Opinion ID: 773006
Heading Depth: 2
Heading Rank: 3

Heading: Causation and Permanent Total Disability

Text: 45 Section 920 of the LHWCA provides in relevant part that it shall be presumed, in the absence of substantial evidence to the contrary- (a) That a claim comes within the provisions of the Act. 33 U.S.C. § 920(a). Inherent in this provision is the presumption that an injury is causally related to a worker's employment. Port Cooper, 227 F.3d at 287. To invoke this presumption, a claimant must make out a prima facie case of causation by establishing both that he suffered harm, and that workplace conditions or a workplace accident could have caused, aggravated, or accelerated the harm. Id. If the claimant thus qualifies for the presumption, the burden shifts to the employer to rebut the presumption with substantial evidence that the alleged harmful workplace condition did not cause, contribute to or aggravate the claimant's condition. Id. at 288. Finally, if the employer offers evidence sufficient to rebut the presumption, then all relevant evidence must be weighed to determine if a causal relationship has been established, with claimant bearing the ultimate burden of persuasion. Id. 46 After finding that Marinelli had established a prima facie case of causation and that ASL had rebutted this case, the ALJ proceeded to step three and concluded that Marinelli was unable and disabled from performance of [his] job. The ALJ based this conclusion on findings that (i) Marinelli suffered angina due to... job stress on March 16, 19[9]7, (ii) a return to [his] job would subject him to continued aggravation of his underlying heart impairment by exposure to conditions likely to cause insufficient blood flow to his heart, and (iii) Marinelli had a well-founded fear that further performance of his job would result in psychological (depression/anxiety) and physical (coronary damage) consequences of intolerable dimension. The Board concluded that these findings were supported by substantial evidence and affirmed the ALJ's award of permanent total disability benefits. Marinelli, 2000 WL 1133566, at -. 47 On appeal, ASL raises four challenges to this conclusion. First, ASL contends that the ALJ failed to make findings of fact as to exactly what the March 16, 1997 injury was. The record belies this contention. As noted, the ALJ explicitly found that Marinelli suffered angina due to the job stress on March 16, 19[9]7. The ALJ based this finding on a statement to this effect in the medical report of Marinelli's treating physician, Dr. Konka. 48 Second, ASL, citing Director v. Newport News Shipbuilding & Dry Dock Co., (Carmines), 138 F.3d 134, 140 (4th Cir. 1998), argues that Dr. Konka's medical report is not substantial evidence because it is an unexplained conclusory opinion, not stated with a reasonable degree of medical certainty. This argument is without substance. Carmines states that [t]he ALJ may not merely credulously accept the assertions of the parties or their representatives, but must examine the logic of their conclusions and evaluate the evidence upon which their conclusions are based. Id. Here, the ALJ did more than merely credulously accept Dr. Konka's report. The ALJ noted that Dr. Konka was Marinelli's treating cardiac surgeon, that he had performed several coronary procedures on Marinelli, and that he was intimately familiar with Marinelli's cardiac state. 49 Third, ASL contends that the ALJ's stated reason for disregarding the testimony of ASL's expert, Dr. Israel, that Marinelli did not suffer an angina attack on March 16, 1997, was based on an erroneous reading of the record. The ALJ found that Dr. Israel's basis for concluding that the March 16, 1997 pain was non-anginal (i.e., the catheterization results of March 16, 19[9]7 indicating 'not enough coronary blockage to cause chest pain') lacks full creditability [sic] since he fails to indicate exactly what degree of blockage may result in angina. ASL claims that Dr. Israel provided this information because, in his written report submitted to the ALJ, he stated that the catheterization showed no areas of myocardium at risk (no stenosis greater than or equal to 50%). This objection is unpersuasive. The ALJ cannot fairly be faulted for failing to interpret Dr. Israel's statement that 50% or greater narrowing of cardiac passages is needed for there to be myocardium risk to mean that 50% or greater blockage is the minimum needed for angina. Moreover, assuming arguendo that the ALJ had erroneously disregarded Dr. Israel's statement about the 50% blockage standard, the error was harmless because the ALJ discounted Dr. Israel's opinion that Marinelli did not suffer an angina attack on March 16, 1997 for several other reasons - not the least of which was that this opinion was inconsistent with the opinion of Dr. Konka, who, according to the ALJ, performed the catheterization and was thus in a much better position than Dr. Israel to interpret the results thereof in terms of degree of blockage. Indeed, as Marinelli points out, the page of Carmines cited by ASL actually undermines ASL's argument, because it states that the testimony of a non examining, non treating physician should be discounted and is not substantial evidence if it is totally contradicted by other evidence in the record. Carmines, 139 F.3d at 140 n.5 (internal quotation marks omitted). 13 50 Finally, ASL objects that the ALJ never addressed Dr. Israel's contention that, even assuming that Marinelli had an angina attack on March 16, 1997, there was no permanent disability resulting from it because it is a temporary condition which resolves. The ALJ implicitly rejected this contention by relying on Dr. Konka's contrary finding that Marinelli was permanently disabled.