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IN THE SUPREME COURT OF THE STATE OF WASHINGTON 

CLARK COUNTY, 

Respondent, 

v. 

PATRICK J. McMANUS, 

Petitioner. 

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. _________ ) 

No. 91963-1 

EnBanc 

Filed APR 2 8 2016 -----------------------

JOHNSON, J..·-In this workers' compensation appeal, the trial court denied 

the worker's proposed instruction, which would inform the jury that it must give 

special consideration to the (opinion) testimony of his attending physician. The 

trial court ruled against the worker. The Court of Appeals reversed and ordered a 

new trial on an unrelated basis---holding that the trial court reversibly erred when it 

refused Patrick McManus's request to revise the Board of Industrial Insurance 

Appeals' (Board) erroneous finding regarding the location ofMcManus's injury. 

Clark County v. McManus, 188 Wn. App. 228,231,345 P.3d 868 (2015). 

However, the Court of Appeals ruled that the trial court correctly rejected the 

instruction. We granted review on the issue of whether it is error to refuse to give 

 	 
	 
   
		

		

Clark County v. McManus, No. 91963-1 

the special consideration instruction. Clark County v. McManus, 184 Wn.2d 1018, 

361 P.3d 747 (2015). We hold the instruction must be given. 

FACTS AND PROCEDURAL HISTORY 

McManus prevailed at the Court of Appeals and is getting a new trial. 

MciVIanus did not prevail on his claim that the trial court erred in refusing to give a 

special consideration instruction regarding his attending physician to the jury. 

Because the trial court on remand would be bound by the law of the case doctrine, 

the prior decision of the trial court to not give the special consideration instruction 

would be binding. See Coy v. Raabe, 77 Wn.2d 322, 325, 462 P.2d 214 (1969) 

(acknowledging the binding effect of determinations made by the appellate court .. 

on further proceedings in the trial court.on remand). We took review to determine 

if such an instruction is required in worker's compensation cases. Order Granting 

Review, Clark County v. McManus, No. 91963-1 (Wash. Dec. 2, 2015). 

McManus worked for the county operating a street sweeper from 1999 until 

2011. He eventually quit work because of a debilitating, degenerative spinal 

diseas~ affecting his low back, which he attributed to the bumpy ride when 

operating a street sweeper and poor ergonomic layout in the operator's cab. 

McManus filed a claim for workers' compensation under Title 51 RCW. 

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Clark Coum); v. McManus, No. 91963-1 

The Department of Labor & Industries (Department) allowed McManus's 

claim and awarded him benefits. Clark County (County) appealed the 

Department's order allowing the claim to the Board, which proceeded to an 

evidentiary hearing before an industrial appeals judge (IAJ). 

The IAJ considered offered deposition testimony from several witnesses. 

McManus's attending physician-Dr. Won-provided testimony in support of 

~ ;McManus's claim. 1 Dr. Won opined that McManus's low back disability was 

employment-related. The County presented contrary opinions by two forensic 

medical experts, one of whom had reviewed McManus's medical records and one 

of whom had examined McManus on one occasion. 

The IAJ issued a proposed decision and order upholding the decision of the 

Department. The County petitioned to the three-member Board for review of the 

proposed decision. The Board denied the County's petition and adopted the 

proposed decision and order. The decision and order upheld the Department's 

determination, concluding that McManus sustained an aggravation of his 

preexisting low back condition that arose naturally and proximately out of the 

distinctive conditions of his employment with the County. 

---~··-~ 

1 Under the Industrial Insurance Act, Title 51 RCW, Dr. Won meets the definition of an 

"attending provider" or "treating physician" as a physician who "actively treats an injured or ill 

worker." WAC 296-20-01002 (providing "attending provider" includes a physician and is one 

who "actively treats an injured or ill worker"). 

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Clark County v. McManus, No. 91963-1 

The County appealed the Board's decision to the superior court, and the case 

was tried on the record before a jury. The superior court instructed the jury on the 

Board's findings, as well as the presumptive correctness of its decision, the legal 

issue for determination, and the County's burden of proving the Board's decision 

incorrect. See Clerk's Papers (CP) at 87-88 (Instr. 4, 5), 98 (special verdict form). 

The superior court also instructed the jury regarding its role in determining the 

,, :credibility of witnesses. See CP at 82-84, 90 (Instr. 1, 7). 2 

The superior court rejected McManus's proposed instruction 10 regarding 

the special consideration rule, which provided as follows: "You should give special 

considerationto testimony given by an attending physician. Such special 

consideration does not require you to give greater weight or credibility to, or to 

believe or disbelieve, such testimony. It does require that you give any such 

testimony careful thought in your deliberations." CP at 57 (Instr. 1 0).3 

·---·-------- 2 These instructions appear to be drawn from 6 Washington Practice: Washington Pattern 

Jury Instructions: Civil1.02 (6th ed. 2012) (WPI) (conclusion of trial-introductory instruction) 

and 6 WPI 2.10 (expert testimony). 

3 This proposed instruction is identical to the current 6A WPI 155.13.01 (testimony of 

attending physician): "You should give special consideration to testimony given by an attending 

physician. Such special consideration does not require you to give greater weight or credibility 

to, or to believe or di$believe, such testimony; It does require that you give any such testimony 

careful thought in your deliberations." 6A Washington Practice: Washington Pattern Jury 

Instructions: Civi/155.13.01 (6th ed. 2012). 

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Clark County v. McMcmus, No. 91963-1 

The only question before the jury was whether the Board was correct in 

determining that McManus's low back condition arose naturally and proximately 

from the distinctive conditions of his employment as a street sweeper operator. The 

jury determined that the Board was incorrect, and the trial court reversed. 

McJ\1anus appealed to the Court of Appeals, Division One, which reversed 

and remanded for a new trial due to evidentiary and instructional errors unrelated 

t ,ito the proposed special consideration instruction. The Court of Appeals rejected 

'MeManus 's cla:irrdhat the trial court erred in refusing to give proposed instruction 

10, which sets forth the special consideration instruction. Holding that it was not an 

abuse of discretion to refuse to give the instruction, the Court of Appeals 

concluded it was unnecessary in light of the general instructions given addressing . .. . ·; . ,· . 

·witness credibility. See .McManus, 188 Wn. App. at 241-42 (concluding that . . . .' ·. . '. 

MciVIanus could argue that Dr. \Von was better qualified to render an opinion as 

his treating physician and the jury was informed that it could accept this theory; 

th~s, the trial court's general instruction was sufficient) . 

. · McManus ~nd the c;:ounty petitioned this court for review. Only McManus's 

petition for review wr:~s granted. 

ANALYSIS 

Generally, the trial court has the discretion whether to give a particular jury 

instruction. Stiley v. Block, 1~0 Wn.2d 486, 498, 925 P.2d 194 (1996). However, a . . . . . . . . . . 

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Clark County v. McManus, No. 91963-1 

trial court abuses its discretion if it based its ruling on an erroneous view of the 

law. Wash. State Physicians Ins. Exch. & Ass 'n v. Fisons Corp., 122 Wn.2d 299, 

339, 858 P.2d 1054 (1993). At issue here is whether our decision in Hamilton v. 

Department of Labor & Industries, 111 Wn.2d 569, 761 P.2d 618 (1988), 

establishes the requirement for juries in workers' compensation cases to be 

instructed regarding the special consideration rule for testimony of attending 

physicians. 

In Hamilton, this court recognized a "long-standing rule of law in workers' 

compensation cases that special consideration should be given to the opinion of a 

claimant's attending physician." Hamilton, 111 Wn.2d at 571. Significantly in 

Hamilton, this court reversed and reinstated the trial court's verdict, holding that 

the instruction was an accurate statement of the law and the long-standing rule that 

special consideration be given to attending physicians. That we reversed the Court 

of Appeals on the instruction issue supports the argument that the special 

consideration instruction in workers' compensation cases is mandatory. The 

language in Hamilton also makes clear that such an instruction is required. 

Hamilton involved a department challenge to a jury verdict overturning a 

board decision denying disability benefits. The Department asserted that a court 

instruction on the special consideration rule constituted an impermissible comment 

on the evidence in violation of the Washington Constitution, article IV, section 16. 

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Clark County v. McManus, No. 91963-1 

The Court of Appeals .held that the instruction was an impermissible comment on 

th~ evidence. This court reversed, concluding the instruction set forth an accurate 

statement of applicable law. This court explained-in reference to the special 

ccmsideration jury instruction-that 

. [i]t reflects binding precedent in this state and correctly states the law. 

Since this is a rule of law, it is appropriate that the jury be informed of 

this by the instructions of the court. To refU;se to do so would convert 

the rule of law into no more than the opinion of the claimant's 

attorney. 

llamilton; 111 Wn.2d at 572 (emphasis added). "The instruction does not require 

the jury to give more weight or credibility to the attending physician's testimony 

but to give it careful thought." Harnilton, 111 Wn.2d at 572. 

Here, while the County contends the special consideration instruction causes 

confusion for the jurors, this court concluded that when the instruction is 

considered in conjunction with the standard instruction regarding weighing 

testimony and credibility ofwitnesses, it is a correct statement of the law in 

workers' compensation cases. Contrary to what the County asserts, the special .. ; 

instruction is not redundant and unnecessary when considering the instructions as a 

whole. We find it neither confusing nor misleading. This court in Hamilton went 

on to explain that the special consideration instruction supports the purpose of the 

act, which is to promote benefits and to protect workers. ' ' . . 

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Clark County v. A1cManus, No. 91963-1 

As amicus curiae Washington State Association for Justice Foundation 

points out, while the Hamilton decision established that the instruction was an 

accm·ate statement of the law, the rule was otherwise well settled before Hamilton. 

See, e.g., Chalmers.;;. Dep.'t of Labor & Indus., 72 Wn.2d 595, 598-602,434 P.2d 

720 .(1967) (reaffirming special consideration rule but concluding attending 

physician's testimony was based on insuffieientfoundation resulting in a failure of 

proofby claimant); Groffv. Dep't of Labor & Indus., 65 Wn.2d 35,44-46, 395 

P.2d 633 (1964) (emphasizing "that special consideration should be given to the 

opinion of the attending physician," and that in order to properly review a superior 

court determination regarding an industrial claim, the superior court should provide 

an explanation as to why the attending physician's testimony was not preferred 

over that of other medical experts); Spalding v. Dep 't of Labor & Indus., 29 Wn.2d I \ ' ' ' I 

115,. 129, 12~? 186 P.2d 76 (1947) (recognizing "that special consideration should 

be given to the opini?n of the attending physician," but declining to establish a 

"'hard and fast rule," concluding the issue is for the jury). 

Several Court of Appeals' cases, including this case, have called into 

question the special consideration instruction. See Larson v. City of Bellevue, 188 

Wn. App. 857, 883.-84, 355 P.3d 331 (2015); Boeing Co. v. Harker-Loft, 93 Wn. 

App._l81, 186-89, 968 P.2d14 (1998); l11fcClelland v. ITT Rayonier, Inc., 65 Wn. 

App. 38,6, 393-94 & n.l, 828 P.2d 1138 (1992). The County asserts that these cases 

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Clark County v .. McManus, No. 91963-1 

support their argument that a mandatory instruction would improperly remove the 

general discretion given to the trial court to assess the appropriateness of jury 

instructions. Ultimately, the Comity argues, the discretion whether to allow an 

inst~l.iction to be submitted to a jury should rest with the trial judge. While perhaps 

correct in other drcumstances, in workers' compensation cases we have 

determined the instruction is required, and agreeing with the County's argument 

,would require overruling Hamilton. 

In turning to past Court of Appeals' decisions, the court in McClelland 

affjrmed a summary judgment upholding denial of benefits where the attending 

physician's opinion lacked the requisite objective proof required for the particular 

occupational disease claim. The opinion did not implicate the special consideration 

rule in resolving the appeal because of the failure of proof. However, in dicta, the 

court remarked: 

We are unsure what the Supreme Court means by "special 

consideration". Hamilton explained that this does not require a jury to 

"give more weight or credibility to the attending physician's 

testiinony, but to give it careful thought." [Hamilton,] 111 Wn.2d at 

572. We assume that the jury gives careful thought to every witness's 

testimony. If the attending physician's testimony does not carry any 

more weight or credibility with the jury, how then does the jury give it 

special consideration? 

McClelland, 65 Wn. App. at 394 n.1. That criticism is misplaced. The instruction 

requires only that the jury be mindful of the special consideration an attending 

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Clark County v. McManus, No. 91963-1 

physician's testimony deserves when weighing the credibility of all witnesses. The 

requirement for the special consideration instruction in Hamilton is clear. 

In _Harker~/.~ott, the Court of Appeals acknowledged that special 

consideration should be given to an attending physician, but concluded in that case 

"the 1Icimilton court did not hold that an instruction to that effect was mandatory. 

Rather~ the court held only that such an instruction was not a comment on the 

f;tevidence. No case has specifically held that such an instruction must be given 

when the evidence. supports it." Harker-Lott, 93 Wn. App. at 186 (footnote 

omitted). This statement disregards our observation in Hamilton that the instruction 

is an accurate statement of the law in workers' compensation cases and the general 

rule that t_he jury be instructed on the law. 

Additionally, Harker-Lott is factually distinguishable from the present case . ·~ . '. ' ' 

because the claimant there had four attending physicians who did not agree the ·.· '·. 

claimant was injured as a result of an on-the-job accident. Because the testimony 

of t~e atteJ:tding physicians was in conflict, and because the general instructions 

given allowed the claimant to argue that the supporting testimony of two of her 

attending physicians should be given special consideration, refusal to give the • . . . • . . I". . . . 

special consideration instruction was not an abuse of discretion by the trial court. 

In Jiarker_-Lott, the situation was somewhat unique and the jury could not give 

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Clark County v. McJVfanus, No. 91963~1 

special consideration to multiple, conflicting attending physicians' testimony. 

Here, t.hqse circumstances do not exist. 

. The analysis in Harker-Lott also overlooks a key aspect of Hamilton. While 

this ·c.ourt may not have used the term "mandatory" when discussing the special 

consideration instruction, we did describe the special consideration rule as a "rule 

of law" <:Jnd stated .that refusing to give the instruction ''would convert the rule of 

,· Jaw into no more than the opinion of the claimant's attorney." Hamilton, 111 

Wn.2d at 572. ··Hamilton thus recognizes a requirement for providing the special 

consideration instruction, except in those cases where there are articulable reasons 

for not accepting the attending physician's or physicians' testimony. 

Finally,_ the County cites to Larson in support of its argument that to give a 

special consideration instruction is discretionary rather than mandatory. In Larson, . . ' . . 

the_trial court expressed concern over the substance of testimony provided by the 

attending physician in comparison to the other more elaborate testimony from 

medical experts. The trial court decided to not provide the special consideration . . . . . 

instn,1c;tion due to concerns that it would be misleading. The Court of Appeals . . . •,. ., ' ' 

found this action was proper and not an abuse of discretion, citing the Harker-Loft 

decision. Larson, 188Wn. App. at 883-84. 

It appears here that the Court of Appeals embraced an analysis in Larson, 

whic_h conflicts with our decision in Hamilton. Our holding in Hamilton was 

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Clark County v. McManus, No. 91963-1 

unambiguou~. The rule requires that where an attending physician testifies, the trial 

court must give the attending physician .instruction. Hamilton dictates that a jury 

conducting .de novo review of a board decision needs to be instructed on this rule. 

To the extel)t Larson holds otherwise, we overrule it. 

The County urges us-in the alternative to asserting that the trial court did 

not abuse its discretion in rejecting the special consideration instruction-to 

··overturn Hamilton and hold that the special consideration instruction never be 

given. We reject this argument. We find Hamilton to be neither incorrect nor 

harmful. As the court explained in Hamilton, a jury instruction regarding the 

special consideration rule is necessary for the jury to meaningfully review board 

decisions.4 

In the present case, the only attending physician who testified was Dr. Won. 

The general witness instruction given in this case did not accurately convey the 

requirement embraced in Hamilton that the jury give special consideration to the 

testimony of McManus's treating physician, nor would giving the special 

consideration instruction cause confusion where there is no conflicting testimony 

4 The comment to 6A WPI 15 5.13. 01 indicates that the special consideration instruction 

need not always be given, citing Harker-Lott. 6A WPI 155.13.01 cmt. at 167. We disavow the 

WPI comment to the extent that it indicates that the special consideration instruction is not 

mandatory. The instruction is mandatory except in those instances where the instruction cannot 

be given, such as where there are multiple attending physicians offering conflicting testimony. 

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Clark County v. McManus, No. 91963-1 

from multiple attending physicians. The trial court did not identify any compelling 

reason why Dr. Won's opinion should not be accepted. 

Importantly, the Board itself recognizes and applies the special consideration 

rule. See, e.g., In re Free, No. 89 0199 (Wash. Bd. of Indus. Ins. Appeals June 20, 

1990); In re Anderson, No. 87 3724 (Wash. Bd. of Indus. Ins. Appeals May 18, 

1989). The Department applies the special consideration rule in adjudicating 

claims. Because self-insured employers are bound to comply with department 

claims handling processes, they also apply the special consideration rule. Special 

consideration should be given to the opinion of an attending physician unless 

specific reasons for not accepting the attending physician's opinion are articulated. 

We hold that in cases such as this where one attending physician testifies, 

the special consideration instruction must be given. Here, the trial court did not 

identify why a special consideration instruction should not be given and we find no 

reason. Our decision in Hamilton-which relied on long-standing policy 

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Clark County v. McManus, No. 91963-1 

surrounding workers' compensation cases-controls. We reaffirm Hamilton. We 

disavow the Court of Appeals' decision on the special consideration instruction 

issue and hold that the instruction is mandatory in situations present here. 

WE CONCUR: 

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