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