ADJ13157138 — California WCAB decision

What the panel ordered

Petition for Reconsideration is denied.

Defendant seeks reconsideration of the Findings of Fact, Award, and Order issued by the WCJ on June 12, 2025, which the WCJ recommended denying. The Appeals Board panel issued a decision on September 15, 2025, denying the petition for reconsideration.

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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.

Medical treatment / UR / IMRApplicant prevailed

The medical reports of Dr. Einbund are admissible because the injury occurred prior to January 1, 2005, and thus the pre-SB 899 medical-legal reporting procedures apply, as supported by case law and statutory interpretation.

From the decision · page 109-10.) The decision in Tanksley emphasized that the parties to a claim of injury occurring prior to January 1, 2005, should not be required to obtain a judicial determination as to the date of injury pursuant to section 5412 in order to determine the appropriate procedure by which to obtain medical-legal reporting. (Ibid.) Such a holding would be inconsistent with the California Constitutional mandate that the workers' compensation law "shall accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character." (Cal. Const., Article XIV, § 4.) In this case, given that the injuries claimed to have occurred prior to January 1, 2005, specifically, during the period of January 5, 1975 to October 1, 1981, Dr. Einbund's reports are admissible.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Applicant was found temporary totally disabled from March 1, 1981 to June 1, 1981, and permanent and stationary as of June 1, 1981.

Favours Applicant prevailed

This fact supports the retroactive award of permanent disability and temporary total disability period.

From the decision · page 4As discussed in the WCJ's report, substantial medical evidence supports the finding of the WCJ that applicant was temporary totally disabled from March 1, 1981 to June 1, 1981, and that applicant's condition became permanent and stationary on June 1, 1981. Additionally, the parties stipulated that June 1, 1981 was the date applicant reached permanent and stationary status.

Favours Applicant prevailed

This credibility finding supports the wage benefits award to the applicant.

Dr. Einbund's medical reports were found admissible and substantial medical evidence despite the date of injury being after January 1, 2005, because the injury occurred prior to 2005 and pre-SB 899 procedures apply.

Favours Applicant prevailed

This fact supports the acceptance of medical evidence for the permanent disability award.

From the decision · page 109-10.) The decision in Tanksley emphasized that the parties to a claim of injury occurring prior to January 1, 2005, should not be required to obtain a judicial determination as to the date of injury pursuant to section 5412 in order to determine the appropriate procedure by which to obtain medical-legal reporting. (Ibid.) Such a holding would be inconsistent with the California Constitutional mandate that the workers' compensation law "shall accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character." (Cal. Const., Article XIV, § 4.) In this case, given that the injuries claimed to have occurred prior to January 1, 2005, specifically, during the period of January 5, 1975 to October 1, 1981, Dr. Einbund's reports are admissible.

The rules the panel named

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

California Labor Code

Labor Code section 5412

Determines the date of injury for cumulative trauma cases and its effect on statute of limitations and indemnity rates.

From the decision · page 3II. Based on our review of the record, we agree with the WCJ's determination that applicant is entitled to a retroactive award of permanent disability beginning June 1, 1981, and total temporary total disability from March 1, 1981 to June 1, 1981. Defendant fails to cite to any authority to support their contention that the section 5412 finding bars a retroactive award. Moreover, we find defendants position contrary to well-established, longstanding precedent regarding the impact of a finding of date of injury pursuant to section 5412. In J. T. Thorp v. Workers' Comp. Appeals Bd. (Butler) (1984) 153 Cal.App.3d 327 [49 Cal.Comp.Cases 224], the court states:

California Labor Code

Labor Code section 4650

Governs timing of payments for temporary and permanent disability indemnity.

From the decision · page 4Section 4650 directs the timing of payments of both temporary and permanent disability. (See, Cal. Lab. Code § 4650.) Further, subsection (b)(1) states, in pertinent part: If the injury causes permanent disability, the first payment shall be made within 14 days after the date of last payment of temporary disability indemnity, except as provided in paragraph (2)3.

California Labor Code

Labor Code section 4062.2

Medical evaluation procedure for injuries occurring on or after January 1, 2005, not applicable here due to injury date prior to 2005.

From the decision · page 9Labor Code Section 4062.2 provides whenever a comprehensive medical evaluation is required to resolve any dispute arising out of an injury or a claimed injury occurring on or after January 1, 2005, and the employee is represented by an attorney, the evaluation shall be obtained only as provided in this section. It has been determined that a void in the law was created when sections 4061 and 4062 were amended under Sen. Bill 899 to apply to the medical evaluation and reporting procedure of section 4062.2. This void occurred because the medical evaluation and reporting procedure in section 4060, section 4061, or 4062 are limited to represented cases for dates of injury occurring on or after January 1, 2005.

ADJ13157138 · September 15, 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

What proof carried it

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