Title: City of Las Vegas v. Lawson

State: nevada

Issuer: Nevada Supreme Court

Document:

126 Nev., Advance Opinion 52.
IN THE SUPREME COURT OF THE STATE OF NEVADA

cry OF LAS VEGAS, No. 53900
‘lant,

Appellant FILED

ROBIN LAWSON,

10

 

‘Respondent. .

 

mon
Appeal from a district court order denying “a petition for

   
  
   
   
  
   
 
 
    
 
 

judicial review in a workers’ compensation action, Kighth Judicial District
Court, Clark County; Kenneth C. Cory, Judge.
Affirmed,

Lynne & Associates and Jill M. Lynne, Las Vegas,
for Appellant,

King, Gross & Sutcliffe, Ltd., and Marvin 8. Gross, Las Vegas; Hilbrecht &
Associates and Norman Ty Hilbrecht, Las Vegas,
for Respondent.

BEFORE HARDESTY, DOUGLAS and PICKERING, JJ.
OPINION

/By the Court, HARDESTY, J.:

While working as a firefighter with appellant City of Las
Vegas, respondent Robin Lawson was diagnosed with breast cancer in
1997 and again in 2005. In this appeal, we first consider whether
[Lawson's 2005 notice of her claim for workers’ compensation was timely.

Because we conclude that Lawson did not learn from her physician until

10-3407

 
 

2005 that her breast cancer was related to her work as a firefighter, we
conclude that she gave the City timely notice of her occupational disease
claim,

Next, we consider whether an appeals officer erroneously
Jdetermined that Lawson was exposed to two known carcinogens during

her employment as a firefighter, and that there was a “reasonable

 

association” between the carcinogens and breast cancer. If so, under NRS
1617.453, it is presumed that Lawson's breast cancer arose “out of and in
{the course of {her] employment.” We conclude that substantial evidence
[supports the appeals officer’s decision that one of the carcinogens falls
jwithin the statutory definition of “known carcinogen.” Although we
conclude that the appeals officer incorrectly determined that the other
carcinogen met the statutory definition, substantial evidence still supports
the finding that Lawson was exposed to the known carcinogen that does
meet the definition and that the known carcinogen is reasonably
associated with her breast cancer. Lawson was therefore entitled to the
[presumption that her breast cancer arose out of her employment, and we
‘conclude that the City failed to rebut the presumption. Accordingly, we
affirm the district court's denial of the City’s petition for judicial review.
EACTS AND PROCEDURAL HISTORY

Lawson began working for the City as a firefighter in 1992. In
1997, Lawson was diagnosed with breast cancer. She underwent
treatment and missed approximately eight to nine months of work.

In December 2004, Lawson had a recurrence of her breast
cancer, and she underwent a double mastectomy and chemotherapy. At a
[January 24, 2005, post-surgery appointment, Lawson asked her treating
oncologist, Dr. Noel Rowan, “if he thought that [her] breast cancers were
due to [her] occupation and due to the exposures that firefighting entails.”

2

 
com oe

 

He stated that he believed the cancer was due to her job as a firefighter

 

and advised her to stop working. ‘That same day, Lawson completed a
which directed her to “[bjriefly

 

notice of injury or occupational disease,
describe [the] accident or circumstances of [the] occupational disease” and

“indicate the date on which employee first became aware of connection

 

between condition and employment.” Lawson answered the directive
noting that the recurrence of her cancer in the right breast was “[d]ue to
my job working around obvious hazardous chemicals, [multiple]
carcinogens and various other [exposures] (smoke, plastic etc.).” On
[March 3, 2005, Lawson filed a claim for workers’ compensation.

The City denied Lawson's claim for two reasons. First, the
City concluded that because Lawson was first diagnosed with breast
cancer in 1997, the notice that she provided and the workers’
compensation claim that she submitted eight years later were untimely
pursuant to NRS 617.342 and NRS 617.344, Second, it determined that
[Lawson failed to demonstrate that her cancer arose out of and in the
course of her employment because “[t]here is no medical evidence that
connects a known carcinogen with [breast cancer]” or that “establishfes} a
direct causal connection between the cancer and [Lawson's] work
performed as a firefighter.” After the denial, Lawson requested a hearing
before the Nevada Department of Administration, Hearings Division. See
INRS 616C.315; NRS 616C.320.

‘The hearing officer concluded that “a medical question exists
irelative to the etiology of [Lawson's] diagnosed breast cancer” and
remanded the matter to the City for a new determination, without
addressing the timeliness of Lawson's claim. The hearing officer also
directed that Lawson undergo an independent medical examination and

 
os

 

provide the City with all of her medical records and the medical literature
relied upon by Dr. Rowan. Dr. Ann Wierman conducted the independent
medical examination and concluded that medical literature supported a
/link between Lawson's breast cancer and her exposure to carcinogens,

After reviewing Dr. Wierman's report and additional
supplemental information, the City again denied Lawson's claim. The
(City determined that Lawson did not demonstrate that her breast cancer
Jarose out of and in the course of her employment, as required by NRS
617.358. Lawson appealed to an administrative hearing officer, who
affirmed the City’s denial. Subsequently, Lawson appealed the hearing
officer's decision. See NRS 616C.345.

During a hearing before the appeals officer, Lawson testified
‘that she first became aware in January 2005 that her breast cancer was
‘caused by her exposure to certain carcinogens. And Dr. Rowan testified
‘that he did not know in 1997 what caused Lawson's breast cancer, but
‘that since then he had been to medical conferences and learned about the
possible connection between exposure to certain carcinogens and the
development of breast cancer. He also testified that he first informed
Lawson on January 24, 2005, that her breast cancer was related to her
employment as a firefighter. In addition, two letters written by Dr. Rowan
{to Lawson’s counsel were introduced into evidence. In one of those letters,
Dr. Rowan concluded, “I can... state to a reasonable degree of medical
[probability that Ms. Lawson's breast cancer resulted from her employment
jas a combat firefighter, where she was exposed to PAH's [polycyclic
aromatic hydrocarbons] and other combustion byproducts.”

Following two hearings, the appeals officer concluded that
Lawson provided notice of her occupational disease and filed her claim for

 
om

 

‘compensation in a timely manner. The appeals officer went on to find that
Lawson was exposed to two known carcinogens, specifically, benzene and
PAHs, through her employment as a firefighter, and that her exposure to
those carcinogens was reasonably associated to her breast cancer. Thus,
the appeals officer concluded that, under NRS 617.453(6), it is presumed
that Lawson's brea

 

cancer arose “out of and in the course of her

‘employment

 

a firefighter,” a presumption the City did not rebut,
making Lawson's breast cancer a compensable occupational disease.
‘The City petitioned the district court for judicial review of the

appeals officer's decision, which the district court denied. The City now

 

DISCUSSION

‘The City argues that Lawson was first diagnosed with breast,
cancer in 1997, and thus her (1) 2005 written notice of an occupational
disease was not filed within 7 days as required by NRS 617.342, and (2)
2005 claim for workers’ compensation was not filed within 90 days as
required by NRS 617.344, The City further argues that Lawson failed to
prove a reasonable association between her exposure to certain
carcinogens during the course of her employment as a firefighter and her
breast cancer, thus making the appeals officer's decision that Lawson's
breast cancer was a compensable occupational disease under NRS 617.453
erroneous.
Standard of review

When reviewing a district court’s order denying a petition for
judicial review of an agency decision, we engage in the same analysis as
the district court: “we evaluate the agency's decision for clear error or an
arbitrary and capricious abuse of discretion.” Ban

evinson v. Milko, 124 Nev. 355, 362, 184 P.3d 378, 383 (2008). We defer

 
wn >

 

to an agency's findings of fact that are supported by substantial evidence
and will “not reweigh the evidence or revisit an appeals officer's credibility
determination.” Id. at 862, 184 P.3d at 383-84. “Substantial evidence
exists if a reasonable person could find the evidence adequate to support
the agency's conclusion.” Id, at 362, 184 P.3d at 384, However, questions

of law are reviewed de novo. Id.

Lawson's notice of occupational disease and her filing of her workers’
compensation claim were timely

‘To recover compensation for an occupational disease, NRS
617.342(1) requires an employee to “provide written notice of an
occupational disease...within 7 days after the employee... has
knowledge of the disability and its relationship to the employee's
employment.” The employee's claim for compensation must be filed
“within 90 days after the employee has knowledge of the disability and its
relationship to his or her employment.” NRS 617.344(1).

‘The City contends that Lawson had knowledge that her breast
cancer was work-related in August 1997 and December 2004, as evidenced
by Lawson's response on her notice of injury form, completed on January
24, 2005, where she stated: “[Recurrence] of breast cancer, 1st incident
8/97 lumpectomy-chemo radiation, of right breast, 2nd incident 12/04 right
breast. Due to my job working around obvious hazardous chemicals,
[multiple] carcinogens and various other [exposures] (smoke, plastic ete.).”
However, the record demonstrates that, during a hearing before the
appeals officer, Lawson testified that in 1997 Dr. Rowan did not believe
her cancer was work-related. Dr. Rowan also testified that he did not
inform Lawson that her cancer was work-related until January 24, 2005,
because studies published since 1997 indicated a possible connection

between carcinogens to which Lawson was exposed as a firefighter and

 
breast cancer. Letters Dr. Rowan sent to Lawson's counsel in 2005 and
2006, indicating that he first told Lawson her cancer was work-related on
January 24, 2005, were also entered into evidence,

‘The appeals officer found that Lawson was first informed by
Dr. Rowan on January 24, 2005, that, in his opinion, there was a
reasonable association between her breast cancer and her employment as
a firefighter. Thus, the appeals officer concluded, Lawson provided timely
notice to her employer, pursuant to NRS 617.342, as she completed the
employer-notice form that same day. Additionally, the appeals officer
concluded that Lawson satisfied NRS 617.344's 90-day requirement by
filing her workers’ compensation claim on March 3, 2005.

Although Lawson's statement on the notice of injury form
gives the impression that she may have possessed the requisite knowledge
in 1997, her testimony before the appeals officer, as well as Dr. Rowan’s
testimony and letters, shows that Lawson did not know that her cancer
was work-related until January 24, 2005. It was for the appeals officer to
evaluate the credibility of the witnesses, and we will not “revisit .. . [such]
credibility determination|s].” Milko, 124 Nev. at 362, 184 P.3d at 384, As
such, we conclude that substantial evidence in the record supports the
appeals officer's decision that both the notice of occupational disease and
the filing of the claim were timely because a reasonable person could have
found the evidence adequate to support the conclusion.

Proper_stan¢ shether Lawson’ a
com ional disease under NI

NRS 617.453(1) declares that cancer “is an occupational
disease and compensable as such” if a firefighter shows that: “(1) [She]

was exposed, while in the course of the employment, to a known

carcinogen as defined by the International Agency for Research on Cancer

 

 
 

[IARC] or the National Toxicology Program [NTP]; and (2) The carcinogen
is reasonably associated with the disabling cancer.”"_ NRS 617.458(1)().
If the claimant establishes both requirements, then the “[dJisabling cancer
is presumed to have developed or manifested itself out of and in the course
of the employment.” NRS 617.453(6).

‘Lawson's exposure to known carcinogens

‘The City does not dispute that Lawson was exposed to
benzene and PAHs. However, while the City concedes that benzene is
listed as a known carcinogen by both the IARC and the NTP, it argues
that the appeals officer erred by concluding that PAHs are known
carcinogens.

According to NRS 617.453(1)(b)(1), a claimant must
demonstrate that the carcinogen to which she was exposed is “a known
carcinogen as defined by the [IARC] or the [NTP].” Lawson argues, and
the appeals officer agreed, that because PAHs are listed in subsection 2 of
NRS 617.453 as known carcinogens for certain other types of cancers,
PAHs should be considered known carcinogens for the purpose of NRS
617.453(1)()(1)2 However, the statutory language clearly states that to

INRS 617.453(1)(a) also provides that the person who develops
cancer must have been employed as a firefighter for at least five years.
Neither party disputes that Lawson satisfied this requirement.

*The City does, however, argue on appeal to this court that the
extent of Lawson's exposure to benzene and PAHs was insignificant.
Because the City failed to properly raise this argument to the appeals
officer, it is precluded from raising it now. See Mason v. Cuisenaire, 122
Nev. 43, 48, 128 P.3d 446, 449 (2006).

SNRS 617.453(2(a) deems certain substances “to be known
carcinogens that are reasonably associated with’ various enumerated
continued on next page...

 

 
be considered a known carcinogen, the substance must be listed in the
IARC or the NTP. Therefore, if PAHs are not listed in either the IARC or
NTP, they are not known carcinogens under NRS 617.453(1)()(1),
regardless of their associations with other cancers under subsection 2.

‘The City points out that PAHs are not listed in either the
IARC or in the “Known to be Human Carcinogens” section of the NTP.
‘Thus, the City concludes that PAHs cannot be considered known
of NRS 617.453(1)(b)(1). We agree.

The IARC divides potentially carcinogenic substances into five

 

carcinogens for purpos

 

categories: carcinogenic, probably carcinogenic, possibly carcinogenic, not
carcinogenic, and probably not carcinogenic. PAHs as a general group are
not listed in any of these categories, although certain substances within
the family of PAHs are listed. Lawson, however, failed to specify what
PAHs she was exposed to. Because of that failure, Lawson could not
“demonstrate[] that [she] was exposed...to a known carcinogen as
defined by the [IARC].” NRS 617.453(1)(b)(1)..

‘The NTP divides its list into two sections, one listing known
carcinogens, and one listing substances reasonably anticipated to be
carcinogens. Because PAHs are listed in the “reasonably anticipated”
section, and not the “known carcinogen” section, the statute's requirement

continued

cancers. Although breast cancer is not enumerated, PAHs are “deemed to
be known carcinogens that are reasonably associated with” several other
types of cancer, specifically, bladder cancer, NRS 617.453(2)(a); kidney
cancer, NRS 617.453(2)(e); lymphatic or haemotopoietic cancer, NRS
617.453(2)(g); and basal cell carcinoma, squamous cell carcinoma, or
malignant melanoma, NRS 617.453(2)(h).

 

 
ee

 

that PAHs be “a known carcinogen as defined by the . .. [NTP]” is not met.
NRS 617.453(1)(b)(1). Therefore, because PAHs are not listed as known
[carcinogens by either the IARC or the NTP, substantial evidence does not,
[support the appeals officer's conclusion that PAHs are known carcinogens.
Therefore, the remainder of our analysis concerns only benzene, which the
City concedes is a known carcinogen to which Lawson was exposed.
‘reasonably associated” with her breast sancer

In addition to showing that she was exposed to a known
learcinogen in the course of her employment, in order to establish a
presumption that her breast cancer arose out of and in the course of her
employment, Lawson must also show that the carcinogen to which she was,
exposed, benzene, is reasonably associated with a disabling cancer. NRS
617.453(1)(b)(2). While subsection 2 of NRS 617.453 lists carcinogens and

cancers that are reasonably associated with them, it is not an exclusive

 

list, and subsection 3 allows a claimant to independently show “that a
substance is a known carcinogen that is reasonably associated with a
disabling cancer.” If a claimant can demonstrate such an association, he
lor she is entitled to a presumption that the cancer arose out of and in the
course of the claimant's work as a firefighter. NRS 617.453(5).

In this case, the appeals officer determined that “{tJhe reliable,
probative and substantial evidence demonstrated ...that there was a
reasonable association between benzene and PAH’s and [Lawson's] breast
lcancer.” We address whether substantial evidence supports the conclusion

{that benzene, on its own and not in conjunction with PAHs, is reasonably

10

 
jassociated with breast cancer. Although the appeals officer referred to

Jexposure to both benzene and PAHs in her final decision, it is clear from

 

[the record that Lawson's expert found a reasonable association between
benzene, by itself and not in conjunction with PAHs, and breast cancer.

The City first argues that benzene cannot be reasonably
associated with breast cancer because both the IARC and NRS 617.453(2)
(which lists certain cancers and carcinogens reasonably associated with
them) do not specifically link one with the other, but do specifically link
benzene to other cancers.* However, under NRS 617.453(3), which
provides that “any person [may] demonstrat[e], on a case-by-case
basis... that a substance is a known carcinogen that is reasonably
associated with a disabling cancer,” the fact that the IARC and subsection
2.do not link benzene to breast cancer is not the end of our inquiry because
the claimant can still offer medical evidence to independently demonstrate
a reasonable association of a known carcinogen to a disabling cancer.

In this case, Dr. James Melius, one of Lawson's expert
witnesses, testified at a hearing before the appeals officer that he has
|spent more than 25 years studying the health risks firefighters face. After
evaluating Lawson's medical records and various scientific studies, Dr.

‘Reasonably associated” differs from the “causal connection”
language found in NRS 617.440 regarding when occupational diseases
other than those affecting firefighters are deemed to arise out of and in the
course of employment. Whether these terms have different meanings is
an issue the parties did not raise, thus we decline to address it here.

"Although the IARC does link benzene to certain cancers, it also
states that benzene, in general, is carcinogenic to humans. Additionally,
breast cancer is not one of the cancers enumerated in NRS 617.453.

 

 
Melius sent a letter to Lawson's counsel, later entered into evidence, in
which he opined that “{blenzene is a potent human carcinogen associated
with leukemia, lymphomas, and other cancers. Several studies have found
‘occupational exposure to benzene to be associated with breast cancor risk
both ms

 

 

and females.” Dr. Melius testified at the hearing that his
opinion remained the same, and supported his opinion by referencing six
scientific studi

 

five regarding “breast cancer and chemical exposures’
and one regarding “exposures of firefighters.”

Dr. Melius testified that he heavily relied upon a 2005 study
published in the American_Journal_of Industrial Medicine entitled
“Mortality in Florida Professional Firefighters, 1972 to 1999" (the Florida
study), which he identified as “the largest study of firefighters done most
Ph.D., et al., 47 Am, J. Indust. Med. 509
(2005), The Florida study evaluated approximately 35,000 male
firefighters and 2,000 female firefighters between 1972 and 1999, Dr.
‘Melius testified that the Florida study indicated “a (sevenfold increase in]

 

recently."6 Fangchao Ma, M,

 

risk of breast cancer in male firefighters,” however, it also concluded that
“{almong female firefighters there was no significant increase or decrease
of” breast cancer. When the City’s expert was questioned about the
difference between breast cancer in men and women, he testified that
“[tJhere is no difference as far as the anatomic or morphologic development
of breast cancer. It's the same. It's treated the same. And ifiit's caught at

the same stage, the survival rate is exactly the same, the end result.”

"The City’s expert agreed that the Florida study was “the best study
available because it covers so many years, and it has the largest number of
women.”

 

 
‘Thus, the fact that the Florida study found a connection between benzene
and breast cancer supports finding a reasonable association, particularly
in light of the City’s expert’s acknowledgment that cancer develops
similarly in both men and women,

Additionally, Dr, Melius relied upon an article titled: “Risk of
premenopausal breast cancer in association with occupational exposure to
[PAHs] and benzene," published in the Scandinavian Journal of Work,
Environment & Health in 1999, Sandra A. Petralia, Ph.D., et al, 25
Scandinavian J. of Work, Env't & Health 215 (1999). Although th

 

tudy
included a smaller sample size and was not as conclusive as the Florida
study, it indicated that there appeared to be a link between exposure to
benzene and breast cancer. Dr. Rowan testified that he also relied upon
these studies in opining that Lawson's breast cancer was reasonably
associated with her exposure to benzene,

After considering all of the evidence presented at the hearings,
officer found that benzene and PAHs were “reasonably
associated” with breast cancer. As stated above, although the appeals

 

the appeal

officer grouped benzene and PAHs together when entering her decision,
Dr. Melius stated that benzene, by itself, had a reasonable association
with breast cancer. The City argues that the studies relied upon were
insufficient to prove the association, and, as such, it was an abuse of
discretion for the appeals officer to consider these studies. We disagree.
Despite the limitations of some of the studies, we conclude that a
reasonable person could have found from the totality of the evidence
presented at the hearings that the benzene Lawson was exposed to was

reasonably associated with breast cancer. Therefore, the appeals officer

did not abuse her discretion in determining that Lawson met her burden

 

 
 

of proof and that she is entitled to the rebuttable presumption that the
cancer arose out of and in the course of her employment. NRS 617.453(6).

"The City fail I .
cancer_arose out of and in the course of her emplovment as 3
firefighter

If a claimant establishes that during her employment, she
"was exposed... to a known carcinogen” and that “[tJhe carcinogen is
reasonably associated with the disabling cancer,” NRS 617.458(1)(b)(1)-(2),
then the “[dlisabling cancer is presumed to have developed or manifested
itself out of and in the course of the employment.” NRS 617.453(5). A
party establishes a presumption by demonstrating “the basic facts.” Law
Offices of Barry Levinson v, Milko, 124 Nev. 355, 366, 184 P.3d 378, 386
(2008). When an opposing party adduces evidence to rebut a presumption,
“the appeals officer must determine how probable the existence of the
presumed fact is.” Id, “If reasonable people would necessarily agree that
the [existence] of the presumed fact is more probable than not,” then the
opposing party has failed to rebut the presumption. Id, Here, the appeals
officer found that the City did not present sufficient evidence to rebut the
presumption, We agree,

When questioned during the appeals hearing regarding
whether he saw a reasonable association between Lawson's exposure to
benzene and her breast cancer, the City’s expert, Dr. Theodore Potruch,
stated that although humans’ exposure to benzene has increased
dramatically, incidents of breast cancer have not. Dr. Potruch also
{testified that, in general, he sees no “close connection between exposure to
chemicals and the development of breast cancer.” Although we recognize
the presence of conflicting expert testimony, “i]t is within the province of
the fact finder to weigh the evidence, determine the credibility, and act

4

 
 

upon such conclusions.” Olivero v, Lowe, 116 Nev. 895, 403, 995 P.2d
1023, 1028 (2000). Because sufficient evidence supports the appeals
officer's decision, we defer to that decision, and we conclude that the
appeals officer did not abuse her discretion.

Similarly, although the City questioned Dr. Potruch regarding
the relationships between smoking and breast cancer, and family history
and breast cancer, Dr, Potruch never opined that Lawson’s breast cancer
was more likely caused by one of these stimuli rather than caused by her
exposure to benzene in the course of her employment as a firefighter.
Although the City’s briefs to this court attempt to show that Lawson's
cancer arose from something other than being a firefighter, we decline to
discuss those arguments because they were not properly raised below.?
‘See Mason v. Cuisenaire, 122 Nev. 43, 48, 128 P.3d 446, 449 (2006). Thus,
wwe hold that the City failed to rebut the presumption that Lawson's cancer
arose out of and in the course of her employment.

The district court incorrectly found that both benzene and
PAHs were known carcinogens—only benzene fits the statutory definition
of a known carcinogen. Despite this, the court came to the correct
conclusion that Lawson was exposed to known carcinogens that were
reasonably associated with breast cancer. This court will affirm a district
court's order if the district court reached the correct result, even if for the
wrong reason. Rosenstein v, Steele, 103 Nev. 571, 575, 747 P.2d 230, 233,

"These arguments include Lawson's history of smoking and her
sister being diagnosed with breast cancer. As stated above, although the
City’s expert discussed these issues, he never opined that Lawson's cancer
was due to either.

 

 
(1987). Accordingly, we affirm the district court's denial of the City's

petition for judicial review.

fardesty