Santa Rosa district office

Released decisions heard here

Newest released decisions whose case card names this venue. Each quotes the passage it turned on and links to the official PDF. Litigated tail — not a win rate for this office.

• ADJ14305554 · 2026-06-09 · Santa Rosa District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.4II Section 4600(b) provides that "medical treatment that is reasonably required to cure or relieve the injured worker from the effects of the worker's injury means treatment that is based upon the guidelines adopted by the administrative director pursuant to Section 5307.27." (Lab. Code, § 4600(b).) Section 5307.27 specifies that these guidelines refer to the Medical Treatment Utilization Schedule (MTUS). (Lab. Code, § 5307.27(a).) The MTUS can be found in AD Rules 9792.20 through 9792.27.23 (Cal. Code Regs., tit. 8, § 9792.20-9792.27.23). The MTUS is presumptively correct on the extent and scope of treatment and is the primary source of guidance for physicians. (Lab. Code, § 4604.5(a); Cal. Code Regs., tit. 8, § 9792.21(c).) However, the MTUS may be rebutted, and treatment may be warranted based on recommendations outside the MTUS in limited situations. (Cal. Code Regs., tit. 8, § 9792.21(d); see also Lab. Code, § 4604.5(d).) If a UR decision is untimely, the determination of medical necessity must be made by the WCAB based on substantial medical evidence consistent with the MTUS. (Dubon II, supra, 79 Cal.Comp.Cases at 1300.)

  The Appeals Board found the December 3, 2024 UR determination was untimely under Labor Code section 4610 and former AD Rule 9792.9.1(f), requiring further development of the record with current medical evidence to determine medical necessity. The WCJ erred in dismissing the request as untimely without considering applicant's medical evidence.

  Official decision · page 4 →
• ADJ10219413 · 2026-05-12 · Santa Rosa District OfficePermanent total disabilityremanded

  Determinative passage · p.1Applicant petitioned for reconsideration of the Findings and Award issued on September 9, 2025 by the workers' compensation administrative law judge (WCJ) in this matter. Therein, the WCJ found that applicant sustained injury arising out of and in the course of employment (AOE/COE) to his thoracic spine, right shoulder, chest/ribs, right-upper extremity, and in the form of peripheral vascular disease/deep vein thrombosis, while employed as a log chocker on October 5, 2015. The WCJ further found that the injury caused permanent disability of 61%, after apportionment.

  The WCJ found permanent disability of 61% after apportionment but did not find permanent total disability; applicant argued for total disability relying on vocational expert opinion, but the Appeals Board did not rule on the merits and returned the matter for settlement consideration.

  Official decision · page 1 →
• ADJ10124964 · 2026-05-07 · Santa Rosa District OfficeJurisdiction / venuedefendant prevailed

  Determinative passage · p.4FINDINGS OF FACT 1. Deborah Hemstead filed an Application for Adjudication of Claim for workers' compensation benefits under California state law, alleging that she sustained injury on September 24, 2014 to her back, hips, shoulders, left wrist, and musculoskeletal system while employed by United Indian Health Services as a Medical Assistant III at Arcata, California. 2. United Indian Health Services is entitled to sovereign immunity as a matter of law under the "arm of the tribe" test (People v. Miami Nation Enterprises (2016) 2 Cal.5th 222 [2016 Cal. LEXIS 9626]) pursuant to United Indian Health Services, Inc./Tribal First v. Workers' Comp. Appeals Bd. (the applicant) (2025) 111 Cal.App.5th 1064 [90 Cal.Comp.Cases 499]. 3. Because United Indian Health Services is entitled to sovereign immunity as a matter of law, it is therefore immune from suit under state law and the Workers' Compensation Appeals Board lacks jurisdiction to adjudicate any claim for workers' compensation benefits against United Indian Health Services.

  The Court of Appeal held that United Indian Health Services is entitled to sovereign immunity as an arm of the tribe, which means the WCAB lacks jurisdiction to adjudicate the claim.

  Official decision · page 4 →
• ADJ18206391 · 2026-05-04 · Santa Rosa District OfficeAOE/COEremanded

  Determinative passage · p.15Here, PQME Dr. McGahan's expert medical opinions are based on inadequate medical history and an incorrect legal theory and therefore are not substantial.

  PQME Dr. McGahan's opinions were not substantial evidence due to inadequate medical history and incorrect legal theory; record requires further development.

  Official decision · page 15 →
• ADJ18574715 · 2026-04-10 · Santa Rosa District OfficePermanent disability ratingremanded

  Determinative passage · p.8V. Accordingly, we grant defendant's Petition for Reconsideration, and order that a final decision after reconsideration is deferred pending further review of the merits of the Petition for Reconsideration and further consideration of the entire record in light of the applicable statutory and decisional law. While this matter is pending before the Appeals Board, we encourage the parties to participate in the Appeals Board's voluntary mediation program. Inquiries as to the use of our mediation program can be addressed to WCABmediation@dir.ca.gov. For the foregoing reasons, IT IS ORDERED that defendant's Petition for Reconsideration is GRANTED.

  The WCJ found 56% permanent disability based on medical evidence and applicant testimony, using the addition method for impairments per Kite and Vigil. The WCAB granted reconsideration to further review whether substantial medical evidence supports the WCJ's decision.

  Official decision · page 8 →
• ADJ15918599 · 2026-04-07 · Santa Rosa District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.5Doctor Fishman also stated his opinion that applicant's cancer was a "insidious, progressive disease" warranting the extension of the Board's jurisdiction beyond the 5-year statute of limitations set forth in Labor Code § 5410 pursuant to General Foundry Service v. WCAB (Jackson), (1986) 42 C3d 331. He states:

  Medical evidence showed applicant's kidney cancer is a progressive, insidious disease with potential for recurrence, justifying extension of jurisdiction beyond the 5-year statute of limitations.

  Official decision · page 5 →