Opinion ID: 867747
Heading Depth: 3
Heading Rank: 2

Heading: Amerada Hess

Text: The ALJ applied the Section 20(a) presumption to Vickers’s CIDP. In affirming the ALJ’s decision, the BRB also found the presumption applicable. Plaintiffs argue that the BRB erred in affirming the ALJ’s decision because Vickers’s CIDP was not included in his claim, and at most was a secondary injury to which the Section 20(a) presumption does not apply under the reasoning in Amerada Hess. 543 F.3d at 761-62. In Amerada Hess, the claimant sought benefits for a heart condition that allegedly resulted from treatment—steroid use and surgery—for work-related back and groin injuries. Id. at 758-59. The ALJ invoked the Section 20(a) presumption, found that the employer did not rebut the presumption, and awarded compensation and medical benefits related to claimant’s heart condition. Id. at 759. The BRB affirmed, holding that if the claimant’s heart 7 No. 12-20228 problems arose as a consequence of the steroid injections he received as treatment for his work injury, then his heart problems were work-related. Id. We reversed the BRB’s decision in that case for reasons that mirror the issues Plaintiffs now raise on appeal. First, we found that the ALJ and BRB erred in applying the Section 20(a) presumption to claimant’s alleged heart condition because it was not part of his original claim, which was for his back and groin injury. Id. at 761 (noting that the presumption applies to the claim) (citing U.S. Indus., 455 U.S. at 613). Second, we decided that the Section 20(a) presumption did not apply to claimant’s heart condition because it was a secondary injury to which the presumption did not apply: In sum, we hold that the statute does not support a presumption that any medical condition that an injured claimant suffers after a work-related injury is caused by the work-related injury. Furthermore, not all “secondary” injuries are covered under the LHWCA simply because the claimant demonstrates a subsequent harm that could have stemmed from the covered injury. Instead, to receive benefits under the LHWCA for a subsequent injury, the claimant must present substantial evidence that the secondary condition “naturally or unavoidably” resulted from the first covered injury, as is required by the statute. Id. at 763 (citation omitted). As discussed, Plaintiffs argue that Vickers did not refer to his CIDP in his claim, and that his CIDP is at most a secondary injury subject to the “naturally or unavoidably” causation standard we articulated in Amerada Hess. Since these issues are related, we address them together.