further proceedings.

From the decision · page 8However, based upon an inadequate record, we cannot determine whether good cause presently exists as to the validity of the subsequent panel requests by each party, as well as the finding and order by the WCJ for a replacement panel in orthopedic surgery (MOS), and thus we must return the matter to the trial level for further proceedings.

The rules the panel named

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

Lab. Code, 5909

Petition for reconsideration must be acted upon within 60 days of transmission to Appeals Board (Lab. Code, 5909).

The Appeals Board acted timely on the petition filed by applicant.

From the decision · page 4Under section 5909(a), the Appeals Board must act on a petition for reconsideration within 60 days of transmission of the case to the Appeals Board. Transmission is reflected in Events in the Electronic Adjudication Management System (EAMS). Specifically, in Case Events, under Event Description is the phrase "Sent to Recon" and under Additional Information is the phrase "The case is sent to the Recon board."

Lab. Code, 5900, 5902, 5903

Petition for reconsideration may only be taken from a final order or decision (Lab. Code, 5900, 5902, 5903).

The WCJ's order included final findings on employment and insurance coverage, making it a final order for reconsideration purposes.

From the decision · page 5A petition for reconsideration may properly be taken only from a "final" order, decision, or award. (Lab. Code, § 5900(a), 5902, 5903.) A "final" order has been defined as one that either "determines any substantive right or liability of those involved in the case" (Rymer v. Hagler (1989) 211 Cal.App.3d 1171, 1180; Safeway Stores, Inc. v. Workers' Comp. Appeals Bd. (Pointer) (1980) 104 Cal.App.3d 528, 534-535 [45 Cal.Comp.Cases 410]; Kaiser Foundation Hospitals v. Workers' Comp. Appeals Bd. (Kramer) (1978) 82 Cal.App.3d 39, 45 [43 Cal.Comp.Cases 661]) or determines a "threshold" issue that is fundamental to the claim for benefits. (Maranian v. Workers' Comp. Appeals Bd. (2000) 81 Cal.App.4th 1068, 1070, 1075 [65 Cal.Comp.Cases 650].)

Cal. Code Regs., tit. 8, 10955(a)

Removal is an extraordinary remedy granted only if petitioner shows significant prejudice or irreparable harm (Cal. Code Regs., tit. 8, 10955(a)).

The WCJ's findings on subsequent panel requests lacked adequate record support, constituting substantial prejudice warranting removal.

From the decision · page 6Here, and for the reasons discussed below, the decision of the WCJ is not supported by an adequate record with respect to the WCJ's findings relating to the parties' subsequent panel requests. Accordingly, we find that the decision rises to the level of substantial prejudice which warrants a grant of removal.

Lab. Code, 4060, 4062.2

QME panel requests must be timely and properly served (Lab. Code, 4060, 4062.2).

Panel 7875837 was stricken as untimely; subsequent requests' validity could not be determined due to inadequate record.

From the decision · page 8As stated by the WCJ in his Opinion, "[b]ased upon Labor Code 4062.2(b) the earliest the request could have been made was 10/29/25, therefore the request was prematurely made, untimely, not properly served and invalid." (Opinion on Decision, at pp. 1-2.)

What proof carried it

The evidence the panel weighed, by kind.

Documentary evidencefavours Applicant prevailed

stipulations of parties on operative dates and denial of claim

From the decision · page 6III. Decisions of the Appeals Board "must be based on admitted evidence in the record." (Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Board en banc).) Furthermore, decisions by the Appeals Board must be supported by substantial evidence. (Lab. Code, § 5903, 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274 [39 Cal.Comp.Cases 310]; Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) An adequate and complete record is necessary to understand the basis for the WCJ's decision. (Lab. Code, § 5313; see also Cal. Code Regs., tit. 8, § 10761.) Here, no testimony exists in the record and only limited exhibits were provided. The parties stipulated to the following: the claim was denied on October 10, 2025, and the denial was served on October 13, 2025. Panel number 7875837 was requested on October 28, 2025. (MOH, Expedited Hearing, December 8, 2025, at p. 2:12-14.) With this information, the matter proceeded to trial on the issues of the validity of both panel number 7875837, as well as the propriety of the subsequent replacement requests by both defendant and applicant.

Documentary evidencefavours Applicant prevailed

lack of sufficient evidence on subsequent panel requests and service

From the decision · page 6While due primarily to the stipulation of the parties as to the operative dates, the WCJ found that panel number 7875837 was prematurely requested and thus not valid, and this finding is not disputed by either party. However, with respect to the second issue set for trial; whether the subsequent request by each party to the Medical Unit was proper, there is a lack of sufficient evidence upon which to determine same. The WCJ notes as much in his Opinion: It appears from Appl. Exh 1 that the applicant made a subsequent request to the medical unit for a new QME Panel, and it was rejected. The request was rejected [on] 10/31/25 by the medical unit. Applicant did not submit the original Form 106 and the request for the court to review. Defendant objected to applicant's Exh.1 based upon the fact that the request to the medical unit was not served on them. The applicant attorney at trial stipulated the request made to generate the 10/31/25

ADJ21492524 · February 17, 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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