WCPanelIQ
PanelQMEMed-legalDenied

Fernando Martinez Decedent; Olga Salas Damian Salas — ADJ16035139

FERNANDO MARTINEZ, Decedent; OLGA SALAS and DAMIAN SALAS, Applicants vs. JNR AG, INC.; STAR INSURANCE COMPANY, Defendants

ADJ number
ADJ16035139
Decision date
Sep 20, 2026
District office
Bakersfield District Office
WCJ
—
Claim administrator
Star Insurance Company
Commissioners
JOSÉ H. RAZO, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: heart, cardiovascular system (cardiac arrest resulting in death)

LC §5909LC §5900LC §5703LC §3600LC §4701LC §3202.5LC §5705LC §4060LC §4622CCR §10940CCR §10600

Summary

Fernando Martinez, a farm laborer, suffered a fatal cardiac arrest on March 31, 2022, shortly after beginning work removing leaves from grapevines on his first day back after weeks off. His dependents, Olga Salas and Damian Salas, claimed a death benefit. The PWCJ found the death arose out of and in the course of employment (AOE/COE) based on the uncontroverted opinion of PQME Dr. Benjamin Simon, who opined that physical work activity was a contributing cause of the cardiac arrest within reasonable medical probability. Defendant sought reconsideration, arguing the medical opinion was speculative and not substantial evidence because the decedent's work was minimal and he had significant pre-existing non-industrial risk factors. The Appeals Board denied reconsideration, holding that Dr. Simon's reporting constituted substantial evidence and that defendant's demand for 'medical certainty' misstated the legal standard, which requires only reasonable medical probability.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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