ADJ10943110 — California WCAB decision

What the panel ordered

Petition for reconsideration granted; matter remanded for status conference and further review; final decision deferred.

Petition for reconsideration of Findings of Fact and Orders issued by WCJ on August 15, 2023, granted by the Appeals Board and matter remanded for status conference and further review.

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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.

Reconsideration / removalApplicant prevailed

The Appeals Board found that the record was insufficiently developed regarding service of lien claimant's exhibits and that due process required further development and reconsideration.

From the decision · page 1Lien claimant MBA Psychiatric Services, Inc. (MBA) through its non-attorney representative Innovative Medical Management, LLC, has petitioned for reconsideration, removal, and in the alternative, rescission, of the Findings of Fact and Orders issued and served by the workers' compensation administrative law judge (WCJ) in this matter on August 15, 2023. In that decision, the WCJ found that applicant sustained injury arising out of and occurring in the course of employment to his psyche, and claims injury to his internal body system as well as the condition of insomnia. The WCJ also found that lien claimant MBA Psychiatric Services, Inc. did not provide medical treatment services reasonably required to cure or relieve [applicant] from the effects of the industrial injury. The WCJ excluded from evidence lien claimant's exhibits 1-14 and 16, admitted lien claimant's exhibit 15, and ordered the lien of MBA disallowed in its entirety.

The rules the panel named

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

Lab. Code, §§ 5903, 5952(d); Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473 (Appeals Board en banc)

Decisions by the Appeals Board must be supported by substantial evidence and based on admitted evidence in the record.

The Board reviewed the record and found the existing record insufficient to support the WCJ's decision, warranting further development.

From the decision · page 3II. It is well established that 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].) "The term `substantial evidence' means evidence which, if true, has probative force on the issues. It is more than a mere scintilla, and means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion...It must be reasonable in nature, credible, and of solid value." (Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, 164 [48 Cal.Comp.Cases 566], emphasis removed and citations omitted.) 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).) 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.

Lab. Code, §§ 5701, 5906; Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389

The Appeals Board has discretionary authority to develop the record to provide due process and fully adjudicate issues.

The Board exercised its authority to order a status conference for further record development and due process.

From the decision · page 4The Appeals Board has the discretionary authority to develop the record when the record does not contain substantial evidence or when appropriate to provide due process or fully adjudicate the issues. (§ 5701, 5906; Tyler v. Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389, 394 [65 Cal. Rptr. 2d 431, 62 Cal.Comp.Cases 924] ["The principle of allowing full development of the evidentiary record to enable a complete adjudication of the issues is consistent with due process in connection with workers' compensation claims."]; see McClune v. Workers' Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117 [72 Cal. Rptr. 2d 898, 63 Cal.Comp.Cases 261]; Rucker v. Workers' Comp. Appeals Bd. (2000) 82 Cal.App.4th 151, 157-158 [65 Cal.Comp.Cases 805]; Gangwish v. Workers' Comp. Appeals Bd. (2001) 89 Cal.App.4th 1284, 1295 [66 Cal.Comp.Cases 584].)

ADJ10943110 · November 3, 2023

What the panel ordered

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The facts that decided it

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