ADJ9360946 · July 15, 2026

The WCJ found injury to the left wrist on January 27, 2013, but not to other claimed body parts or dates. The Appeals Board rescinded the WCJ's findings and returned the matter for further proceedings due to issues with record development and due process.

From the decision · page 1We previously granted applicant’s Petition for Reconsideration of the “Joint Findings of Fact and Orders” (F&O) issued on August 22, 2022, by the workers’ compensation administrative law judge (WCJ), in order to further study the factual and legal issues. This is our Opinion and Decision After Reconsideration. The WCJ found, in pertinent part, that applicant sustained industrial injury to the left wrist in ADJ9360948, but not to any additionally claimed body parts, while employed by defendant as a dim sum chef on January 27, 2013.

Applicant sustained admitted injury to left wrist on January 27, 2013

Favours Applicant prevailed

This injury was found industrial and is the basis for the claim

From the decision · page 1We previously granted applicant’s Petition for Reconsideration of the “Joint Findings of Fact and Orders” (F&O) issued on August 22, 2022, by the workers’ compensation administrative law judge (WCJ), in order to further study the factual and legal issues. This is our Opinion and Decision After Reconsideration. The WCJ found, in pertinent part, that applicant sustained industrial injury to the left wrist in ADJ9360948, but not to any additionally claimed body parts, while employed by defendant as a dim sum chef on January 27, 2013.

Applicant alleged additional injuries on November 15, 2013, March 4, 2014, and September 19, 2014

Favours Applicant prevailed

These additional injury claims were not found industrial by the WCJ but require further development

From the decision · page 2and for the reasons discussed below, as our Decision After Reconsideration we will rescind the August 22, 2022 F&O and return this matter to the trial level for further proceedings. FACTS Applicant sustained an admitted injury on January 27, 2013, to the left wrist while working as a dim sum chef and claimed further injury to the head, ear, eye, upper extremities, wrists, psyche, and internal body parts. (Transcript of Proceedings, June 14, 2022, p. 5, lines 14-19.) Applicant alleged three additional injuries, including an injury on November 15, 2013, to the bilateral upper extremities, bilateral wrists, bilateral hand, psyche, and internal body parts. (Id. at p. 6, lines 16-23.) Applicant further alleged injury during the cumulative period ending on March 4, 2014, to the head, bilateral upper extremities, bilateral wrists, bilateral hands, bilateral shoulders, and in the form of hemorrhoids. (Id. at p.

Applicant's credibility issues noted but not sufficient to preclude further discovery and due process

Favours Applicant prevailed

Due process requires full development of the record before final findings on credibility and injury

From the decision · page 6(1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].) The Appeals Board will follow the opinions of the AME unless good cause exists to find his opinion unpersuasive. (Ibid.) While we recognize that the present record notes significant issues with applicant’s credibility, that issue alone cannot preclude applicant from completing discovery on her case prior to proceeding to trial, including additional discovery which could impact the determination of applicant’s credibility. Doing so violates a party’s right to due process. However, and notwithstanding the above, we would encourage the parties to meet and confer on the issue of settlement prior to proceeding with further discovery. Accordingly, as our Decision After Reconsideration we rescind the August 22, 2022 F&O and return this matter to the trial level for further proceedings.

Diagnosed malingering, undifferentiated somatization disorder, possible depressive disorder, and status post minor industrial injuries; concluded complaints were due to psychiatric problems rather than the cause.

The WCJ relied on Dr. Sigal's opinion to assess the credibility and causation of applicant's complaints.

From the decision · page 28, lines 1-8.) Finally, applicant alleged injury on September 19, 2014, to the bilateral upper extremities, bilateral lower extremities, and psych. (Id. at p. 8, line 22 through p. 9, line 4.) The sole issues for trial were industrial injury and body parts injured. (Ibid.) Applicant argued that the matter should be taken off calendar for further discovery. In the WCJ’s Opinion on Decision, the WCJ thoroughly details applicant’s medical records and testimony at trial. As relevant herein, she stated, Dr. Sigal provided a detailed review of over 1,500 pages of records spanning the period from 2004 to 2016, the vast majority of which were not offered into evidence.

Rated 80% whole person impairment due to severe psychological reaction to injury of November 15, 2013; deferred hemorrhoid issues to general surgeon.

The AME's report was considered but deferred some issues; the Appeals Board noted the AME's neutrality and expertise.

From the decision · page 2(Defendants’ Exhibit C, supra, at 11-50.) Dr. Sigal discussed treatment reports immediately following the January 27, 2013 injury, as well as extensive reports documenting treatment received by applicant in the years that followed. (Id. at 12-40.) Additionally, Dr. Sigal reviewed an orthopedic QME report by Dr. John Lavorgna (July 16, 2015). (Id. at 29-30.)... It was Dr. Sigal’s opinion that much of the medical reporting in applicant’s case was based on inadequate or flatly erroneous history...... Dr. Sigal diagnosed applicant with malingering, undifferentiated somatization disorder, possible depressive disorder, and status post minor industrial injuries. (Id. at 51-52.) He concluded that applicant’s complaints are the result of her psychiatric problems, rather than the cause of them. (Defendants’ Exhibit C, supra, at 56.)... On November 9, 2018, orthopedic AME Dr. Mandell saw applicant a second time. (Defendants’ Exhibit E, report of Dr. Mandell dated November 9, 2018.)... Dr. Mandell concluded that applicant sustained a major psychological event which caused a near catatonic state in which she remained. (Defendants’ Exhibit E, supra, at 4.) Because applicant was wheelchair bound, he rated her at 80% whole person

Noted applicant's anxiety, depression, and frustration; recommended neuropsychological evaluation, psychiatric care, and brain MRI; opined medication contributed to complaints.

The report was reviewed and considered in the record for the applicant's psychiatric and neurological condition.

From the decision · page 3Dr. Jonathan Rutchik issued a neurology supplemental treatment report in September 2021, indicating that he last saw the applicant in October 2015. (Applicant’s Exhibit 8, report of Dr. Rutchik dated September 17, 2021, p. 2.) He noted that at the time of her previous visit, applicant was taking Norco “many times per day” and requested more, and that he refused to endorse the requested treatment and applicant was directed to seek another doctor. (Id. at 2-3.) Dr. Rutchik wrote, “I think the issue is anxiety, depression and frustration that she cannot work.” (Id. at 3.)

Labor Code §§ 3202.5, 3600(a), 5705; South Coast Framing v. Workers’ Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291

Applicant must prove industrial causation by preponderance of evidence; injury must occur AOE/COE

The WCJ and Appeals Board applied these standards to assess injury and causation

From the decision · page 4(Opinion on Decision, August 22, 2022, pp. 4 – 13.) DISCUSSION When applicant claims a physical injury, applicant has the initial burden of proving industrial causation by showing the employment was a contributing cause. (South Coast Framing v. Workers’ Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302; Lab. Code 1, § 5705.) Applicant must prove by a preponderance of the evidence that an injury occurred AOE/COE. (§§ 3202.5; 3600(a).) The requirement of Labor Code section 3600 is twofold. On the one hand, the injury must occur in the course of the employment. This concept ordinarily refers to the time, place, and circumstances under which the injury occurs. On the other hand, the statute requires that an injury arise out of the employment. It has long been settled that for an injury to arise out of the employment it must occur by reason

Applicant's credibility issues noted but not sufficient to preclude further discovery and due process rights

From the decision · page 6(1986) 179 Cal.App.3d 775, 782 [51 Cal.Comp.Cases 114].) The Appeals Board will follow the opinions of the AME unless good cause exists to find his opinion unpersuasive. (Ibid.) While we recognize that the present record notes significant issues with applicant’s credibility, that issue alone cannot preclude applicant from completing discovery on her case prior to proceeding to trial, including additional discovery which could impact the determination of applicant’s credibility. Doing so violates a party’s right to due process. However, and notwithstanding the above, we would encourage the parties to meet and confer on the issue of settlement prior to proceeding with further discovery. Accordingly, as our Decision After Reconsideration we rescind the August 22, 2022 F&O and return this matter to the trial level for further proceedings.