ADJ16908650 — California WCAB decision

ADJ16908650 · April 28, 2025

The WCAB panel denied the defendant's petition for reconsideration, affirming the WCJ's findings that the applicant sustained an injury arising out of and in the course of employment and that the claim was not barred by the statute of limitations.

Issues decided

Medical opinions weighed

Authorities named

District office

Los Angeles

What the panel ordered

Defendant filed a petition for reconsideration of the January 27, 2025 Findings and Order, which was denied by the WCAB panel on April 28, 2025.

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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.

AOE/COEApplicant prevailedlumbar spine

The WCJ found the applicant credible despite minor inconsistencies in testimony, supported by the QME report of Dr. Penilla, which was found to be substantial medical evidence.

From the decision · page 4II. Turning to the merits of the Petition, defendant contends that the WCJ's decision was based on "significant misrepresentations," including applicant's "inaccurate lay testimony given at trial on October 28, 2024." (Petition, p. 4.) Defendant argues that applicant provided different accounts regarding the mechanism of injury, including one account to Dr. Penilla wherein he alleged injury from lifting a heavy machine and another account at trial wherein he testified to falling and striking his back. (Id. at p. 9.) Defendant believes that due to the inconsistencies, applicant should not be considered a credible witness. Pursuant to Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 318-319 [35 Cal.Comp.Cases 500], credibility determinations of the WCJ, as the trier of fact, are entitled to great weight based upon the WCJ's opportunity to observe the demeanor of the witnesses and weigh the witnesses' statements in connection with their manner on the stand. Credibility determinations are not to be disturbed except where there is contrary evidence of considerable substantiality. (Id.) Unfortunately, no such evidence was provided here.

The rules the panel named

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

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

Credibility determinations of the WCJ are entitled to great weight based on opportunity to observe demeanor and weigh statements; not to be disturbed except with contrary evidence of considerable substantiality.

Applied to assess applicant's credibility despite inconsistencies.

From the decision · page 4II. Turning to the merits of the Petition, defendant contends that the WCJ's decision was based on "significant misrepresentations," including applicant's "inaccurate lay testimony given at trial on October 28, 2024." (Petition, p. 4.) Defendant argues that applicant provided different accounts regarding the mechanism of injury, including one account to Dr. Penilla wherein he alleged injury from lifting a heavy machine and another account at trial wherein he testified to falling and striking his back. (Id. at p. 9.) Defendant believes that due to the inconsistencies, applicant should not be considered a credible witness. Pursuant to Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 318-319 [35 Cal.Comp.Cases 500], credibility determinations of the WCJ, as the trier of fact, are entitled to great weight based upon the WCJ's opportunity to observe the demeanor of the witnesses and weigh the witnesses' statements in connection with their manner on the stand. Credibility determinations are not to be disturbed except where there is contrary evidence of considerable substantiality. (Id.) Unfortunately, no such evidence was provided here.

Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473 (Appeals Bd. en banc)

A medical opinion must be based on reasonable medical probability, pertinent facts, adequate examination and history, and set forth reasoning; not speculative or based on inadequate premises to be substantial evidence.

Applied to evaluate the QME report of Dr. Penilla as substantial medical evidence.

From the decision · page 5As explained in Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Bd. en banc), a decision "must be based on admitted evidence in the record" (Id. at p. 478) and must be supported by substantial evidence. (Lab. Code, § 5903, 5952, subd. (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 [35 Cal.Comp.Cases 500]; LeVesque v. Workers' Comp. Appeals Bd. (1970) 1 Cal.3d 627 [35 Cal.Comp.Cases 16].) "The term `substantial evidence' means evidence which, if true, has probative force on the issues. It is more than a mere scintilla, and means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion...It must be reasonable in nature, credible, and of solid value." (Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, 164 [48 Cal.Comp.Cases 566], emphasis removed and citations omitted.) A medical opinion proffered as substantial evidence must be framed in terms of reasonable medical probability, be based on pertinent facts, an adequate examination, and history, set forth reasoning in support of its conclusions, and not be speculative. (E.L. Yeager v. Workers' Comp. Appeals Bd. (Gatten) (2006)

Reynolds v. Workmen's Comp. Appeals Bd. (1974) 12 Cal.3d 726

Employer has duty to notify employee of workers' compensation rights when aware of injury; failure to notify precludes statute of limitations defense.

Applied to find claim not barred by statute of limitations due to employer's failure to notify applicant of rights.

What proof carried it

The evidence the panel weighed, by kind.

Testimony and credibilityfavours Applicant prevailed

Applicant's credible testimony despite minor inconsistencies favored applicant's injury claim.

From the decision · page 4II. Turning to the merits of the Petition, defendant contends that the WCJ's decision was based on "significant misrepresentations," including applicant's "inaccurate lay testimony given at trial on October 28, 2024." (Petition, p. 4.) Defendant argues that applicant provided different accounts regarding the mechanism of injury, including one account to Dr. Penilla wherein he alleged injury from lifting a heavy machine and another account at trial wherein he testified to falling and striking his back. (Id. at p. 9.) Defendant believes that due to the inconsistencies, applicant should not be considered a credible witness. Pursuant to Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 318-319 [35 Cal.Comp.Cases 500], credibility determinations of the WCJ, as the trier of fact, are entitled to great weight based upon the WCJ's opportunity to observe the demeanor of the witnesses and weigh the witnesses' statements in connection with their manner on the stand. Credibility determinations are not to be disturbed except where there is contrary evidence of considerable substantiality. (Id.) Unfortunately, no such evidence was provided here.

Medical recordsfavours Applicant prevailed

QME report of Dr. Penilla was substantial medical evidence supporting injury causation.

From the decision · page 6Based upon our review of the October 7, 2022 QME report, we find that Dr. Penilla provided adequate reasoning and relied upon relevant facts and history, including a thorough examination of the applicant. We find no evidence of bias, speculation, or inexperience on the part of Dr. Penilla and no evidence, proffered by defendant or otherwise, to rebut Dr. Penilla's findings. As such, we find that the October 7, 2022 QME report constitutes substantial medical evidence.

ADJ16908650 · April 28, 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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