Opinion ID: 31300
Heading Depth: 2
Heading Rank: 3

Heading: The ALJ Reached the Right Result the First Time.

Text: 24 Once an employer successfully rebuts a § 20(a) presumption by producing substantial evidence — more than a modicum but less than a preponderance — that the injury was not work-related, the ALJ must assess the issue of causation by looking at all record evidence. 12 In these cases, the BRB reviews such determinations of the ALJ under the same deferential standard that governs our review: If the BRB determines that the ALJ's decision is supported by substantial evidence and is in accordance with the law, the ALJ's decision must be affirmed. 13 The BRB may not substitute its judgment for that of the ALJ, nor may [it] reweigh or reappraise the evidence. 14 25 Here, the BRB did not give proper deference to the ALJ's initial assessment of the evidence, incorrectly erecting a higher evidentiary hurdle than the one specified in the LHWCA. Under the proper standard of review, the ALJ's first holding, i.e., that Charpentier was not entitled to LHWCA benefits, was supported by substantial evidence and was consistent with the law. That should have marked the end of the BRB's review. 26 Nevertheless, the BRB vacated the ALJ's initial decision that Charpentier was ineligible for benefits under the LHWCA on the basis of the aggravation rule. 15 This rule specifies that when an employment injury worsens or combines with a preexisting impairment to produce a disability greater than that which would have resulted from the employment injury alone, the entire resulting disability is compensable. 16 27 At first blush, the aggravation rule might appear to weigh in favor of Charpentier's claim. Decedent's heart attack, although clearly having begun the previous evening while he was at home, not work, concluded fatally some fifteen minutes after he started his painting work for Ortco the next morning. Thus, it would appear on the surface that Decedent's pre-existing and ongoing heart attack might have been aggravated by his work, leading to the fatal cardiac arrest. If this assessment were correct, then the ALJ would have erred in failing to acknowledge this causal link in the aggravation of Decedent's heart attack. 28 We reached such a conclusion in Gooden, when we vacated an ALJ's decision that denied LHWCA benefits. We held that the ALJ improperly focused on the non-work-related origins of an employee's chronic heart condition, which pre-dated by several years the heart attack that struck the employee while he was on the job. We stated that [i]t is well settled that a heart attack suffered in the course and scope of employment is compensable even though the employee may have suffered from a related preexisting heart condition.  17 Thus, in that case, the ALJ erred in failing to consider the work conditions under which the employee suffered his actual heart attack. We remanded with instructions for the ALJ to make findings that address the heart attack itself, not the pre-existing heart condition. 18 29 Our decision in Gooden is easily distinguishable from the record before us in the instant case. The employee's injury in Gooden — his heart attack — began and ended on the job. The injury was the heart attack in toto; only the cardiac disease pre-dated the injury and that was for an extended time. In this case, it is indisputable that Decedent's heart attack began in the evening while he was at home, continued there throughout the night and early morning, and finally concluded in the fatal cardiac arrest 15 minutes into his morning's work. Unlike the situation in Gooden, the heart attack in this case did not begin and end entirely in the context of Decedent's employment. Here, Decedent brought an ongoing heart attack to work with him that morning. And — according to un-rebutted medical testimony — it would have escalated to a fatal cardiac arrest no matter where he was at that time, with the possible exception of the hospital. 30 Respondents nevertheless repeat the BRB's contention that Decedent's employment might have contributed to the fatal nature of his heart attack, a possibility that the BRB tries to ascribe to Petitioners' expert witnesses for not having been able to rule out or unequivocally deny. The BRB infers this supposition from the fact that Decedent's heart attack, although beginning many hours earlier when he was at home, turned fatal shortly after his arrival at work. Ergo, reasons the BRB, there is circumstantial evidence that Decedent's working conditions aggravated his pre-existing heart attack. We see this evidence not as circumstantial but as coincidental. 31 Of course, the BRB was able to draw this inference only because it first rejected the ALJ's detailed findings by employing the impermissibly stringent standard of review that Petitioners' expert witnesses must rule out or unequivocally deny such a possibility. In his first decision, the ALJ gave much weight to the testimony of Dr. Eiswirth, a board-certified cardiologist. 19 Dr. Eiswirth related that if you're having a heart attack and you do any physical activity, you're at increased risk of death. (Emphasis added.) Dr. Eiswirth further explained, according to the ALJ, that this meant that the only action that would have [favorably] affected the outcome would have been if [Decedent] had gone to the hospital. (Emphasis added.) In other words, Decedent could have gone fishing, he could have gone shopping, he could have mowed his lawn or carried in the groceries — he could have engaged in virtually any activity, and not necessarily one involving stress or exertion — and the cardiac arrest still would have occurred. Thus, as the ALJ recognized, it was only happenstance that Decedent was at work when the heart attack process concluded. 32 To apply the aggravation rule in this context would empty it of any meaning under the LHWCA. If an employee's preexisting injury would necessarily be exacerbated by any activity regardless of where or when this activity takes place, and an employee happens to go to work, it is an impermissible leap of logic to say that there must be a causal connection between the worsening of the employee's injury and his work. There is a causal connection between the employee's life activity and his exacerbated injury, but it does not matter whether this activity happened to take place at work or elsewhere. To approve LHWCA benefits in such cases would be to place a thumb on the scale in favor of LHWCA claimants; yet the Supreme Court has expressly disapproved when, in the past, we weighted the LHWCA to the advantage of claimants. 20 There is no reason for us — or the BRB — to incur the condemnation of the Court by doing so again. 33 In their appellate briefs, Respondents attempt to buttress the BRB's opinions by labeling as contradictory and speculative the nature of the physicians' testimony, such as Dr. Daniels's changing his conclusion following his review of Dr. Tamimie's report. These arguments miss the point entirely. An ALJ is a factfinder and is entitled to consider all credibility inferences. He can accept any part of an expert's testimony; he may reject it completely. 21 The ALJ's selection among inferences is conclusive if supported by the evidence and the law. 22 Based here on substantial evidence and the applicable law, the ALJ found that Petitioners had rebutted the § 20(a) presumption and had established that there was no specific causal connection between Decedent's heart attack turning fatal and his work. And, in doing so, the ALJ relied on evidence that was of significantly greater probative value than substantial. Thus, according to the circumscribed scope of our review, this is a factual finding to which we — and the BRB — must defer. 23