What the panel ordered
Petition for Reconsideration denied.
Petition for Reconsideration filed by defendant was timely acted upon by the Appeals Board within 60 days of case transmission.
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 Appeals Board acted timely on the petition within 60 days of case transmission and found no grounds to overturn the WCJ's findings and award.
From the decision · page 2Under section 5909(a), the Appeals Board must act on a petition for reconsideration within 60 days of transmission of the case to the Appeals Board. Transmission is reflected in Events in the Electronic Adjudication Management System (EAMS). Specifically, in Case Events, under Event Description is the phrase "Sent to Recon" and under Additional Information is the phrase "The case is sent to the Recon board."
The medical legal report by Dr. Michaels met the regulatory requirements and Dr. Michaels was properly designated as the PTP. The lien claimant was entitled to payment.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
The case was transmitted to the Appeals Board on July 18, 2025, and the Board acted within 60 days.
Favours Defendant prevailed
This timely action satisfied the requirements of Labor Code section 5909 for petition reconsideration.
From the decision · page 2Under section 5909(a), the Appeals Board must act on a petition for reconsideration within 60 days of transmission of the case to the Appeals Board. Transmission is reflected in Events in the Electronic Adjudication Management System (EAMS). Specifically, in Case Events, under Event Description is the phrase "Sent to Recon" and under Additional Information is the phrase "The case is sent to the Recon board."
Dr. Michaels' medical legal report met the regulatory requirements and was accepted as valid.
Favours Applicant prevailed
This supported the lien claimant's entitlement to payment and upheld the PTP designation.
From the decision · page 8In the case herein, the report issued by Dr. Michaels on November 28, 2022, meets the above requirements, and is a medical legal report. Further, defendant appears to not have issued any payments or EOBs as required by CCR § 10786(e), and thus waived their objections.
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.
Applicant does not have notable psychiatric symptoms but has impaired sleep due to the work injury, found 100% related to the injury.
Dr. Michaels' medical legal report was found to meet the requirements and was relied upon to determine the validity of the lien and PTP status.
From the decision · page 7Dr. Michaels subsequently issued a Medical Legal evaluation dated November 28, 2022, LC Exhibit 6. In said report, Dr. Michaels reports that he was referred the applicant by his attorney, and was asked to clarify issues and the applicant's condition on a psychological basis. Id. at page 2. Dr. Michaels further reports that the report is being conducted at the request of the applicant's attorney because the claim has been denied. Id. at page 2.
Initially treated and discharged applicant on August 2, 2022, with no ratable disability.
Dr. Batch's treatment and discharge were part of the background to the dispute over the medical legal report and PTP designation.
From the decision · page 4Applicant was initially treated by Dr. Batch, who discharged the applicant on August 2, 2022, for which a denial of PD benefits notice was issued to the applicant on August 16, 2022. LC Exhibit 2. On August 10, 2022, the applicant amended their application to include psyche as a body part. Lien Claimant's Exhibit 1.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 5909
Petition for reconsideration must be acted upon within 60 days of case transmission to the Appeals Board.
The Appeals Board acted timely on the petition within 60 days of case transmission.
From the decision · page 2Under section 5909(a), the Appeals Board must act on a petition for reconsideration within 60 days of transmission of the case to the Appeals Board. Transmission is reflected in Events in the Electronic Adjudication Management System (EAMS). Specifically, in Case Events, under Event Description is the phrase "Sent to Recon" and under Additional Information is the phrase "The case is sent to the Recon board."
CCR section 9793(h)
Medical legal report must meet CCR 9793(h) requirements to qualify for payment.
Dr. Michaels' report met the requirements and was accepted as a valid medical legal report.
From the decision · page 8Further, pursuant to CCR § 9793(h)(1)-(5), the report must meet the following conditions to qualify as a medical legal report:
Labor Code sections 4600, 4621(b)
PTP designation valid if properly designated by applicant's attorney and not lost due to incomplete RFA response.
Dr. Michaels was properly designated as PTP and did not lose designation despite incomplete RFA response.
From the decision · page 6The L.C. § 4600 letter designating Dr. Michaels as the PTP is valid, and uncontroverted. The argument that because Dr. Michaels did not respond to petitioner's request of an incomplete RFA on September 21, 2022, Defense Exhibit G, caused Dr. Michaels to lose his PTP designation is not proper. Based on the evidence submitted, Dr. Michaels was properly designated as the PTP, and did not lose his designation as such.
What proof carried it
The evidence the panel weighed, by kind.
Service of the Report and Recommendation on July 18, 2025, provided actual notice to parties of case transmission.
From the decision · page 2Here, according to the proof of service for the Report and Recommendation by the workers' compensation administrative law judge, the Report was served on July 18, 2025, and the case was transmitted to the Appeals Board on July 18, 2025. Service of the Report and transmission of the case to the Appeals Board occurred on the same day. Thus, we conclude that the parties were provided with the notice of transmission required by section 5909(b)(1) because service of the Report in compliance with section 5909(b)(2) provided them with actual notice as to the commencement of the 60-day period on July 18, 2025.
The medical legal report by Dr. Michaels met the regulatory requirements and was not objected to by defendant.
From the decision · page 8In the case herein, the report issued by Dr. Michaels on November 28, 2022, meets the above requirements, and is a medical legal report. Further, defendant appears to not have issued any payments or EOBs as required by CCR § 10786(e), and thus waived their objections.
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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.
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