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California Supreme Court Clarifies Appropriate Standard of Causation in Workers’ Compensation Death Case as Contributing, not Substantial Factor

The California Supreme Court recently clarified the standard of causation in workers’ compensation death cases. Recognizing the different causation standards in tort law and the workers’ compensation system, the court in this case determined the contributing factor standard as the appropriate link in work-related injuries.The devastating facts of this case demonstrate that Brandon Clark, 36 years old, fell 8-10 feet while working as a carpenter for his employer. As a result, he suffered neck and back injuries, as well as a concussion. Mr. Clark’s workers’ compensation doctor then prescribed medication to treat his injuries, including antidepressants and pain relievers (Elavil, Neurontin, and Vicodin). Mr. Clark’s personal doctor additionally prescribed an anti-anxiety medicine and a sleep aid (Xanas and Ambien).

Months following the accident, Mr. Clark was pronounced dead when his wife was unable to wake him. He had various drugs in his blood, and his autopsy concluded the death was accidental, the combined effect of some of the drugs he had taken. The issue was which drugs contributed to his death, to what degree, and why were certain drugs prescribed.

Mr. Clark’s family and three minor children sought death benefits, alleging that the medications caused his death. The parties agreed upon a qualified medical examiner, who reported that the drugs prescribed by Mr. Clark’s personal physician were found in excess of what is normally considered peripheral blood concentrations, and that it was these medications that caused Mr. Clark’s overdose.  While he retreated from this conclusion slightly at trial, there appeared to be conflicting evidence as to why Mr. Clark’s physician prescribed the sleep aid, Ambien.

The workers’ compensation judge (WCJ) awarded death benefits to the family, holding that the original industrial injury and ensuing need for medication was the cause of death. The employer petitioned for reconsideration, arguing there was no substantial evidence supporting the WCJ’s causation finding. The Board denied reconsideration, and the Court of Appeal granted the employer’s petition for writ of review and reversed. Mr. Clark’s family petitioned for review, and the Supreme Court granted the petition.

The Supreme Court stated that Labor Code section 3600 provides for workers’ compensation liability, without regard to negligence, should an employee’s death arise out of and in the course of employment. The issue before the court centered on the causal link, the nature and strength of the connection between the industrial injury and death. Traditionally, the “but for” test in tort law has required that the injury would not have occurred but for the defendant’s negligence. California has adopted the substantial factor test, requiring that a cause in fact be a substantial factor in causing the injury.

In comparison, the court stated that workers’ compensation is not based on fault, and instead it seeks to ensure that employees are compensated for their work injuries, regardless of fault. The statutory proximate cause language has been less restrictive than tort law. The connection between work and the injury must be more like a contributing cause of the injury.

The Supreme Court reviewed the Court of Appeal’s reversal of the WCJ’s finding of proximate cause. The appellate court concluded that no substantial evidence supported the finding, reasoning that the medical testimony failed to set a percentage figure approximating the level of causation attributable to the prescription medications. According to the appeals court, the evidence did not establish industrial causation.

According to the Supreme Court, in the workers’ compensation system, the accident must be a contributing cause and not a substantial factor in causing the injury. The test is whether the injury follows as a natural incident, contemplated by a reasonable person familiar with the situation. Here, the Supreme Court stated that substantial evidence supported the WCJ’s finding that the prescriptions for Mr. Clark’s industrial injury contributed to his death. The drugs prescribed by the workers’ compensation doctor increased the likelihood of death by overdose, and while Mr. Clark may have died from an overdose of just those drugs prescribed by his treating physician (anti-anxiety and sleep aid), there was a reasonable probability that the other drugs made his death more likely.

The Supreme Court stated that the Court of Appeal was not to reweigh the evidence. Here, the evidence, including the autopsy and the doctor’s report, stated the cause of Mr. Clark’s death to be the combination of all the sedative drugs in his system. Simply because the doctor could not assign a precise percentage for one drug’s contribution does not render evidence of causation insubstantial.

Alternatively, the sleep aid prescribed by the workers’ compensation doctor contributed to Mr. Clark’s death. The WCJ could reasonably conclude that Mr. Clark could not sleep because of his work-related injury. His prescription for sleeping pills, and the later overdose, were causally related to the work injury.

In conclusion, the court stated they are not to assign a more stringent proximate cause standard to death cases when the California legislature has not done so. The Court reversed the Court of Appeal’s judgment.

The attorneys at Sharifi Firm represent clients in both workers’ compensation and personal injury lawsuits. Contact our office today for a free consultation by calling 866-422-7222.

More Blog Posts:

California Court of Appeals Holds that Denial of Right to Cross-Examine Plaintiff Deprived Defendant of Right to Fair Trial in Workers’ Compensation Case, Southern California Injury Lawyer Blog, July 27, 2015

California Court of Appeals Holds that Professional Negligence Claim Requires the Negligence Have Occurred in the Rendering of Professional Services,Southern California Injury Lawyer Blog, July 13, 2015

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