What Is Substantial Medical Evidence?

The applicant filed a claim alleging a cumulative trauma to the back, lower extremities, neck and diabetes. The applicant later amended the claim to include a claim for hypertension.

The case was eventually tried before a Workers’ Compensation Judge (WCJ). The WCJ found the applicant’s hypertension non industrial. The WCJ believed the applicant’s history of job stress was not credible. The WCJ found the orthopedic injuries and the diabetes industrially related.

The judge found on a physician report that indicated the diabetes was stress related. However, the WCJ did not find that stress caused the diabetes, but rather it was caused by an injection of epinephrine for the industrial back injury.

This case, even though it is non published, cites cases that our published. Substantial evidence is considered in light of the whole record. Levesque v. WCAB. Medical reports cannot be based on surmise, speculation or conjecture. Hegglin v WCAB.

It is important to read this case because they differentiate between an aggravation of short duration and one that has long- term effects. They indicate that the medical cause of an ailment is a scientific question.. You must have a medical opinion based upon scientific knowledge.

In this case the judge made a lay opinion. The court indicated that where an issue is exclusively a matter of scientific medical knowledge you need expert medical evidence form a physician. Lay testimony or opinion is not sufficient to meet the test of substantial evidence.

There was no medical evidence in this case to support the finding that the diabetes was industrial related. The case was remanded to the trial level for further development of the record.

Case: County of San Bernadino v WCAB (Andrews)
This is an unpublished decision

Harvey Brown
3501 Jamboree Rd. Suite 602
Newport Beach, CA 92660

Newsletter Sign up

Workers Compensation Feed

Recent Newsletters