ADJ18543951 — California WCAB decision

What the panel ordered

Petition for Reconsideration denied; prior ODAR granting reconsideration and finding injury AOE/COE to left knee on September 30, 2023, upheld.

Defendant seeks reconsideration of the August 29, 2025 WCAB Opinion and Order Granting Petition for Reconsideration and Decision After Reconsideration (ODAR), which rescinded the May 20, 2025 WCJ decision denying injury AOE/COE and substituted findings that applicant sustained industrial injury to his left knee on September 30, 2023.

Read the official decision →

This docket was decided more than once. Shown here is the latest released decision; we also hold August 29, 2025.

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.

AOE/COEApplicant prevailedleft knee

The WCAB found that the QME's medical-legal determination, supported by medical records and applicant's unchallenged trial testimony, constituted substantial evidence establishing injury AOE/COE to the left knee on September 30, 2023, by a preponderance of the evidence.

From the decision · page 4the WCJ's concerns regarding the lack of contemporaneous reporting as to the alleged mechanism of injury, but following a review of the entire record, determined that "the QME's medical-legal determination as supported in the medical record and applicant's unchallenged trial testimony supports a finding of industrial injury, to a preponderance of the evidence." (Id. at p. 11.)

The rules the panel named

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

Labor Code section 3202.5

Injury arising out of and in the course of employment must be established by a preponderance of the evidence.

Applicant met burden by preponderance of evidence including QME report and trial testimony.

From the decision · page 6It 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, 319 [35 Cal.Comp.Cases 500, 505]); LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Bd. en banc).) 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 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a); 3202.5.)

Labor Code section 4060

Qualified Medical Evaluator (QME) reports must be based on reasonable medical probability and supported by pertinent facts and adequate examination.

QME Dr. Retodo's reports met these criteria and were relied upon by the WCAB.

From the decision · page 6It 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, 319 [35 Cal.Comp.Cases 500, 505]); LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Bd. en banc).) 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 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a); 3202.5.)

Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312

Medical opinion must not be speculative and must set forth reasoning in support of conclusions to constitute substantial evidence.

The QME's opinion was found to be substantial evidence despite defendant's credibility challenges.

From the decision · page 6It 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, 319 [35 Cal.Comp.Cases 500, 505]); LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) To constitute substantial evidence "... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions." (Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Bd. en banc).) 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 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a); 3202.5.)

ADJ18543951 · December 9, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

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