ADJ17097194 · February 23, 2026

The WCJ found applicant intoxicated and that intoxication was a proximate cause of injury, but the WCAB found evidentiary deficiencies including exclusion of key witness testimony, incomplete medical records for the AME, and lack of applicant testimony on pre-injury vertigo, requiring remand for further development of causation evidence.

From the decision · page 1Applicant seeks reconsideration of the Findings and Order (F&O), issued by the workers' compensation administrative law judge (WCJ) on November 25, 2025, wherein the WCJ found in pertinent part that applicant sustained injury arising out of and in the course of employment (AOE/COE) to his head and lumbar spine; that applicant was intoxicated at the time of injury and that his intoxication was a proximate and substantial cause of the injury; and ordered that applicant take nothing.

Applicant's blood alcohol level was 320 mg/dL at 1:13 pm on injury date, indicating intoxication.

Favours Defendant prevailed

Supports intoxication defense if causation proven.

From the decision · page 2BACKGROUND Applicant filed an Application for Adjudication of Claim (Application) on December 22, 2022, claiming a specific injury on September 22, 2021 when he fell off a roof, while employed by defendant as a handyman, to his brain, neck, head, shoulders and multiple body parts. Applicant filed an Amended Application on March 29, 2023 (Amended Application) to add the body parts psyche and teeth. There is no dispute that applicant was seriously injured in his fall from the roof, including sustaining a traumatic brain injury, and that the injury was industrial. (11/25/25 F&O; Defendant's Exh. D, 3/3/23 Report by Neurologist Jan H. Merman, M.D., at pp 1, 4; Defendant's Exh. G Excerpts from Scripps Mercy Hospital.) The dispute here centers on whether defendant has proven the elements of the intoxication defense, including proving that applicant was intoxicated at the time of injury and that his intoxication was a proximate or substantial cause of the injury. The hospital records from the date of applicant's injury indicate that applicant told hospital staff that "he had a couple of drinks" before he fell. (Defendant's Exh. G, at p. 2.) His blood alcohol level at 1:13 pm on that date was 320 mg/dL. (Id. at pp.

Homeowner Kevin Crennan's testimony was excluded despite relevance to intoxication defense and estoppel.

Favours Applicant prevailed

Exclusion deprived parties and WCJ of relevant evidence on intoxication and estoppel, requiring remand.

From the decision · page 14Here, our review of the record reveals at least four evidentiary concerns that lead to our conclusion that this matter must be returned to the trial level for further development of the record on the issue of causation: the exclusion of Kevin Crennan's testimony; the lack of evidence from witnesses to applicant's fall or from the ambulance that transported applicant to the hospital; the failure to provide Dr. Grodan with applicant's complete medical records; and, the lack of testimony from applicant about whether he suffered from dizziness or vertigo prior to his injury. These concerns are discussed below.

Dr. Grodan was not provided with applicant's complete medical records pre-dating injury, limiting causation analysis.

Favours Applicant prevailed

Incomplete records undermine substantial evidence on causation, requiring further development.

From the decision · page 16The third evidentiary problem in this matter involves the WCJ's reliance on Dr. Grodan's opinion to establish that intoxication was a proximate and substantial cause of injury, when Grodan was not provided with applicant's complete medical records. To 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. Marshalls, CNA Ins. Co. (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).)

Applicant did not testify about pre-injury vertigo or dizziness, relevant to causation.

Favours Applicant prevailed

Lack of testimony on pre-existing condition affects causation determination, requiring further testimony.

From the decision · page 17The last identified evidentiary problem in this matter is that there is no testimony from applicant about his alleged vertigo prior to his injury. Despite the statement in Dr. Lee's deposition that "the vertigo pre-existed date of injury" the record indicates that applicant was not asked and thus did not testify about whether or how often he had experienced dizziness or vertigo prior to the date of the accident. (Applicant's Exh. 2, at p. 34; 9/22/25 Minutes of Hearing, at pp. 5-6; 10/27/25 Minutes of Hearing, at pp. 2-5.) Upon return, applicant's testimony on this issue may be needed, as it goes directly to the issue of causation.

Applicant sustained industrial injury from fall; blood alcohol test not forensically valid; intoxication not proven as proximate cause.

Dr. Lee opined blood alcohol test was not forensically valid and intoxication defense not proven; WCJ found his opinion less credible.

From the decision · page 3Dr. Lee, an occupational medicine specialist, served as the QME in toxicology. He evaluated applicant on June 17, 2023, and concluded that applicant sustained industrial injury when he fell off the roof and hit his head from 15-20 feet high. (Applicant's Exh. 1, Dr. Lee's 6/17/23 QME Report, at pp. 55-58.) Applicant's injuries included: closed head injury; traumatic brain injury (TBI); post traumatic vertigo; dizziness and giddiness; mild neurocognitive disorder due to TBI with behavioral disturbances; scalp laceration; left subdural hematoma; bilateral subarachnoid hemorrhages; pneumothorax and hemothorax; multiple right-sided rib fractures; L1 compression fracture and right clavicle fracture and scapular fracture. (Ibid.) In his record review, Dr. Lee summarized a record dated August 16, 2021, prior to applicant's injury, where applicant was diagnosed with vertigo. (Id. at p. 7.)

Applicant was intoxicated at time of fall; intoxication was a proximate cause of injury; incomplete medical records limited causation analysis.

WCJ found Dr. Grodan's opinion more credible than Dr. Lee's; however, Grodan lacked complete medical records, limiting substantial evidence on causation.

From the decision · page 4Dr. Paul J. Grodan evaluated applicant on August 14, 2024, and issued reports on that date and on May 5, 2025. Dr. Grodan reported that applicant stated he "slipped" and fell off the roof, landed on his back, was able to walk to the porch and knock on the door, and then lost consciousness and woke up on the hospital nine days later. (Joint Exh. 3, Dr. Grodan's 8/14/24 Report, at pp. 2, 20.) Applicant acknowledged drinking alcohol the night before the accident. (Ibid.) Dr. Grodan reviewed Dr. Lee's December 5, 2025 deposition transcript, noting that Dr. Lee miscalculated applicant's blood alcohol level. (Id. at p. 7.) Dr. Grodan summarized applicant's March 8, 2023 deposition, noting that applicant stated that in the week prior to the accident, he drank "a couple of drinks per day," the night before the accident he drank four beers while at the Padres game, and he denied having any alcohol the morning of the accident. (Id. at p. 20.) Applicant indicated that he spoke to the homeowner at 8 am on the day of the accident before he began work. (Id. at 21.) Dr. Grodan deferred to Dr. Merman regarding applicant's traumatic brain injury, and the cognitive and neurological aspects of disability. (Id. at pp. 21-22.) He concluded that applicant "was intoxicated when he fell off the roof.

Evaluated applicant's traumatic brain injury and cognitive aspects; deferred to by Dr. Grodan.

From the decision · page 4Dr. Paul J. Grodan evaluated applicant on August 14, 2024, and issued reports on that date and on May 5, 2025. Dr. Grodan reported that applicant stated he "slipped" and fell off the roof, landed on his back, was able to walk to the porch and knock on the door, and then lost consciousness and woke up on the hospital nine days later. (Joint Exh. 3, Dr. Grodan's 8/14/24 Report, at pp. 2, 20.) Applicant acknowledged drinking alcohol the night before the accident. (Ibid.) Dr. Grodan reviewed Dr. Lee's December 5, 2025 deposition transcript, noting that Dr. Lee miscalculated applicant's blood alcohol level. (Id. at p. 7.) Dr. Grodan summarized applicant's March 8, 2023 deposition, noting that applicant stated that in the week prior to the accident, he drank "a couple of drinks per day," the night before the accident he drank four beers while at the Padres game, and he denied having any alcohol the morning of the accident. (Id. at p. 20.) Applicant indicated that he spoke to the homeowner at 8 am on the day of the accident before he began work. (Id. at 21.) Dr. Grodan deferred to Dr. Merman regarding applicant's traumatic brain injury, and the cognitive and neurological aspects of disability. (Id. at pp. 21-22.) He concluded that applicant "was intoxicated when he fell off the roof.

Labor Code section 3600(a)(4)

Intoxication defense under Labor Code section 3600(a)(4) requires proof of intoxication at time of injury and proximate causation.

Defendant must prove intoxication and proximate cause by preponderance of evidence.

From the decision · page 1Applicant seeks reconsideration of the Findings and Order (F&O), issued by the workers' compensation administrative law judge (WCJ) on November 25, 2025, wherein the WCJ found in pertinent part that applicant sustained injury arising out of and in the course of employment (AOE/COE) to his head and lumbar spine; that applicant was intoxicated at the time of injury and that his intoxication was a proximate and substantial cause of the injury; and ordered that applicant take nothing.

Labor Code section 5705

Defendant bears burden of proof by preponderance of evidence under Labor Code section 5705.

Defendant must meet burden of proof to deny compensation.

From the decision · page 1Applicant contends that defendant did not prove the statutory elements required to deny compensation pursuant to Labor Code section 3600(a)(4)1, including intoxication at the time of injury and proximate causation; that under section 5705, defendant failed to meet its burden of proof by a preponderance of the evidence; that section 5313 requires the WCJ to provide reasoned findings, which are absent here; and that the blood alcohol concentration (BAC) result lacks foundational reliability and cannot support a statutory bar to compensation.

Labor Code section 5313

WCJ must provide reasoned findings under Labor Code section 5313.

Findings must be reasoned and supported by evidence.

From the decision · page 1Applicant contends that defendant did not prove the statutory elements required to deny compensation pursuant to Labor Code section 3600(a)(4)1, including intoxication at the time of injury and proximate causation; that under section 5705, defendant failed to meet its burden of proof by a preponderance of the evidence; that section 5313 requires the WCJ to provide reasoned findings, which are absent here; and that the blood alcohol concentration (BAC) result lacks foundational reliability and cannot support a statutory bar to compensation.

Applicant's inconsistent and evasive testimony about alcohol use and time of fall, and hospital records indicating intoxication.

From the decision · page 11We have given the WCJ's credibility determinations great weight because the WCJ had the opportunity to observe the demeanor of the witnesses. (Garza v. Workers' Comp. Appeals Bd. (1970) 3 Cal.3d 312, 318-319 [35 Cal.Comp.Cases 500].) The WCJ found applicant not to be a credible witness, due to his "evasive" response when asked if he ever abused alcohol; his false testimony that he had not been drinking after he moved to San Diego, disproven by his DUI arrest; his denial that he drank before work on the day of the accident when hospital records indicate otherwise; his assertion that the fell because the roof was wet and he slipped, and his conflicting answers regarding the time of day that he fell. (Report, at pp. 6-8.) We conclude there is no evidence of considerable substantiality that would warrant rejecting the WCJ's credibility determinations regarding applicant or regarding Dr. Grodan. (Garza, supra, 3 Cal.3d at pp. 318- 319.)

Exclusion of homeowner Kevin Crennan's testimony despite relevance to intoxication defense and estoppel.

From the decision · page 14Here, our review of the record reveals at least four evidentiary concerns that lead to our conclusion that this matter must be returned to the trial level for further development of the record on the issue of causation: the exclusion of Kevin Crennan's testimony; the lack of evidence from witnesses to applicant's fall or from the ambulance that transported applicant to the hospital; the failure to provide Dr. Grodan with applicant's complete medical records; and, the lack of testimony from applicant about whether he suffered from dizziness or vertigo prior to his injury. These concerns are discussed below.

Incomplete medical records provided to Dr. Grodan limiting causation analysis.

From the decision · page 16The third evidentiary problem in this matter involves the WCJ's reliance on Dr. Grodan's opinion to establish that intoxication was a proximate and substantial cause of injury, when Grodan was not provided with applicant's complete medical records. To 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. Marshalls, CNA Ins. Co. (2005) 70 Cal.Comp.Cases 604, 621 (Appeals Board en banc).)

Lack of applicant testimony on pre-injury vertigo relevant to causation.

From the decision · page 17The last identified evidentiary problem in this matter is that there is no testimony from applicant about his alleged vertigo prior to his injury. Despite the statement in Dr. Lee's deposition that "the vertigo pre-existed date of injury" the record indicates that applicant was not asked and thus did not testify about whether or how often he had experienced dizziness or vertigo prior to the date of the accident. (Applicant's Exh. 2, at p. 34; 9/22/25 Minutes of Hearing, at pp. 5-6; 10/27/25 Minutes of Hearing, at pp. 2-5.) Upon return, applicant's testimony on this issue may be needed, as it goes directly to the issue of causation.