What the panel ordered
The Appeals Board granted defendant's petition for reconsideration and deferred final decision pending further review of the merits and entire record.
Defendant filed a timely petition for reconsideration of the November 27, 2024 Findings and Award by the WCJ, which was granted by the Appeals Board on February 24, 2025, deferring final decision pending further review.
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.
The WCJ found applicant permanently totally disabled based on medical and vocational evidence; the Appeals Board granted reconsideration to further review the sufficiency of medical evidence and rating.
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
The WCJ found no bias by QME Reiss and denied replacement; the Appeals Board granted reconsideration to further review the issue.
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
The WCJ found no good cause to delay trial for QME Reiss to review sub rosa video; the Appeals Board granted reconsideration to further review the issue.
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
QME Reiss consistently reported the need for more aggressive treatment and found no bias in his opinions.
Favours Applicant prevailed
This supported the WCJ's denial of replacement of QME Reiss and was a key factor in the reconsideration grant to further review the issue.
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
Defendant did not provide the sub rosa video to QME Reiss prior to trial despite its availability since 2021.
Favours Defendant prevailed
This fact was central to the dispute over whether QME Reiss should have reviewed the video and was a basis for reconsideration.
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
Applicant has not made progress in treatment and requires supportive psychotherapy to benefit from vocational rehabilitation.
Favours Applicant prevailed
This fact supported the WCJ's finding of permanent total disability and was considered in the reconsideration grant to further review the sufficiency of medical evidence.
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Consistently reported that applicant needed more aggressive treatment to improve condition; found no bias and opposed replacement; opinions remained steadfast since 2021.
The WCJ found no evidence of bias and relied on Reiss's consistent opinions regarding treatment needs and condition progression.
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, §§ 5903, 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274; Braewood Convalescent Hosp. v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604
Decisions by the Appeals Board must be supported by substantial evidence, which means evidence that a reasonable mind might accept as adequate to support a conclusion.
The Appeals Board preliminarily found the record may not be properly developed and substantial evidence may be lacking to support the WCJ's decision, warranting reconsideration.
From the decision · page 6We highlight the following legal principles that may be relevant to our review of this matter:
What proof carried it
The evidence the panel weighed, by kind.
QME Reiss's consistent opinions on treatment needs and condition progression
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
Defendant's failure to provide sub rosa video to QME Reiss prior to trial
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
Applicant's lack of progress in treatment and need for supportive psychotherapy for vocational rehabilitation
From the decision · page 1Defendant seeks reconsideration of the November 27, 2024 Findings and Award issued by the workers' compensation administrative law judge (WCJ). Therein and as relevant here, the WCJ found that applicant sustained industrial injury to his left ring and left middle finger, neck, right upper extremity including shoulder, forearm, hand, in the form of a diagnosis of CRPS, and psyche in the form of PTSD while employed as a lube technician on May 16, 2020. The WCJ further found that the Petition to Replace Panel QME Reiss is denied and that applicant is permanently totally disabled.
The same issues, filtered across the whole corpus — or paste your own facts and let the search rank by factor match.
About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
- The injured worker is not named here, and the case caption is not printed. Physicians appear as the decision names them, because a medical opinion is an act in a public proceeding.
- Issues, outcomes and weights were extracted by AI and released only where the source passage checked. Read the official decision before relying on anything here. Not legal advice.
- If you are named in this decision and want this page removed, write to privacy@similarcase.com.