ADJ12008723 · August 5, 2022

The Board found substantial medical evidence based on reasonable medical probability that the decedent's job duties contributed to his death, supported by the PQME's opinion and circumstantial evidence, and rejected the defendant's arguments against industrial causation.

From the decision · page 5First, the death certificate states the cause of death, and that is the starting point in order to determine causation. Dr. Borsada opines (to be more fully discussed below) that hypertension is a contributing factor towards arteriosclerosis, the condition that caused the applicant' death. The doctor then discusses the stressors that can lead to an aggravation of hypertension. After reviewing the evidence presented, the doctor concludes that the decedent's stressors at work aggravated his hypertension and his atherosclerotic cardiovascular disease that caused his death.

PQME Dr. Minal Borsada opined that the decedent's job duties contributed to his heart attack and death by aggravating hypertension and atherosclerotic cardiovascular disease.

Favours Applicant prevailed

This medical opinion provided substantial evidence based on reasonable medical probability linking employment to death, which was central to the Board's decision to deny reconsideration.

From the decision · page 5First, the death certificate states the cause of death, and that is the starting point in order to determine causation. Dr. Borsada opines (to be more fully discussed below) that hypertension is a contributing factor towards arteriosclerosis, the condition that caused the applicant' death. The doctor then discusses the stressors that can lead to an aggravation of hypertension. After reviewing the evidence presented, the doctor concludes that the decedent's stressors at work aggravated his hypertension and his atherosclerotic cardiovascular disease that caused his death.

Deposition testimony of the decedent's daughter described the decedent's work stress, long hours, poor diet, and fatigue, supporting the PQME's findings.

Favours Applicant prevailed

This testimony corroborated the medical opinion and contributed to the totality of evidence supporting industrial causation.

From the decision · page 6decedent's daughter to find a work-related connection. Contrary to the defendant's assertion that she knew "nothing" about her father's medical history, work history, job duties, or any other relevant facts, the court found the deposition transcript to contain relevant facts pertaining to how tired her father was after a day's work, that he was stressed and always on the go because of deadlines, that he would drive through the night to get to his locations on time, that he would not sleep at times, that he drove to and from Oakland once every week, that he ate junk food and fast food when on the road, and that he would sometimes work from 6:00 a.m. to 9:00 p.m. the applicant knew much more than nothing.

Circumstantial evidence showed the decedent was found dead next to his truck with hoses detached and key in ignition, indicating acute physical exertion related to work duties at time of death.

Favours Applicant prevailed

This evidence supported the medical opinion that the death arose out of and in the course of employment, reinforcing the Board's finding of industrial causation.

From the decision · page 8In addition to all factors described above, Dr. Borsada opines that acute physical exertion can aggravate hypertension. Because the decedent was found dead next to his truck with the hoses detached, the reliable circumstantial evidence points to the fact that the decedent was in the middle of either attaching them or detaching them from his truck, similar to the situation where a man found dead of a heart attack next to his truck was found to have been killed due to the strain of tying down his load [see Builders Fence Company, et al. v. Workers' Comp. Appeals Bd. (Fields) (1998) 63 CCC 287 (writ denied)].

The PQME concluded to a reasonable degree of medical probability that the decedent's job duties contributed to his heart attack and death by aggravating hypertension and atherosclerotic cardiovascular disease, citing long work hours, stress, poor diet, and physical exertion as factors.

The Board relied on the PQME's comprehensive opinion linking the decedent's employment to his death based on medical probability and totality of circumstances.

From the decision · page 5First, the death certificate states the cause of death, and that is the starting point in order to determine causation. Dr. Borsada opines (to be more fully discussed below) that hypertension is a contributing factor towards arteriosclerosis, the condition that caused the applicant' death. The doctor then discusses the stressors that can lead to an aggravation of hypertension. After reviewing the evidence presented, the doctor concludes that the decedent's stressors at work aggravated his hypertension and his atherosclerotic cardiovascular disease that caused his death.

South Coast Framing v. Workers' Comp. Appeals Bd. (2015) 61 Cal.4th 291

Substantial medical evidence based on reasonable medical probability is required to establish industrial causation of death.

The Board applied this standard to find that the PQME's opinion and the totality of evidence met the burden of proof for industrial causation.

From the decision · page 7to the defendant having to prove that the death was not work related. The court disagrees and is aware of the Labor Code provisions and case law cited by counsel. The defendant's position is conclusory and does not lend credence to its position. The court found that the applicant met her burden of proof of finding that work stressors contributed to the decedent's death and that industrial causation was not zero, consistent with case law, including South Coast Framing v. Workers' Comp. Appeals Bd. (2015) 61 Cal.4th 291 [80 Cal.Comp.Cases 489].

Deposition testimony of decedent's daughter describing work stress, long hours, poor diet, and fatigue

From the decision · page 6decedent's daughter to find a work-related connection. Contrary to the defendant's assertion that she knew "nothing" about her father's medical history, work history, job duties, or any other relevant facts, the court found the deposition transcript to contain relevant facts pertaining to how tired her father was after a day's work, that he was stressed and always on the go because of deadlines, that he would drive through the night to get to his locations on time, that he would not sleep at times, that he drove to and from Oakland once every week, that he ate junk food and fast food when on the road, and that he would sometimes work from 6:00 a.m. to 9:00 p.m. the applicant knew much more than nothing.

Circumstantial evidence of decedent found dead next to his truck with hoses detached and key in ignition

From the decision · page 8In addition to all factors described above, Dr. Borsada opines that acute physical exertion can aggravate hypertension. Because the decedent was found dead next to his truck with the hoses detached, the reliable circumstantial evidence points to the fact that the decedent was in the middle of either attaching them or detaching them from his truck, similar to the situation where a man found dead of a heart attack next to his truck was found to have been killed due to the strain of tying down his load [see Builders Fence Company, et al. v. Workers' Comp. Appeals Bd. (Fields) (1998) 63 CCC 287 (writ denied)].