ADJ20478767 — California WCAB decision

ADJ20478767 · May 8, 2026

The WCAB granted the petition for reconsideration, rescinded the February 2, 2026 Findings and Order, substituted new findings of fact, and returned the matter to the WCJ for further proceedings consistent with the opinion.

Issues decided

Medical opinions weighed

Authorities named

District office

San Jose

What the panel ordered

Applicant sought reconsideration of the WCJ's Findings and Order issued on February 2, 2026, which denied his claim of injury arising out of and in the course of employment. The WCJ found no injury to psych, teeth, head, and circulatory system. The WCAB granted reconsideration, rescinded the F&O, substituted new findings, and returned the matter for further proceedings.

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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 prevailedpsych · teeth · head · circulatory system

The WCAB found the record was not properly developed with substantial medical evidence to support the WCJ's finding of no injury to non-psychiatric body parts. The Board has a duty to further develop the record where evidence is insufficient and granted reconsideration to allow further proceedings on the non-psychiatric claims.

From the decision · page 6Based on our review of the record, we are not persuaded that the record is properly developed. There is a lack of substantial medical evidence to support the WCJ's finding that applicant did not sustain injury to his alleged non-psychiatric body parts. By July 25, 2025, applicant had alleged injury to his head in the form of headaches, teeth, and circulatory system. In the initial evaluation on July 29, 2025, Dr. Abenes noted applicant's complaints related to his heart, headaches, and teeth. (Applicant Exhibit #1, at pp. 5, 7, 13.) Substantial medical evidence regarding causation to the alleged non-psychiatric body parts is necessary to render a determination on the issue of whether or not applicant sustained a separate and distinct injury from the psychiatric injury and that, in turn, is not subject to section 3208.3(d).

The facts that decided it

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

Applicant alleged injury to head, teeth, and circulatory system by July 25, 2025, and Dr. Abenes noted related symptoms on July 29, 2025.

Favours Applicant prevailed

This showed the need for substantial medical evidence on non-psychiatric injuries to determine compensability.

From the decision · page 6Based on our review of the record, we are not persuaded that the record is properly developed. There is a lack of substantial medical evidence to support the WCJ's finding that applicant did not sustain injury to his alleged non-psychiatric body parts. By July 25, 2025, applicant had alleged injury to his head in the form of headaches, teeth, and circulatory system. In the initial evaluation on July 29, 2025, Dr. Abenes noted applicant's complaints related to his heart, headaches, and teeth. (Applicant Exhibit #1, at pp. 5, 7, 13.) Substantial medical evidence regarding causation to the alleged non-psychiatric body parts is necessary to render a determination on the issue of whether or not applicant sustained a separate and distinct injury from the psychiatric injury and that, in turn, is not subject to section 3208.3(d).

The record lacked substantial medical evidence to support the WCJ's finding of no injury to non-psychiatric body parts.

Favours Applicant prevailed

This justified the Board's decision to grant reconsideration and remand for further proceedings.

From the decision · page 6Based on our review of the record, we are not persuaded that the record is properly developed. There is a lack of substantial medical evidence to support the WCJ's finding that applicant did not sustain injury to his alleged non-psychiatric body parts. By July 25, 2025, applicant had alleged injury to his head in the form of headaches, teeth, and circulatory system. In the initial evaluation on July 29, 2025, Dr. Abenes noted applicant's complaints related to his heart, headaches, and teeth. (Applicant Exhibit #1, at pp. 5, 7, 13.) Substantial medical evidence regarding causation to the alleged non-psychiatric body parts is necessary to render a determination on the issue of whether or not applicant sustained a separate and distinct injury from the psychiatric injury and that, in turn, is not subject to section 3208.3(d).

Applicant's failure to file a petition for removal did not preclude raising the issue at trial, and the issue of further record development was properly deferred to the WCJ.

Favours Applicant prevailed

This allowed reconsideration and remand for further development of the record on non-psychiatric claims.

From the decision · page 7IV. We observe that applicant's failure to file a petition for removal did not preclude him from raising the issue at trial, and the issue of whether further development of the record is needed was appropriately deferred to the trial WCJ. Accordingly, we grant applicant's Petition, rescind the February 2, 2026 F&O, substitute new Findings of Fact, and return the matter to the WCJ for further proceedings consistent with this opinion. Upon return to the trial level, we recommend that the WCJ consider what further development of the record is appropriate with respect to applicant's claims to his teeth, head, and circulatory system. For the foregoing reasons, IT IS ORDERED that applicant's Petition for Reconsideration of Findings and Order issued by the WCJ on February 2, 2026 is GRANTED. IT IS FURTHER ORDERED, as the Decision After Reconsideration of the Workers' Compensation Appeals Board, that the February 2, 2026 Findings and Order is RESCINDED and the following is SUBSTITUTED therefor:

The rules the panel named

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

Hamilton v. Lockheed Corporation (2001) 66 Cal.Comp.Cases 473

Decisions of the Appeals Board must be based on admitted evidence in the record and supported by substantial evidence.

The WCAB found the record was not properly developed and lacked substantial medical evidence to support the WCJ's findings, requiring further development of the record.

From the decision · page 5Decisions of the Appeals Board "must be based on admitted evidence in the record." (Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 476 (Appeals Board en banc).) An adequate and complete record is necessary to understand the basis for the WCJ's decision. (Lab. Code, § 5313.) "It is the responsibility of the parties and the WCJ to ensure that the record is complete when a case is submitted for decision on the record. At a minimum, the record must contain, in properly organized form, the issues submitted for decision, the admissions and stipulations of the parties, and admitted evidence." (Hamilton, supra, 66 Cal.Comp.Cases at p. 475.) The WCJ's decision must "set[] forth clearly and concisely the reasons for the decision made on each issue, and the evidence relied on," so that "the parties, and the Board if reconsideration is sought, [can] ascertain the basis for the decision[.]... For the opinion on decision to be meaningful, the WCJ must refer with specificity to an adequate and completely developed record." (Id. at p. 476 (citing Evans v. Workmen's Comp. Appeals Bd. (1968) 68 Cal.2d 753, 755 [33 Cal.Comp.Cases 350]).)

San Bernardino Cmty. Hosp. v. Workers' Comp. Appeals Bd. (McKernan) (1999) 74 Cal.App.4th 928

The Appeals Board has a constitutional mandate to ensure substantial justice and may develop the record with new evidence if neither side has presented substantial evidence.

The WCAB exercised its duty to further develop the record where evidence was insufficient, in favor of the applicant.

From the decision · page 6The nature and cause of injury are proper subjects for medical expert opinion, and the Appeals Board has a duty to further develop the record where there is insufficient evidence on an issue. (McClune v. Workers' Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261].) The Appeals Board has a constitutional mandate to "ensure substantial justice in all cases" and may not leave matters undeveloped where it is clear that additional discovery is needed. (Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396, 403- 404 [65 Cal.Comp.Cases 264].) The "Board may act to develop the record with new evidence if, for example, it concludes that neither side has presented substantial evidence on which a decision could be based, and even that this principle may be appropriately applied in favor of the employee." (San Bernardino Cmty. Hosp. v. Workers' Comp. Appeals Bd. (McKernan) (1999) 74 Cal.App.4th 928, 937-938 [64 Cal.Comp.Cases 986].)

ADJ20478767 · May 8, 2026

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

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The rules the panel named

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