ADJ14483830 · May 30, 2025

The WCJ's May 20, 2022 decision did not address the issues framed for decision, including whether the QME reporting was substantial medical evidence and whether the report complied with section 4628, thus failing to make findings on all facts involved as required by section 5313. The WCAB granted removal, rescinded the WCJ decision, and returned the matter for further proceedings.

From the decision · page 2On December 1, 2021, the parties proceeded to trial, framing issues of injury AOE/COE and "entitlement to replacement panel and disqualification of Dr. Woythaler as QME based upon the Applicant's [October 1, 2021] Petition." (Minutes of Hearing (Minutes), December 1, 2021, at p. 2:8.)

The WCJ's May 20, 2022 Findings and Order did not address the issues framed for decision, including whether the QME reporting was substantial medical evidence and whether the report complied with section 4628.

Favours Applicant prevailed

This failure meant the decision did not meet the requirements of Labor Code section 5313 to make findings on all facts involved, leading to removal and rescission of the decision.

From the decision · page 4Here, the parties framed two issues for decision: (1) whether applicant sustained injury arising out of and in the course of employment, and (2) the "entitlement to replacement panel and disqualification of Dr. Woythaler as QME based upon the Applicant's 10/1/21 Petition." (Minutes, at 2:8.) The WCJ's decision does not substantively address either issue. Accordingly, the decision fails to make the requisite "findings upon all facts involved in the controversy," and does not meet the minimum standards set forth in sections 5313 and 5815, or in our en banc decision in Hamilton, supra. Accordingly, we will rescind May 20, 2022 Findings and Order, and return the matter to the WCJ to conduct further proceedings consistent with this opinion.

Evaluated applicant and issued two medical-legal reports; reports were challenged as not substantial medical evidence and for failure to comply with Labor Code section 4628.

The reports were central to the dispute over the QME's disqualification and the substantiality of the medical evidence.

From the decision · page 2Applicant while unrepresented selected Julius Woythaler, M.D., as the QME in internal medicine. Thereafter, applicant retained legal representation. (Application for Adjudication, April 8, 2021, p. 11.) Dr. Woythaler evaluated the applicant on July 15, 2020, and issued two medical- legal reports. (Exs. 1 & 2, Reports of Julius Woythaler, M.D., various dates.) The parties also undertook the deposition of Dr. Woythaler on September 15, 2021. (Ex. 3, Transcript of the Deposition of Julius Woythaler, M.D., September 15, 2021.)

Labor Code section 5313

Labor Code section 5313 requires the WCJ to make and file findings upon all facts involved in the controversy and an award, order, or decision stating the determination as to the rights of the parties.

The WCJ's May 20, 2022 decision failed to comply with this requirement by not addressing all issues framed for decision.

From the decision · page 3The appeals board or the workers' compensation judge shall, within 30 days after the case is submitted, make and file findings upon all facts involved in the controversy and an award, order, or decision stating the determination as to the rights of the parties. Together with the findings, decision, order or award there shall be served upon all the parties to the proceedings a summary of the evidence received and relied upon and the reasons or grounds upon which the determination was made.

Labor Code section 4628

Labor Code section 4628 sets mandatory minimum standards for medical-legal reporting and disclosures by evaluating physicians.

Applicant alleged the QME's report did not comply with section 4628, including review and signing requirements, which the WCJ must determine and address.

From the decision · page 5A. Section 4628 sets forth mandatory minimum standards for both the preparation of medical- legal reporting and the concomitant disclosures that must be made by the evaluating physician. The statute provides, in relevant part:

WCJ's May 20, 2022 Findings and Order did not address the issues framed for decision, failing to make findings on all facts involved in the controversy as required by Labor Code section 5313

From the decision · page 4Here, the parties framed two issues for decision: (1) whether applicant sustained injury arising out of and in the course of employment, and (2) the "entitlement to replacement panel and disqualification of Dr. Woythaler as QME based upon the Applicant's 10/1/21 Petition." (Minutes, at 2:8.) The WCJ's decision does not substantively address either issue. Accordingly, the decision fails to make the requisite "findings upon all facts involved in the controversy," and does not meet the minimum standards set forth in sections 5313 and 5815, or in our en banc decision in Hamilton, supra. Accordingly, we will rescind May 20, 2022 Findings and Order, and return the matter to the WCJ to conduct further proceedings consistent with this opinion.