ADJ11763808 · September 28, 2026

The WCJ found applicant sustained injury arising out of employment causing 100% permanent disability and requiring further medical treatment. The Board affirmed the 100% PD finding and amended the award to provide for future medical care generally, based on medical evidence and legal standards for causation and treatment.

From the decision · page 1Defendant seeks reconsideration of the Amended Findings and Award (F&A), issued by the workers’ compensation administrative law judge (WCJ) on July 16, 2026, wherein the WCJ found in pertinent part that applicant, while employed on April 20, 2015 as a deli clerk, occupational group number 322 by “Safeway” 1 sustained injury arising out of and in the course of 0F

Applicant sustained injury arising out of and in the course of employment on April 20, 2015, to left knee, left leg, right ankle, and right foot.

Favours Applicant prevailed

This established the compensable injury basis for the permanent disability and medical treatment claims.

From the decision · page 1Defendant seeks reconsideration of the Amended Findings and Award (F&A), issued by the workers’ compensation administrative law judge (WCJ) on July 16, 2026, wherein the WCJ found in pertinent part that applicant, while employed on April 20, 2015 as a deli clerk, occupational group number 322 by “Safeway” 1 sustained injury arising out of and in the course of 0F

Dr. Timothy Lo's medical evaluations found applicant had no prior right ankle limitations and that the left knee and right ankle impairments have a synergistic effect, supporting a 100% permanent disability rating and work restrictions.

Favours Applicant prevailed

These medical opinions supported the finding of 100% permanent disability and need for further medical treatment.

From the decision · page 2BACKGROUND We will briefly review the relevant facts. Applicant sustained injury arising out of and in the course of employment to her left knee, left leg, right ankle, right foot, but not to her right toes, while employed by defendant on April 20, 2015. (Minutes of Hearing and Summary of Evidence (MOH/SOE, June 11, 2026, at p. 2:6-9.) Timothy Lo, M.D., served as the Qualified Medical Evaluator (QME). In his March 20, 2023 report, Dr. Lo examined applicant. He concluded that: “Due to her functional limitations, it is unlikely that she will be able to ever return back to work at Safeway unless she is accommodated in a sedentary capacity. She would not be able to perform the job duties as deli clerk, and the formal job description of deli clerk was again reviewed, which was accompanying the claims examiner cover letter.” (Exhibit 3, p. 29.) With respect to apportionment, he found that: the applicant had no difficulty performing her job duties as a deli clerk prior to the specific injury sustained on April 20, 2015. She had no prior history of right ankle functional limitations or pain.

Applicant's credible testimony that she misses more work due to pain than the four days per month opined by Dr. Lo.

Favours Applicant prevailed

This testimony supported the credibility of the applicant's disability claim over the defendant's vocational expert's speculative opinion.

From the decision · page 6On July 13, 2023, after applicant underwent multiple surgeries and was MMI, Dr. Lo provided ratings, work restrictions, and filled out the residual functional capacity report. On July 13, 2023, Dr. Lo provided the work restrictions completed the residual functional capacity report. Defendant had ample opportunity to question Dr. Lo on whether the prior injuries contributed to the work restrictions and functional capacity. Dr. Lo opined applicant could miss “about four days per month” (Exhibit 4); however, applicant credibly testified, that she misses cancels more times per month due to the pain. The residual functional capacity report was based a review of substantial medical records and evaluations of the applicant; thus, there is no evidence to support the argument that Dr. Lo’s opinions were speculative.

Dr. Lo concluded applicant could not return to prior work as deli clerk due to functional limitations and provided a permanent disability rating of 100%. He opined that the left knee and right ankle impairments have a synergistic effect and work restrictions include no prolonged standing or walking more than five minutes per hour, lifting no more than five pounds, and use of a cane as needed.

Dr. Lo's medical evaluations and reports were relied upon to support the finding of 100% permanent disability and need for further medical treatment.

From the decision · page 2BACKGROUND We will briefly review the relevant facts. Applicant sustained injury arising out of and in the course of employment to her left knee, left leg, right ankle, right foot, but not to her right toes, while employed by defendant on April 20, 2015. (Minutes of Hearing and Summary of Evidence (MOH/SOE, June 11, 2026, at p. 2:6-9.) Timothy Lo, M.D., served as the Qualified Medical Evaluator (QME). In his March 20, 2023 report, Dr. Lo examined applicant. He concluded that: “Due to her functional limitations, it is unlikely that she will be able to ever return back to work at Safeway unless she is accommodated in a sedentary capacity. She would not be able to perform the job duties as deli clerk, and the formal job description of deli clerk was again reviewed, which was accompanying the claims examiner cover letter.” (Exhibit 3, p. 29.) With respect to apportionment, he found that: the applicant had no difficulty performing her job duties as a deli clerk prior to the specific injury sustained on April 20, 2015. She had no prior history of right ankle functional limitations or pain.

Labor Code § 4600; Labor Code § 4610; Wilson v. State of CA Cal Fire (2019) 84 Cal.Comp.Cases 393 (Appeals Board en banc); Granado v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 399

An applicant is entitled to reasonable and necessary medical treatment to cure or relieve from the effects of the industrial injury, including compensable consequence injuries.

The Board applied these standards to affirm the finding of entitlement to further medical treatment generally, amending the WCJ's award to remove specific body parts.

From the decision · page 9responsibility and place the burden on the Appeals Board to discover where the evidence supporting the petition can be found in the record. As explained below, we are granting the Petition to find that applicant is entitled to further medical treatment, but otherwise we would have denied the Petition for Reconsideration. Furthermore, defendant submitted no evidence of the prior Stipulations at trial and made no effort to obtain medical reporting with respect to applicant’s prior injuries. If the Petition was not subject to denial for failing to cite to the record, we would have denied it on the merits. III. In her decision, the WCJ found that applicant will require further medical treatment to cure or relieve from the effects of the injury to her right ankle and left knee. Section 4600 defines medical treatment broadly, as “[m]edical, surgical, chiropractic, acupuncture, and hospital treatment, including nursing, medicines, medical and surgical supplies, crutches, and apparatuses, including orthotic and prosthetic devices and services, that is reasonably required to cure or relieve the injured worker from the effects of his or her injury[.]” (Lab.

Applicant's credible testimony that she misses more work due to pain than the four days per month opined by Dr. Lo.

From the decision · page 6On July 13, 2023, after applicant underwent multiple surgeries and was MMI, Dr. Lo provided ratings, work restrictions, and filled out the residual functional capacity report. On July 13, 2023, Dr. Lo provided the work restrictions completed the residual functional capacity report. Defendant had ample opportunity to question Dr. Lo on whether the prior injuries contributed to the work restrictions and functional capacity. Dr. Lo opined applicant could miss “about four days per month” (Exhibit 4); however, applicant credibly testified, that she misses cancels more times per month due to the pain. The residual functional capacity report was based a review of substantial medical records and evaluations of the applicant; thus, there is no evidence to support the argument that Dr. Lo’s opinions were speculative.

Defendant's vocational rehabilitation expert's opinion was speculative and not based on substantial evidence to support 100% permanent disability.

From the decision · page 55. Finally, the WCJ’s reliance on the vocational rehabilitation expert’s opinion that applicant might possibly not comply with a potential employer’s absenteeism policies is speculative and not based on substantial evidence to support an Award of 100% PD.