ADJ18492736 · September 30, 2025

The WCAB found substantial evidence supporting injury to the left hand only, deferring other body parts due to incomplete medical evidence and the need for further development of the record.

From the decision · page 92007 to November 9, 2023, as a cashier, occupational group number: 214, at Los Angeles, California by Vallarta Food Enterprises, Inc., insured by Safety National Casualty Corporation, sustained injury arising out of and in the course of employment to her left hand. 2. The issue of injury to other body parts is deferred pending further development of the record.

Applicant sustained cumulative injury to her left hand only as supported by QME Dr. Benton's reports and defendant's concession.

Favours Applicant prevailed

This fact led to the rescission of prior findings and substitution of new findings limiting injury to the left hand.

From the decision · page 8Here, we are not persuaded by defendant's argument that applicant failed to treat and therefore did not meet her burden to prove injury. Dr. Benton finds that applicant sustained a cumulative injury to her left hand, and defendant concedes in its Petition that applicant sustained injury to the left hand. Moreover, there is no evidence that the diagnostics were authorized. Regardless, the MRI that was completed was not reviewed by either physician. Last, applicant provided a detailed job description to the QME, while her testimony at trial and her description to Dr. Kandkhorov were much less thorough. We suggest that a job description be obtained and sent to each physician accordingly. There is a clear need for development of the record here.

Diagnosed bilateral shoulder, wrist, and hand sprain/strain and contusion due to cumulative trauma but did not review medical records or MRI; report lacked interpreter and proper job description, thus not substantial evidence.

Lack of medical records review, no interpreter, incomplete job description, and unsigned report issues led to rejection of substantial evidence status.

From the decision · page 6In this matter, we disagree that the primary treating physician report is substantial medical evidence. As noted by defendant, Dr. Kandkhorov, an interpreter was not utilized at the evaluation as no interpreter listed. The lack of proper translation affected the job description outlined by applicant as compared to the detailed description provided to Dr. Benton. More importantly, Dr. Kandkhorov was not afforded the opportunity to review applicant's medical records or the MRI

Diagnosed left shoulder strain, left wrist strain, and left hand strain but found only left hand injury industrially related; recommended further diagnostics; opinion partially credited for left hand injury only.

Incomplete diagnostics and lack of explanation for excluding other body parts led to partial credit for left hand injury only.

From the decision · page 7In turn, we likewise do not find that Dr. Benton's reporting is complete as it relates to all other body parts aside from the left hand. Dr. Benton also did not review the MRI of the left shoulder, but also he repeatedly requests diagnostics that do not appear to have been completed. Without the same, he relies merely on the fact that there were no records of injury pre-dating her resignation on November 9, 2023. The fact that there is no report prior to his own opinion or her resignation does not invalidate the existence of a cumulative injury where the medical evidence would otherwise support such a finding. In general, an employee is not charged with knowledge that their disability is job-related without medical evidence to that effect. (Johnson, supra, 163 Cal.App.3d at p. 471; Newton v. Workers' Comp. Appeals Bd. (1993) 17 Cal.App.4th 147, 156, fn. 16 [58 Cal.Comp.Cases 395].) It is the physician's job to opine as to whether the symptoms are due to a cumulative injury. For example, Dr.

E.L. Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922

A medical opinion must be predicated on reasonable medical probability and not be speculative.

Applied to assess the validity of medical opinions in this case.

Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159

Substantial evidence must be reasonable, credible, and of solid value to support findings.

Applied to evaluate medical opinions and evidence for injury causation.

From the decision · page 5II It is well established that decisions and awards 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 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen's 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].) To constitute substantial medical evidence, a medical opinion must be predicated on reasonable medical probability. (E.L. Yeager Construction v. Workers' Comp. Appeals Bd.

Labor Code section 3208.1

Definition of cumulative injury as repetitive traumatic activities causing disability or need for medical treatment.

Used to define the nature of the injury sustained by applicant.

From the decision · page 6Section 3208.1 defines a "cumulative" injury as one "occurring as repetitive mentally or physically traumatic activities extending over a period of time, the combined effect of which causes any disability or need for medical treatment. Cumulative injury occurs from repetitive mental or physical activities at work over a period of time, which causes any disability or need for medical treatment. (§ 3208.1; Western Growers Ins. Co., v. Workers' Comp. Appeals Bd. (Austin) (1993) 16 Cal.App.4th 227, 234 [58 Cal.Comp.Cases 323]; J.T. Thorp, Inc., v. Workers' Comp. Appeals Bd. (Butler) (1984) 153 Cal.App.3d 327, 332-333 [49 Cal.Comp.Cases 224].) Findings regarding cumulative injury and the date of injury must be based on substantial evidence such as medical opinion and testimony considering the entire record. (Garza, supra, 3 Cal.3d at pp. 317- 319; Austin, supra, 16 Cal.App.4th at pp. 233- 241; City of Fresno v. Workers' Comp. Appeals Bd. (Johnson) (1985) 163 Cal.App.3d 467, 470-473 [50 Cal.Comp.Cases 53].)

Applicant's detailed job description to QME Dr. Benton was more thorough than to treating physician, affecting credibility of medical opinions.

From the decision · page 8Here, we are not persuaded by defendant's argument that applicant failed to treat and therefore did not meet her burden to prove injury. Dr. Benton finds that applicant sustained a cumulative injury to her left hand, and defendant concedes in its Petition that applicant sustained injury to the left hand. Moreover, there is no evidence that the diagnostics were authorized. Regardless, the MRI that was completed was not reviewed by either physician. Last, applicant provided a detailed job description to the QME, while her testimony at trial and her description to Dr. Kandkhorov were much less thorough. We suggest that a job description be obtained and sent to each physician accordingly. There is a clear need for development of the record here.