South Coast Framing, Inc. v. Workers' Compensation Appeals Board
61 Cal. 4th 291
| Cal. | 2015Background
- Brandon Clark (36) fell at work in Sept 2008, suffered neck/back injuries and concussion; received workers’ compensation treatment including Elavil and Neurontin (from WC physician) and Vicodin; his personal physician later prescribed Xanax and Ambien.
- On July 20, 2009 Clark was found dead; autopsy found Elavil, Neurontin, Xanax, Ambien in blood and Vicodin in urine; death ruled accidental from combined sedative drug effects.
- Medical testimony: Dr. Bressler attributed death to combined sedative effects of multiple drugs; Dr. Bruff (agreed medical examiner) initially attributed death mainly to Ambien and Xanax but conceded Elavil and Vicodin may have incremental, nonzero contributory effects though he could not quantify percentages.
- The Workers’ Compensation Judge (WCJ) found Clark’s death resulted from medications prescribed for his industrial injury (including Elavil and Vicodin) and alternatively that Ambien was prescribed for sleep problems caused by work-related pain; awarded death benefits; Board denied reconsideration.
- Court of Appeal reversed, concluding insufficient substantial evidence that industrially-prescribed medications materially contributed to death; California Supreme Court granted review.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether death is compensable under Lab. Code §3600 when nonindustrial and industrial causes combine | Clark’s family: industrially‑prescribed drugs (Elavil, Vicodin) and medication related to work pain (Ambien) contributed to death so §3600 satisfied | Employer: evidence shows death mainly from nonindustrial prescriptions (Ambien/Xanax); Elavil’s contribution was speculative/insignificant | Held: §3600 requires only that employment be a contributing cause; substantial evidence supported WCJ that Elavil and Vicodin contributed and that Ambien was prescribed for work‑related sleep problems; reverse Court of Appeal |
| Proper causation standard for death claims under workers’ comp | Family: apply the traditional contributing‑cause/substantial‑probability standard used in workers’ comp (not a higher “material factor” test) | Employer: Court of Appeal applied a stricter “material factor” or significance requirement and reversed | Held: Rejected heightened “material factor” requirement for death claims; affirmed contributing‑cause standard (employment need only be a contributing cause) |
| Whether inability to quantify percentage contribution defeats causation | Family: precise percentages are not required; reasonable probability/substantial evidence is sufficient | Employer: Bruff’s inability to assign percentages shows causation is speculative | Held: Bruff’s concessions that Elavil/Vicodin had nonzero, additive effects were sufficient; lack of numeric apportionment does not negate substantial evidence |
| Compensability of death following medical treatment and prescriptions | Family: treatment and prescriptions for work injury (including physician‑prescribed Ambien and epidural history) make subsequent death compensable | Employer: some prescriptions came from non‑WC physician and death mainly from those; causation not established | Held: Treatment‑related injuries/deaths are compensable; evidence supported WCJ’s alternative finding that Ambien was taken for work‑related sleep disturbance and contributed to death |
Key Cases Cited
- LaTourette v. Workers’ Comp. Appeals Bd., 17 Cal.4th 644 (discussing contributing‑cause standard under §3600)
- Maher v. Workers’ Comp. Appeals Bd., 33 Cal.3d 729 (employment must be a contributing cause of the injury)
- McAllister v. Workmen’s Comp. App. Bd., 69 Cal.2d 408 (establishes reasonable probability standard; precise apportionment not required)
- Ballard v. Workmen’s Comp. App. Bd., 3 Cal.3d 832 (employer takes employee as found; prescribed drugs can contribute to compensable disability)
- Pacific Gas & Electric Co. v. Ind. Acc. Com., 56 Cal.2d 219 (apportionment in death claims; court declined to apportion and is not authority for heightened causation test)
- Kimbol v. Industrial Acc. Commission, 173 Cal. 351 (early articulation of contributing‑cause test in workers’ compensation)