Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, § 3600(a)(4); Smith v. Workers' Comp. Appeals Bd. (1981) 123 Cal.App.3d 763; Douglas Aircraft, Inc. v. Industrial Acc. Com. (1957) 47 Cal.2d 903
Intoxication is an affirmative defense; defendant bears burden to prove by preponderance of evidence that employee was intoxicated at time of injury and that intoxication was a proximate or substantial cause of the injury
Defendant established intoxication but failed to establish proximate or substantial causation
From the decision · page 4Among these is that "the injury is not caused by the intoxication, by alcohol or the unlawful use of a controlled substance, of the injured employee." (§ 3600(a)(4).) Intoxication is an affirmative defense, and the burden of proof rests on the employer, as the defendant, to establish that affirmative defense.
Escobedo v. Marshalls (2005) 70 Cal.Comp.Cases 604
Medical opinion must be framed in terms of reasonable medical probability, not speculative, based on pertinent facts and adequate examination and history, and set forth reasoning in support of conclusions to constitute substantial evidence
QME's conclusion based on partial record without requested additional information is not substantial evidence
From the decision · page 4To constitute substantial evidence “... a medical opinion must be framed in terms of reasonable medical probability, it must not be speculative, it must be based on pertinent facts and on an adequate examination and history, and it must set forth reasoning in support of its conclusions.” ( Escobedo v.
McDuffie v. Los Angeles County Metropolitan Transit Authority (2001) 67 Cal.Comp.Cases 138
Before directing augmentation of medical record, WCJ or Board must establish as threshold matter that specific medical opinions are deficient; preferred procedure is to allow supplementation by physicians who have already reported
WCJ's appointment of regular physician was not appropriate; parties should follow Rule 31.7 process for additional panel QME
From the decision · page 6In our en banc decision in McDuffie v. Los Angeles County Metropolitan Transit Authority (2001) 67 Cal.Comp.Cases 138 (Appeals Board en banc), we stated that "[s]ections 5701 and 5906 authorize the WCJ and the Board to obtain additional evidence, including medical evidence, at any time during the proceedings (citations) [but] [b]efore directing