Opinion ID: 2551330
Heading Depth: 3
Heading Rank: 2

Heading: Substantial Evidence Supports the Board's Decision.

Text: The Alaska Workers' Compensation Act creates a presumption that an employee's claims are compensable. [12] Applying this presumption involves a three-step analysis. [13] First, to trigger the compensability presumption the employee must establish a link between his injury and his employment. [14] In this case, the board found that Orchitt had produced sufficient evidence to establish a link between Orchitt's employment and his disability. AT & T does not appear to contest this part of the board's findings. Second, once the employee establishes the presumption of compensability, the employer may rebut the presumption with substantial evidence. [15] In Orchitt's case, the board found that AT & T had rebutted the presumption. Orchitt does not challenge the board's finding that AT & T rebutted the presumption. Third, if an employer rebuts the presumption, the burden shifts to the employee to prove his claim by a preponderance of the evidence. [16] Here the board found that Orchitt had provided sufficient evidence to establish his claim. AT & T challenges the board's conclusion that Orchitt proved his claim by a preponderance of the evidence, raising several issues about whether substantial evidence supports the board's decision.
AT & T first claims that the board's finding that Orchitt was overexposed to radio frequency radiation is not supported by substantial evidence because the board rejected the testimony of the board's engineering expert and AT & T's radiation expert and relied instead on the lay testimony of Orchitt and his coworker, as well as its own common sense. AT & T asserts that Dr. Ziskin, a medical doctor who also calculated Orchitt's exposure, retracted his initial opinion that Orchitt had been overexposed. It argues that because the issue of overexposure to radio frequency radiation is highly technical, any finding that Orchitt was overexposed must be supported by expert scientific testimony. It alleges that only Kimberly Kantner and Dr. Guy had adequate expertise to properly evaluate the level of Orchitt's exposure. In some workers' compensation cases expert medical testimony is necessary to demonstrate a relationship between the claimant's employment and his disability. [17] Whether expert testimony is necessary depends on the probative value of the available lay evidence and the complexity of the medical facts involved. [18] AT & T relies on Commercial Union Cos. v. Smallwood in arguing that the board erred in its finding of overexposure. But the board based its finding that Orchitt was overexposed to radiation not just on lay testimony and common sense; it also relied on Dr. Ziskin's expert opinion. Although AT & T contends that Dr. Ziskin retracted his opinion, the record does not support this assertion. In his April 16, 1999 letter, he did not, as AT & T argues, say that it was unlikely that Orchitt sustained any significant overexposure. This letter contains no reference at all to exposure level. Nor did Dr. Ziskin change his mind in his deposition. Dr. Ziskin there testified that he still had concerns about whether Dr. Guy's models adequately accounted for specular reflection in determining how quickly the radiation would dissipate once it left the waveguide. AT & T points to the following excerpts from Dr. Ziskin's deposition testimony to support its argument: Q: Okay. All right. You haven't done any calculations or analysis yourself, have you, to the degree Dr. Guy has? A: About what? I mean, I do make calculations of radiation exposures and so on from antennas and things like that. Q: No. I mean in this case, Doctor. I'm sorry. A: Oh, in this particular case? Q: Yeah. A: The calculations that I made were very  Q: Rough? A:  limited. I took the total power that was coming through the waveguide, and I divided it by the area to come up with what was the average power density within the waveguide, which would be at the starting point. Q: Right. And it would be  it would lose power as it moved away, right? A: Well, within the waveguide, for the most part, the power will stay the same. Q: Within the waveguide, but once it  A: Within the waveguide. But once it leaves the waveguide, it gets attenuated, yeah. It depends upon the nature of the way it leaves how rapidly it attenuates. Q: Okay. A: And most of the modeling was done on the idea of the inverse square law; but with specular reflection, that would not necessarily be true. Q: And specular reflection you deal with in ultrasound, right? A: That's correct. . . . . Q:. . . . Now, as to the differences between the sort[] of doctor[] that you are as compared to Dr. Guy, can you explain the differences for  so that we can understand the kind of testimonies that we can expect that you would be able to testify to accurately as opposed to the type of testimony Dr. Guy would be able to testify to accurately? A: Well, there is a great deal of overlap. However, I'll  I think he would defer to me when it comes to medical judgment and biology. And unless there was something very specific, I will always defer to him when it comes to the physical engineering side of things. And I think the same thing is true with  it's possible that, because he has done some biological research, that there could be something that I would not be correct on and he would maybe correct me when it comes to even biology or even medicine, but in general, he would defer to my opinion when it comes to medical aspects. We do not believe that Dr. Ziskin's testimony that he would defer to Dr. Guy's opinions with respect to physical engineering unless there was something very specific indicates that he retracted or otherwise abandoned his opinion that Orchitt was overexposed. Dr. Ziskin identified the specific issue of specular reflection as an area of possible disagreement with Dr. Guy. In his deposition, Dr. Ziskin reiterated his belief that Dr. Guy's model had not taken specular reflection into account. A: Where I have a question is in the initial assumptions of what was the exposure ahead of time, what went into that model. And that's why I said I wanted to look to see what was the incident power density that he felt was started to expose the head with. And here is where I have a little different point of view. It has to do with reflections off of the flange. Because I have a background in ultrasound for diagnosis where we look at reflections, that's the whole diagnosis concerned with, I'm aware that you can have pretty large reflections off of structures that are relatively strong compared to just the scatter and the back scatter that you would have otherwise. And see, I haven't seen the actual setup. But it would be possible that if the two flanges that had been  that the waveguide segments that had been separated had overlapped and there was strong reflections coming off of one of the flanges, that that reflection could actually be quite high and might not be measured in the model  the modeling that Dr. Guy had used. That's sort of a rather important point because that would establish what that initial maximum exposure would be. . . . . Q: And Dr. Guy did take that into account in the third report. Do you see that? A: Well, looking at it, though, it's not clear to me whether or not it actually addressed what I call specular reflections, the type of reflections I'm talking about. It looked more of the defraction type of reflection, which is certainly true, but I don't know whether or not the model actually takes into account the specular reflections. . . . . A: The only thing, I'm not sure whether that model takes into account specular reflections or not. I just don't know for sure. I would have to ask Dr. Guy. Dr. Ziskin's report and testimony provide substantial scientific evidence to support the board's finding. AT & T does not argue that Dr. Ziskin was not qualified to give an opinion about overexposure. Moreover, the board was free to credit the testimony of Dr. Ziskin over that of Dr. Guy and Kimberly Kantner. [I]f the Board is faced with two or more conflicting medical opinions  each of which constitutes substantial evidence  and elects to rely upon one opinion rather than the other, we will affirm the Board's decision. [19] This is particularly so if the board believed that, based on Orchitt's description of the separation between the segments of the waveguide and his distance from the flange, specular reflection had occurred, and if it found that Dr. Ziskin's opinion more accurately matched how the accident happened than Dr. Guy's. We therefore find no merit in AT & T's contention that the board's finding was not supported by adequate scientific evidence. Furthermore, in Beauchamp v. Employers Liability Assurance Corp., we held that the board could permissibly combine uncontradicted lay testimony with uncertain medical testimony to support a conclusion that a worker's injury was work related. [20] Here, the board did not err in relying on the lay testimony of Orchitt's coworkers in combination with the medical evidence in determining that Orchitt had suffered a work-related injury.
AT & T also argues that the board's findings that Orchitt suffered a work-related injury and that Orchitt's mental deficits were related to the radio frequency radiation are based on incompetent medical evidence. It contends that the evidence presented by Drs. Russell and Amen does not meet the standards articulated in State v. Coon [21] to test the reliability of scientific testimony. Thus, it argues that the SPECT scan that was the foundation of Dr. Amen's diagnosis of brain damage does not satisfy Coon and that because Dr. Russell was not a licensed clinical psychologist, her opinions were not sufficiently reliable to provide a basis for the board's ruling. In State v. Coon we set out factors for trial courts to use in determining whether expert scientific evidence is sufficiently reliable to be admitted into evidence [22] AT & T did not object before the board to the admission of either Dr. Russell's or Dr. Amen's reports or testimony on this basis, [23] nor did it make an argument about the applicability of the Coon standard to workers' compensation cases in its superior court appeal. Because AT & T first raises the issue before us, it has waived the issue. [24] AT & T did argue before the board, as it argues here, that Dr. Russell's testimony should not be credited because she was not licensed as a clinical psychologist. But AT & T does not dispute that Dr. Russell has a doctorate degree in psychology and is certified as a rehabilitation specialist. These credentials provide her with some expertise. The board did not make a specific finding about Dr. Russell's credibility or the weight it accorded her testimony; nonetheless, the board acted within its discretion in rejecting AT & T's challenge to her expertise and in admitting her testimony. [25] AT & T also argues that the board must have relied on the opinions of Drs. Russell, May, and Keene in finding that Orchitt's injury caused his impairments. [26] It argues that none of these experts had sufficient expertise in radio frequency radiation exposure to be able to connect Orchitt's injury and his medical condition. AT & T's argument overlooks the opinions of Drs. Ziskin and Smith. Dr. Ziskin stated in his letter to the claims adjuster that neurological problems would be expected to result from Orchitt's overexposure to radio frequency radiation. As we have already noted, AT & T is incorrect in asserting that Dr. Ziskin withdrew his opinion about Orchitt's overexposure. In addition, Dr. Smith wrote that he believed that Orchitt sustained neurocognitive deficits related to radio frequency radiation. AT & T does not argue that the medical opinions of Drs. Smith or Ziskin are suspect. The board has the sole power to determine witness credibility and assign weight to medical testimony. [27] When medical experts disagree about the cause of an employee's injury, we have held that as a general rule `it is undeniably the province of the Board and not this court to decide who to believe and who to distrust.' [28] Substantial medical evidence in the record supports the board's determination that Orchitt is entitled to medical and TTD benefits.