Star Ins. Co. v. Workers' Compensation Appeals Board CA6

CourtCalifornia Court of Appeal
DecidedJanuary 21, 2016
DocketH042244
StatusUnpublished

This text of Star Ins. Co. v. Workers' Compensation Appeals Board CA6 (Star Ins. Co. v. Workers' Compensation Appeals Board CA6) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Star Ins. Co. v. Workers' Compensation Appeals Board CA6, (Cal. Ct. App. 2016).

Opinion

Filed 1/21/16 Star Ins. Co. v. Workers’ Compensation Appeals Board CA6

NOT TO BE PUBLISHED IN OFFICIAL REPORTS

California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SIXTH APPELLATE DISTRICT

STAR INSURANCE COMPANY, H042244 (W.C.A.B. No. ADJ8247302) Petitioner,

v.

WORKERS’ COMPENSATION APPEALS BOARD and MARIA ROSA TAVARES et al.,

Respondents.

Maria Rosa Tavares (Maria), the widow of Armando Tavares (Tavares), and Tavares’s dependent children were awarded workers’ compensation death benefits. Tavares, a tractor driver, died of ischemic heart disease after complaining of chest pain while at work. After the Worker’s Compensation Appeals Board (Board) denied its petition for reconsideration, Star Insurance Co., the employer’s workers’ compensation insurance carrier, (petitioner) filed a petition for writ of review in this court. (See Labor Code, § 5950.)1 It asserts that substantial evidence did not support a finding that Tavares’s death arose out of his employment. The medical experts agreed Tavares had very severe coronary artery disease and his sudden death at work was the result of a cardiac event. The issue before us is whether

1 All further statutory references are to the Labor Code. the evidence was sufficient to show that Tavares’s employment contributed to his death. We find the evidence sufficient and affirm. I Procedural History Maria applied for adjudication of her workers’ compensation claim for death benefits on behalf of herself and three dependent children. Maria was appointed as those children’s guardian ad litem and trustee to prosecute the case on their behalf. Following a hearing on December 3, 2014, the Worker’s Compensation Administrative Law Judge (WCJ) found that Tavares had sustained an injury arising out of employment and in the course of employment (AOE/COE) “consisting of a fatal heart attack/heart-cardiovascular injury resulting in death.” The WCJ determined that the dependents were entitled to a death benefit of $320,000. The WCJ’s opinion explained that the determination had been based on the medical reports of two physicians, Revels Cayton, M.D., and Maria Nellie Betancourt, M.D. It stated: “Both doctors agree that Mr. Tavares’[s] heart attack was caused by the physical strain he exerted while using the restroom facilities at work. [Tavares’s] restroom activities are considered to have arisen out of and during the course and scope of his employment based on decisions in Allied Signal Inc. v. WCAP (Briggs) 66 Cal. Comp. Cases 1333 (2001) and Smith v. WCAB (196[9]) 71 Cal.2d 588, 34 Cal. Comp. Cases 424. These cases hold that an injury precipitated by a movement which is incidental to the employment constitutes a compensable injury even though it is a normal bodily movement.” Petitioner filed a petition for reconsideration challenging the sufficiency of the evidence. Petitioner pointed out that Dr. Cayton expressed no opinion that physical straining in the bathroom was a causal factor in Tavares’s heart attack. Petitioner argued that the finding that Tavares’s death arose out of his employment was not supported by substantial evidence.

2 More specifically, petitioner asserted that Dr. Cayton’s report, which indicated that the exertion of power washing his equipment contributed to or hastened Tavares’s fatal heart attack, did not constitute substantial evidence because it was conclusory and speculative and it failed to provide supportive scientific reasoning. Petitioner further argued that Dr. Betancourt’s report did not constitute substantial evidence because her articulated theory, that Tavares had engaged in a Valsalva maneuver in an attempt to defecate, and he had, thereby, precipitated his heart attack did not reflect medical probability. The WCJ’s report and recommendation on the petition for reconsideration concluded that each doctor’s opinion provided independent, substantial evidence supporting the decision to award death benefits. As to Dr. Cayton’s report, which indicated that Tavares’s work activity was a contributing cause of his heart attack and death, the WCJ’s report stated that the doctor’s opinion was neither conclusory nor speculative because the doctor provided a logical explanation for concluding that activity hastened Tavares’s death. As to Dr. Betancourt’s report, the WCJ indicated that the report permitted an inference of industrial injury and that scientific certainty is not necessary to establish industrial causation. The WCJ indicated that Dr. Betancourt’s stated conclusion that the Valsalva maneuver was the most likely cause of injury met the burden of proof. The WCJ further concluded that, under the personal comfort and convenience doctrine, Tavares’s fatal injury while using restroom facilities was sufficient to establish an industrial injury because it resulted from a combination of the Valsalva maneuver and his compromised coronary artery system. The Board adopted the reasons stated in the WCJ’s report and denied the petition for reconsideration.

3 II Facts Tavares had been employed by Luis Scattini & Sons for three to four years before his death. He worked as a tractor driver on a seasonal basis and drove a tractor approximately 10 hours a day. Tavares sometimes worked as many as 12 hours a day, and he was a dedicated and conscientious employee. In the opinion of Gregory Scattini (Gregory), who managed the business’s operations in the fields and office, the job duties of a tractor driver were not physically demanding. On June 13, 2011, Tavares reported to work at 6:00 a.m. He drove a Caterpillar Challenger that pulled a disc. At about 11:00 a.m., Tavares was pressure washing the mud off the tractor and disc. He used a motorized cart with a hose for this purpose. Tavares went over to Gregory’s truck and told Gregory and the foreman, that he was having chest pain. It did not appear to be an emergency and the foreman was going to drive Tavares to see a doctor. Gregory left for another area of the ranch. Tavares asked to use the restroom before he went to the doctor. He went into the portable toilet, but he did not come out. Coworkers knocked on the door, but they did not receive a response. The door was forced open, and Tavares was found in a sitting position, leaning against the wall. Someone called 911. The first responders pronounced Tavares dead at 12:15 p.m., after they had attempted advanced cardiac life support and consulted with a doctor at Salinas Valley Memorial Hospital. A day or two before his death, Tavares had complained of chest pain to a coworker. Tavares’s younger brother indicated that Tavares had diabetes. The report of the forensic pathologist, who performed the postmortem examination of Tavares, described him as a Hispanic male, 48 years of age, 70 inches tall, and weighing 251 pounds. It stated that Tavares “died as a result of ischemic heart disease due to coronary artery atherosclerosis (heart attack due to hardening and narrowing of arteries which supply the heart muscle).” It listed the cause of death as

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Daubert v. Merrell Dow Pharmaceuticals, Inc.
509 U.S. 579 (Supreme Court, 1993)
Pacific Gas & Electric Co. v. Industrial Accident Commission
363 P.2d 596 (California Supreme Court, 1961)
Maher v. Workers' Compensation Appeals Board
661 P.2d 1058 (California Supreme Court, 1983)
Zemke v. Workmen's Compensation Appeals Board
441 P.2d 928 (California Supreme Court, 1968)
Lamb v. Workmen's Compensation Appeals Board
520 P.2d 978 (California Supreme Court, 1974)
Hegglin v. Workmen's Compensation Appeals Board
480 P.2d 967 (California Supreme Court, 1971)
LaTourette v. Workers' Compensation Appeals Board
951 P.2d 1184 (California Supreme Court, 1998)
Ballard v. Workmen's Compensation Appeals Board
478 P.2d 937 (California Supreme Court, 1971)
Nicky Blair's Restaurant v. Workers' Compensation Appeals Board
109 Cal. App. 3d 941 (California Court of Appeal, 1980)
Crown Appliance v. Workers' Compensation Appeals Board
9 Cal. Rptr. 3d 415 (California Court of Appeal, 2004)
Lumbermen's Mutual Casualty Co. v. Industrial Accident Commission
175 P.2d 823 (California Supreme Court, 1946)
Department of Rehabilitation v. Workers' Compensation Appeals Board
70 P.3d 1076 (California Supreme Court, 2003)
South Coast Framing, Inc. v. Workers' Compensation Appeals Board
349 P.3d 141 (California Supreme Court, 2015)
Fogarty v. Department of Industrial Relations
273 P. 791 (California Supreme Court, 1928)
Kimbol v. Industrial Acc. Commission
160 P. 150 (California Supreme Court, 1916)
Granado v. Workmen's Compensation Appeals Board
445 P.2d 294 (California Supreme Court, 1968)
Smith v. Workmen's Compensation Appeals Board
455 P.2d 822 (California Supreme Court, 1969)
Liberty Mutual Insurance v. Industrial Accident Commission
166 P.2d 908 (California Court of Appeal, 1946)

Cite This Page — Counsel Stack

Bluebook (online)
Star Ins. Co. v. Workers' Compensation Appeals Board CA6, Counsel Stack Legal Research, https://law.counselstack.com/opinion/star-ins-co-v-workers-compensation-appeals-board-ca6-calctapp-2016.