AOE/COE — was the injury industrial

What the Appeals Board did with this

Newest released decisions that turned on this issue. Each quotes the passage it turned on and links to the official PDF. Litigated tail — not a win rate, not a settlement value.

• ADJ11687715 · 2026-09-24 · Sacramento District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.4The Court held that the uncontroverted evidence established exposure to smoke, the doctor stated that it was probable that the smoke inhaled contained carcinogens and it was reason that prolonged exposure could lead to lung cancer, need only establish that it was reasonably probable and was not required to produce exact type/amount of exposure, and that employment need only be a contributing cause. In the present matter, the issue of AOE/COE was addressed in the Findings of Fact. Applicant alleged that the decedent’s lung cancer and resulting death were caused by diesel exhaust exposure at work. The parties used Stuart Lonky, MD as the panel qualified medical evaluator. QME Lonky provided five reports and sat for four depositions. He reviewed extensive medical records, deposition transcripts from various employees at the City of Sacramento, including the Kristal the applicant, the injured worker’s spouse, and multiple medical articles on the relationship between diesel fumes and lung cancer. Throughout the reporting and deposition testimony, QME Lonky opined that there was industrial causation. QME Lonky’s

  The Appeals Board agreed with the WCJ that the expert opinion of PQME Dr. Lonky constituted substantial medical evidence that the decedent's lung cancer and death were industrially caused by diesel exhaust exposure as a co-carcinogen, even with the decedent's smoking history, meeting the burden of proof by reasonable probability.

  Official decision · page 4 →
• ADJ7316783 · 2026-09-24 · Goleta District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.181. the applicant, while employed during the period of January 1, 2005 through October 31, 2009 as an office manager, occupational group number 214, at Santa Barbara, California by Ehlen, Spiess & Haight, Inc., sustained injury arising out of and in the course of employment to her left shoulder, neck, psyche and TMJ, right shoulder, and teeth. The issue of whether applicant sustained injury in the form of memory loss and headaches is deferred.

  The Board found substantial evidence supporting industrial injury to these body parts and affirmed the WCJ's finding of injury.

  Official decision · page 18 →
• ADJ16035139 · 2026-09-21 · Bakersfield District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of the Rulings and Orders Admitting Evidence, Findings of Fact and Order (FF&O) issued by the presiding workers’ compensation administrative law judge (PWCJ) on April 30, 2026, wherein it was found that decedent sustained an injury arising out of and in the course of his employment (AOE/COE) in the form of cardiac arrest resulting in his death on March 31, 2022, while employed by defendant as farm worker. Defendant contends that the finding of AOE/COE was not based on substantial medical evidence. 10F

  The substantial medical evidence from PQME Dr. Simon, who opined with reasonable medical probability that the decedent's physical labor activities contributed to his cardiac arrest and death, was unrebutted and supported the finding of injury AOE/COE. Defendant's argument for medical certainty was rejected as the law requires only reasonable medical probability for causation.

  Official decision · page 1 →
• ADJ21161039 · 2026-09-04 · Santa Ana District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.4The medical opinions of Dr. Nikakhtar constitutes substantial medical evidence of injury AOE/COE and were unrefuted. The WCJ provided the following analysis in the Opinion on Decision (OOD): A defendant will not be liable for medical treatment where there is no industrial injury. (Kunz v. Patterson Floor Coverings (2002) 67 Cal.Comp.Cases 1588, 1593 (Appeals Board en banc).) Where a lien claimant litigates the issue of entitlement to payment for industrially related medical treatment, the lien claimant stands in the shoes of the injured worker and the lien claimant must establish industrial injury by a preponderance of evidence. (Kaiser Foundation Hospitals v. Workers' Comp. Appeals Bd. (Martin) (1985) Cal.3d 57, 67 [50 Cal.Comp.Cases 411]; Kunz, supra, 67 Cal.Comp.Cases at p. 1592.)”

  The WCJ found substantial medical evidence of injury AOE/COE based on Dr. Nikakhtar's medical opinion, which was unrefuted and based on reasonable medical probability after an adequate examination and evaluation. Defendant failed to provide evidence to refute the medical history or opinion. The WCAB affirmed the WCJ's findings and admitted lien claimants' exhibits into evidence.

  Official decision · page 4 →
• ADJ21943588 · 2026-09-01 · Pomona District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.4section 5402(b), which states, “If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 90-day period.” Preliminarily, we note that applicant seeks relief from the Board by petitioning for reconsideration and in the alternative for removal. Pursuant to section 5900, the Board only has jurisdiction to grant reconsideration from a “final order, decision, or award.” In Maranian v. Workers’ Compensation Appeals Bd. (2000) 81 Cal.App.4th 1068 [65 Cal.Comp.Cases 650], it was held that a ruling regarding the applicability of the section 5402(b) presumption is “final” for purposes of section 5900, and thus properly raised by way of a petition for reconsideration. We therefore consider the merits of applicant’s contentions as a petition for reconsideration. Turning to the merits, we do not find the fact that two numbers were transposed in an apparent typographical error to invalidate the denial. We note that Administrative Rule 9812 does not require the date of injury to be listed in a Notice of Denial. (Cal. Code Regs., tit. 8, § 9812, subd.

  The WCJ correctly determined that the applicant was not entitled to the presumption because the claim was timely denied within the statutory period despite a typographical error in the denial notice.

  Official decision · page 4 →
• ADJ18016076 · 2026-08-31 · San Francisco District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.11I deferred the issue of earnings and set the matter for status conference regarding the earnings issue; therefore, I did not rule on the issue of earnings. As such, the rate of permanent disability indemnity and attorney’s fees were not yet calculated or awarded. 3. Contentions on reconsideration. In its petition for reconsideration, defendant contends this WCJ erred in relying on the reporting of QME Dr. Fields Brewer regarding compensability of the cervical spine and left shoulder, and WPI opinions. Defendant contends that the WPIs assigned by the QME are not substantial evidence and should not be utilized in determining applicant’s permanent disability. DISCUSSION 1. Compensability of cervical spine and left shoulder Applicant bears the burden of proving injury AOE/COE by a preponderance of the evidence. (South Coast Framing v. Workers’ Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302; Lab. Code, §§ 3600(a); 3202.5.) It is sufficient to show that work was a contributing cause of the injury.

  The QME Dr. Fields Brewer's well-reasoned medical opinion, supported by applicant's testimony and medical records, established industrial causation for cervical spine and left shoulder injuries, meeting the burden of proof for compensability.

  Official decision · page 11 →
• ADJ13613836 · 2026-08-18 · Salinas District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.7(Rodarte) (2004) 119 Cal.App.4th 998 [69 Cal.Comp.Cases 579].) Moreover, based on our review of the evidentiary record, including the PQME reports of Dr. Lockwood, we observe that Dr. Lockwood’s opinions are grounded not only in the reported history of the injury, but also comprehensive physical examinations of applicant, and thorough review of extensive medical records, numbering more than 2,500 pages. Ultimately, even after review of records pertaining to applicant’s prior injuries with Earthbound Farms, Dr. Lockwood continued to find injury AOE/COE. Defendant contends that Dr. Lockwood relied primarily upon applicant’s inaccurate depiction of her job duties, but in his March 19, 2022 report, Dr. Lockwood noted review of applicant’s actual job description. (Exhibit A1, p. 2.) Thus, despite being given the opportunity to reverse his opinions, he continually opted to find injury. Ultimately, in reviewing Dr. Lockwood’s reports, we find his opinions to be well-reasoned and not based upon surmise, speculation, conjecture, or guess. We thus conclude that Dr. Lockwood’s opinions constitute substantial medical evidence on the issue of injury AOE/COE to the cervical spine, lumbar spine, bilateral shoulders, and bilateral wrists. We also find, for the

  The WCAB found Dr. Lockwood’s opinions to be well-reasoned, based on comprehensive physical exams and extensive medical records review, constituting substantial medical evidence supporting injury AOE/COE. Applicant’s claim was found compensable for the cervical spine, lumbar spine, bilateral shoulders, and bilateral wrists.

  Official decision · page 7 →
• ADJ20868523 · 2026-08-17 · Oakland District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of the Findings and Award and Opinion on Decision (FA&O) issued on May 14, 2026, by the workers’ compensation administrative law judge (WCJ). By the FA&O, as relevant here, the WCJ found that applicant, while employed by defendant on March 25, 2025 as a Transit Operator, Occupational Group Number 250, sustained injury arising out of and occurring in the course of employment to his right elbow, right wrist, and right hand. The issue of injury to the psyche required development and was deferred. Defendant contends in relevant part that the WCJ denied defendant due process by taking trial testimony without a court reporter, then ordering the testimony to be retaken, and exercising an excess of power by asking the parties to appear the next business day to review video evidence; and that the decision is not based on substantial evidence. We received an Answer from applicant. The WCJ issued a Report and Recommendation on Petition for Reconsideration (Report) recommending that the Petition for Reconsideration be denied. We have considered the allegations of the Petition, the Answer, and the contents of the WCJ’s Report. Based on our preliminary review of the record, we will grant defendant’s Petition for Reconsideration and we will issue a notice of intention and order defendant to file Joint Exhibit

  The WCJ found injury to right elbow, wrist, and hand arising out of and in the course of employment. The issue of injury to psyche was deferred. The Appeals Board granted reconsideration to review video evidence relevant to the injury circumstances.

  Official decision · page 1 →