Scott McCartney was diagnosed with actinic keratosis in October 2013. In his June 2014 application for workers’ compensation benefits, he alleged that this injury arose out of the course of his employment as a deputy Sheriff for the County of Sacramento.

The County requested that he submit to the QME (a dermatologist) for an evaluation. The QME noted that McCartney had been a surfer/body surfer growing up in Southern California. He described his skin as burning easily, and he had experienced blistering sunburns. During most of his 21 years working for the County, he was on motorcycle patrol, with his arms and face exposed to UV radiation (though he had used sunscreen from 1991 on). In his leisure time, he also was active outdoors with sports, exercise, and golf. At the time of the QME examination, the County had contracted his services to the City of Rancho Cordova, where he was out of doors 70 percent of the time. In 2013, he began noticing scabbed and crusty red lesions on his face and arms; a biopsy showed these to be actinic keratosis, which is not itself a form of cancer.

The QME could not find any documented support for a 51 percent certainty linking the on-job sun exposure to the manifestation of the skin condition, because medical literature had not identified any particular dosage of sunlight as triggering it. Therefore, attributing the skin condition to any contribution from workplace sunlight – as opposed to the sun exposure McCartney received throughout his life or during his pursuit of outdoor activities in his leisure time – would simply be pure speculation.

At the deposition the QME testified that sunlight is but one of the factors leading to development of these lesions, which also include aging, genetics, and the responses of the immune system.

After a trial, the WCJ found that work-related sun exposure was not proven to be a contributing factor to McCartney’s condition by a reasonable medical probability. On reconsideration the WCAB reversed and amended the Order finding the McCartney had suffered an industrial injury, and that the QME applied the wrong legal standard.

The Court of Appeal reversed the WCAB finding that McCartney did not suffer the industrial injury he alleged in the unpublished case of County of Sacramento v WCAB (McCartney).

On appeal, McCartney argued that the recent case of South Coast Framing, Inc. v. Workers’ Comp. Appeals Bd. (2015) 61 Cal.4th 291 (South Coast) compelled a finding of injury.

In South Coast, the decedent was taking three drugs as a result of an injury on the job; his personal physician prescribed two other drugs for anxiety and sleeplessness. He was found dead of respiratory failure with all five of the drugs present in his system, the autopsy attributing the cause to the synergistic effect of the medications and early stages of pneumonia. One physician concluded the drugs separately and in combination could cause respiratory depression or arrest.

The Court of Appeal held that “the present case is distinguishable” from South Coast.

“Both respondents (McCartney and the WCAB) misapprehend the QME testimony. The QME never acknowledged that there was a causative role of unknown degree arising out of McCartney’s employment. Rather, she took great pains to explain (repeatedly) that it was not possible to attribute the cause of McCartney’s condition to any particular period of exposure to the sun, and therefore it was nothing more than speculation to identify the work-related exposure as a contributing cause.”