Authorities as the decision cited them, with how this panel applied each one.
Lab. Code §§ 3600(a), 3202.5; South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291
The employee bears the burden of proving the injury arose out of and in the course of employment by a preponderance of the evidence.
Applied to determine whether applicant met burden for AOE/COE.
From the decision · page 3The employee bears the burden of proving the injury arose out of and in the course of
employment by a preponderance of the evidence. (South Coast Framing v. Workers' Comp.
Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code,
§ 3600(a), 3202.5.)1 Whether an employee's injury arose out of and in the course of employment
is generally a question of fact to be determined in light of the particular circumstances of the case.
(Wright v. Beverly Fabrics (2002) 95 Cal.App.4th 346, 353 [67 Cal.Comp.Cases 51].) The phrase
"in the course of employment" "`ordinarily refers to the time, place, and circumstances under
which the injury occurs.'" (Latourette v. Workers' Comp. Appeals Bd. (1998) 17 Cal.4th 644, 651
[63 Cal.Comp.Cases 253], citing Maher v. Workers' Comp. Appeals Bd. (1983) 33 Cal.3d 729,
733.) An "employee is in the `course of his employment' when he does those reasonable things
which his contract with his employment expressly or impliedly permits him to do." (Latourette,
supra, at p. 651.) For the injury to arise out of employment, it must "`occur by reason of a
condition or incident of [the] employment.' [citation] That is, the employment and the injury must
be linked in some causal fashion. [citation]" (Id. at p. 651.)
Lab. Code, §§ 4060(c)(d), 4061(i), 4062.3(l)
Medical evidence is required if there is an issue regarding the compensability of the claim.
Applied to require medical evidence for compensability determination.
From the decision · page 4Medical evidence is required if there is an issue regarding the compensability of the claim.
(Lab. Code, § 4060(c)(d), 4061(i), 4062.3(l).) A medical opinion must be framed in terms of
reasonable medical probability, it must be based on an adequate examination and history, it must
not be speculative, and it must set forth reasoning to support the expert conclusions reached. (E.L.
Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, 928
[71 Cal.Comp.Cases 1687]; Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604, 620-621
(Appeals Bd. en banc).) "Medical reports and opinions are not substantial evidence if they are
known to be erroneous, or if they are based on facts no longer germane, on inadequate medical
histories and examinations, or on incorrect legal theories. Medical opinion also fails to support
the Board's findings if it is based on surmise, speculation, conjecture or guess." (Hegglin v.
Workmen's Comp. Appeals Bd. (1971) 4 Cal.3d 162, 169 [36 Cal.Comp.Cases 93].)
Lab. Code, §§ 5701, 5906; Nunes (Grace) v. State of California, Dept. of Motor Vehicles (2023) 88 Cal.Comp.Cases 741
The WCJ and the Appeals Board have a duty to further develop the record where there is insufficient evidence on a threshold issue.
Applied to remand for further development of the medical record.
From the decision · page 5The WCJ and the Appeals Board have a duty to further develop the record where there is
insufficient evidence on a threshold issue. (Lab. Code, § 5701, 5906; Nunes (Grace) v. State of
California, Dept. of Motor Vehicles (2023) 88 Cal.Comp.Cases 741, 752; McClune v. Workers'
Comp. Appeals Bd. (1998) 62 Cal.App.4th 1117, 1121-1122 [63 Cal.Comp.Cases 261]; Tyler v.
Workers' Comp. Appeals Bd. (1997) 56 Cal.App.4th 389, 392-394 [62 Cal.Comp.Cases 924];
McDonald v. Workers' Comp. Appeals Bd., TLG Med. Prods. (2005) 70 Cal.Comp.Cases 797,
802.) The Appeals Board has a constitutional mandate to ensure "substantial justice in all cases."
(Kuykendall v. Workers' Comp. Appeals Bd. (2000) 79 Cal.App.4th 396, 403.)