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 compensability of the injury claim.
From the decision · page 1The 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.)
Lab. Code, 5952(d)
A WCJ's decision must be supported by substantial evidence in light of the entire record.
Applied to evaluate the sufficiency of medical evidence supporting the claim.
From the decision · page 1Further, a WCJ's decision must be supported by substantial evidence in light of the entire
record. (Lab. Code, § 5952(d); Lamb v. Workmen's Comp. Appeals Bd. (1974) 11 Cal.3d 274,
281 [39 Cal.Comp.Cases 310];Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 317
[35 Cal.Comp.Cases 500]; LeVesque v. Workmen's Comp. Appeals Bd. (1970) 1 Cal.3d 627, 635
[35 Cal.Comp.Cases 16].) "The term `substantial evidence' means evidence which, if true, has
probative force on the issues. It is more than a mere scintilla, and means such relevant evidence
as a reasonable mind might accept as adequate to support a conclusion...It must be reasonable in
nature, credible, and of solid value." (Braewood Convalescent Hosp. v. Workers' Comp. Appeals
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. A medical opinion must be framed in terms of reasonable medical probability, based on an adequate examination and history, not speculative, and must set forth reasoning to support conclusions.
Applied to assess the quality and sufficiency of medical opinions in the case.
From the decision · page 2Medical 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].)