Opinion ID: 884122
Heading Depth: 2
Heading Rank: 3

Heading: Application of Appropriate Standard of Causation in this Case

Text: As noted by the hearings examiner, [e]xamination and analysis of [Polk]'s condition as well as the cause of that condition by numerous doctors resulted in one group of doctors concluding [Polk] suffers from an occupational disease and another group of doctors concluding [Polk] does not suffer from an occupational disease. Based on the presumption of correctness given to the medical panel's adverse decision and on the hearings examiner's determination that the doctors who found no occupational disease were more qualified and presented better-reasoned conclusions, the examiner concluded that Polk did not suffer from an occupational disease. Polk argues that had the hearings examiner reviewed the evidence under the appropriate standard, to determine whether an occupational exposure contributed to or aggravated Polk's condition, rather than simply adopted these doctors' conclusion that Polk does not suffer from an occupational disease, the balance of evidence would have been tipped in his favor. As stated above, each doctor came to different conclusions as to the cause of Polk's pulmonary disease. As noted by Dr. Merchant, placing a name on the myriad of symptoms Polk suffers is difficult: [O]ne of the reasons that we term it `COPD' [chronic obstructive pulmonary disease] rather than... going past that and actually saying, `You have chronic bronchitis versus emphysema,' is that very often you have a mixture of the various conditions, because some of the things that cause one of them can also cause the others. Four of the eight doctors involved in this case, Drs. Sadaj, Thigpen, Demeter, and Merchant, concluded that Polk did not suffer from hypersensitivity pneumonitis, or any other occupational disease. Based on their testimony, the hearings examiner concluded that Polk was not entitled to compensation. However, the testimony of three of these four doctors could support a finding that the conditions to which Polk was exposed at Koch aggravated or contributed to his pulmonary condition. Dr. Merchant concluded that Polk suffers from emphysema and some bronchiectasis. However, Dr. Merchant also testified that occupational exposures would be very likely to play a significant role in exacerbating [Polk's] emphysema. Dr. Thigpen, the doctor who reported to the Department of Labor on behalf of the medical panel, concluded that hypersensitivity pneumonitis was not the most likely cause of Polk's pulmonary condition, but did not exclude it as a possibility. Further, Dr. Thigpen stated that if one does have any type of underlying lung disease (and that includes emphysema and chronic bronchitis) exposure to various types of dust and other irritants will aggravate claimant's condition. [Emphasis added]. Dr. Sadaj, another panel doctor, concluded that Polk suffers from chronic obstructive pulmonary disease and chronic respiratory insufficiency as a result of long-term heavy smoking. However, in support of this conclusion, Dr. Sadaj testified: The only way that I could say the occupation was a major part in his problem was if he has hypersensitivity pneumonitis. As stated above, Polk need not prove that the occupational exposures, as compared to smoking or other contributing factors, were the major or primary factor causing his present condition. Rather, as long as occupational exposures substantially aggravated Polk's pulmonary condition, he is entitled to pro rata compensation for his injuries. However, in concluding that he did not suffer from an occupational disease, Drs. Merchant, Sadj, and Thigpen were operating under the mistaken assumption that, to qualify him for occupational disease benefits, Polk's exposure to dust and other irritants at Koch had to be the major factor causing his pulmonary condition. When the testimony of Drs. Merchant, Sadaj, and Thigpen is reviewed under the correct standard of causation and added to the testimony of the four doctors who concluded that Polk indeed suffers from an occupational disease, it could support a finding that occupational factors contributed to or aggravated Polk's pulmonary disease. By adopting the doctors' threshold requirement that Polk's occupational exposures be the major or primary factor causing his medical condition rather than reviewing their testimony to determine whether it supports a finding that an occupational exposure contributed to or aggravated Polk's condition, the hearings examiner applied the wrong standard of causation. We hold that the Workers' Compensation Court erred in not overruling the Department of Labor's decision based on this error of law. Based on the foregoing, we reverse the decision of the Workers' Compensation Court and remand to that court for further proceedings consistent with this opinion. TURNAGE, C.J., and TRIEWEILER, NELSON and REGNIER, JJ., concur.