Title: Phelps v. INDUSTRIAL COM'N OF ARIZONA
Citation: 155 Ariz. 501, 747 P.2d 1200
Docket Number: 86-0604
State: Arizona
Issuer: Arizona Supreme Court
Date: December 15, 1987

155 Ariz. 501 (1987) 747 P.2d 1200 Hensel PHELPS, Petitioner Employer, Aetna Casualty &amp; Surety Co., Petitioner Carrier, v. INDUSTRIAL COMMISSION OF ARIZONA, Respondent, Walter Dice, Respondent Employee. No. CV 86-0604-PR. Supreme Court of Arizona, In Banc. December 15, 1987. *502 Bury, Moeller, Humphrey &amp; O'Meara by J. Michael Moeller and Marshall Humphrey III, Tucson, for petitioner employer/carrier. Dennis P. Kavanaugh, Chief Counsel, Phoenix, for respondent Indus. Com'n. Dix, Rehling &amp; Waterman by Charles G. Rehling II, Tucson, for respondent/employee Walter Dice. CAMERON, Justice. I. JURISDICTION Walter Dice, petitioner, seeks review of a court of appeals' decision which set aside an award of the Industrial Commission of Arizona (Commission). We have jurisdiction pursuant to Ariz. Const. art. 6, § 5(3) and A.R.S. § 23-948. II. QUESTION PRESENTED We must determine whether the testimony of the treating physican establishes a compensable heart-related injury meeting the requirements of A.R.S. § 23-1043.01(A). III. FACTS Petitioner severely fractured his left leg in seven places within the scope and course of his employment on 24 November 1980. From the date of the accident until release by his physician in August 1984, petitioner received temporary workers' compensation benefits. During the period December 1983 to September 1984, petitioner was unemployed due to recurring stability problems with his leg. On 8 September 1984, while unloading building materials, petitioner experienced severe chest pains. Petitioner was hospitalized and diagnosed as suffering from a myocardial infarction. Petitioner subsequently underwent surgery for a quadruple by-pass. In December 1984, the workers' compensation insurance carrier, Aetna Casualty &amp; Surety Company, terminated temporary compensation benefits. In March 1985, pursuant to A.R.S. § 23-1061(J), petitioner filed a new report of injury and petitioned to reopen the claim. At the hearing, all parties stipulated to a permanent partial disability of the petitioner's leg. The issue presented to the administrative law judge by the evidence was whether petitioner's myocardial infarction was related to the industrial injury. At a deposition, Dr. Katzenberg testified, in part, as follows: *503 Dr. Katzenberg testified at the hearing on direct examination that the unloading activity performed by petitioner constituted an extreme exertion of effort and that it was reasonably, medically probable that the effort contributed to the onset of the heart attack. He also concluded that the effort of lifting and hurling the bags due to the modified lifting mechanics would be a substantial contributing cause of the heart attack. He further opined that the inactivity due to the industrial leg injury masked the symptoms of coronary artery disease as "a reasonable hypothesis." On cross-examination, Dr. Katzenberg was even more explicit. He was asked whether he believed, within reasonable medical probability, that petitioner's industrial leg weakness was a substantial contributing cause to the heart attack. He answered: By Mr. Moeller [carrier's attorney]: Dr. Katzenberg was asked to explain the terminology [substantial, possible, and probable] as he understood the terms: The administrative law judge accepted the testimony of Dr. Katzenberg, one of two testifying physicans, and found: The carrier sought judicial review, arguing that the testimony of Dr. Katzenberg failed to satisfy petitioner's burden of proving that the leg injury substantially contributed to the myocardial infarction. The court of appeals, in a memorandum decision, set aside the award. In doing so, the court specifically focused on Dr. Katzenberg's testimony as to whether the leg injury was a "substantial contributing factor" within a degree of medical probability to the infarction. The court of appeals believed Dr. Katzenberg's testimony to be equivocal and that the judgment of the administrative law judge could not be upheld due to Dr. Katzenberg's confusion concerning whether the injury "possibly," "probably," or "substantially" caused the infarction. We granted the worker's petition for review. IV. DISCUSSION The applicable statute reads: A.R.S. § 23-1043.01(A) The cases interpreting A.R.S. § 23-1043.01(A) suggest that the legislature accomplished a two-fold purpose by enacting the statute. First, holdings of this court that heart attacks may be accidents within the meaning of the Workers' Compensation Law were codified. See Bush v. Industrial Commission, 136 Ariz. 522, 667 P.2d 222 (1983). Second, the legislature imposed an additional requirement that the job-related injury be a substantial contributing cause of the heart injury. Id. at 523, 667 P.2d at 223. Thus, according to A.R.S. § 23-1043.01(A), a worker claiming that a heart-related injury is an industrial injury compensable under the act must prove: If the result of an industrial accident is not clearly apparent to a layman, then the causal relationship of the accident to the physical or mental condition complained of must be established by expert medical testimony. Eldorado Insurance Co. v. Industrial Commission, 27 Ariz. App. 667, 670, 558 P.2d 32, 35 (1976). The carrier argued, and the court of appeals agreed, that Dr. Katzenberg's testimony was equivocal as to the leg injury contributing substantially to the myocardial infarction and thus failed to meet the burden of proof necessary to establish a compensable injury under A.R.S. § 23-1043.01(A). We disagree. An administrative law judge has the prerogative to resolve conflicting medical opinions. Stephens v. Industrial Commission, 114 Ariz. 92, 96, 559 P.2d 212, 216 (App. 1977). In the instant case, the administrative law judge heard the testimony of two experts but discounted the testimony of one cardiologist and relied on the testimony of treating cardiologist, Dr. Katzenberg. *506 Since medical certainty in this context is impossible, at a minimum reasonable assurance must exist that the industrial injury caused the infarction. Reasonable assurances are met if medical probabilities of industrial contribution exist. These probabilities are met for purposes of the act if the possibility can be defined as "more than insubstantial or slight." Skyview Cooling Co. v. Industrial Commission, 142 Ariz. 554, 559, 691 P.2d 320, 325 (App. 1984). In reviewing Dr. Katzenberg's testimony, we believe that this standard was met to substantiate medical causation. See infra. Therefore, the administrative law judge could find that there was a "recognizable causal connection," between the injury and infarction. Bush v. Industrial Commission, 136 Ariz. 522, 524, 667 P.2d 222, 224 (1983). As we have stated: Carabetta v. Industrial Commission, 12 Ariz. App. 239, 241, 469 P.2d 473, 475 (1970). In the present case, the administrative law judge was faced with determining whether an employee had sustained a myocardial infarction caused by a previous compensable impairment causally related to an industrial injury. The administrative law judge is the sole judge of the witnesses credibility. Holding v. Industrial Commission, 139 Ariz. 548, 551, 679 P.2d 571, 574 (App. 1984). As such, he may reject testimony if it is self-contradictory, inconsistent with other evidence, or directly impeached. Id. After hearing the evidence and weighing the witnesses credibility, the administrative law judge understood Dr. Katzenberg's opinion that the leg injury "substantially contributed" to the myocardial infarction. Based on Dr. Katzenberg's factual opinion on the record, understanding of issues on cross-examination and testimony at deposition, it appears that, although he failed to use the prescribed legal terminology, he understood that "substantial" meant more than "insubstantial or slight" and, in testimony, affirmatively conveyed such a belief. In this context, mere semantics of the language used will not preclude the award. The employer and carrier assert that even assuming this liberal interpretation of "substantial," the petitioner failed to meet his burden of proof. However, proof does not require magic words. As stated by Professor Larson: 3 A. Larson, The Law of Workmen's Compensation § 80.32(d), at 15-460 to -461 (1983). When the "magic word" has not been used in the medical witness's testimony, it becomes necessary for us, as in the present case, to review thoroughly and carefully such testimony. The question to be resolved then, is whether any reasonable theory of evidence supports the hearing officer's resolution of the question of causation as it relates to the myocardial infarction. If the testimony in the context in which it was given establishes "substantial contribution," the burden of proof is satisfied. Skyview Cooling Co., 142 Ariz. at 559, 691 P.2d at 325. The Commission's findings will be disturbed only if its conclusion cannot be reasonably supported on any reasonable theory of evidence. An appellate court is limited to that role even if its members would reach a different conclusion if sitting as the triers of fact. Perry v. Industrial Commission, 112 Ariz. 397, 399, 542 P.2d 1096, 1098 (1975). We believe the award of the administrative law judge was reasonably supported by the evidence. V. DISPOSITION We have reviewed the medical evidence in a light most favorable to sustaining the award of the Commission. U.S. Fidelity &amp; *507 Guaranty Co. v. Industrial Commission, 114 Ariz. 472, 476, 561 P.2d 1244, 1248 (App. 1977). We find that the evidence supports the award and cannot say that the administrative law judge erred in reaching his decision. We, therefore, reinstate the award of compensation. GORDON, C.J., and FELDMAN, V.C.J., concur. MOELLER, J., did not participate in the determination of this matter. HOLOHAN, Justice, dissenting. From my review of the medical testimony I agree with the conclusion of the Court of Appeals that the judgment of the administrative law judge is not supported by the evidence; I, therefore, dissent.