Opinion ID: 1311017
Heading Depth: 3
Heading Rank: 1

Heading: Rebuttal of Presumption of Compensability

Text: Stephens argues that the Board erred in failing to make findings regarding his working conditions, the testimony of lay witnesses, and Dr. Thieman's opinion in its determination that ITT had overcome the presumption of compensability. In reaching its decision, the Board relied on the testimony of three physicians: Stephens's treating otolaryngologist, Richard Raugust, M.D., [4] Stephens's treating cardiologist, William Mayer, M.D., and ITT's cardiologist, Geoffrey Tofler, M.D. The Board also considered Stephens's testimony regarding his job and the conditions surrounding the job. The Board's decision did not mention the testimony of Stephens's co-workers about the working conditions. None of the physicians who evaluated Stephens directly heard the co-workers' comments. Stephens argues that the Board erred by declining to issue detailed findings of fact regarding the testimony of the lay witnesses. In determining whether ITT rebutted the presumption of compensability, however, the Board does not weigh evidence offered by the employer against that offered by the employee, but rather examines the evidence offered by the employer standing alone. Wolfer, 693 P.2d at 869. Although the Board need only look at evidence tending to rebut the presumption of compensability, that evidence must be comprehensive and reliable. To be comprehensive and reliable, the physicians' testimony about whether Stephens's work was a substantial cause of his heart attack necessarily had to consider Stephens's work conditions on the day of his attack. These conditions included the temperature, the amount of dust in the atmosphere, the level of physical exertion required, the level of emotional stress, and Stephens's diet. Even though the physicians did not directly hear the lay witnesses' testimony, the attorneys asked the physicians about various hypothetical situations. Some of these hypotheticals incorporated the content of the lay witnesses' testimony. The doctors also interviewed Stephens to some extent, and at least one of them, Dr. Tofler, reviewed Stephens's deposition before formulating his opinion. The two cardiologists, Drs. Mayer and Tofler, agreed that as represented to them, the levels of Stephens's physical exertion, emotional stress, diet, and cold were not substantial factors in bringing about his heart attack. [5] They agreed that coughing may have triggered the heart attack, although neither physician professed to know the cause of the cough. Dr. Raugust, an ear, nose, and throat specialist, stated that the cause of Stephens's coughing and laryngospasm was not the cold dry air of the North Slope, the dust, or the level of physical exertion, but was the phlegm produced by Stephens's smoking and chronic sinus disease. He testified that because of Stephens's smoking and sinus disease, this coughing episode would have occurred anywhere in the world. Thus, in reaching their conclusions that Stephens's heart attack was not work-related, the physicians took into account their understanding of his work conditions. Their understanding was based on a factually permissible interpretation of the work conditions. Drs. Mayer and Tofler agreed that if Stephens's work conditions differed from those that they considered (for example, if there were a higher level of physical exertion involved) the conditions might in fact have been a significant factor in causing his heart attack. See supra note 5. The existence of a potentially material, genuine fact dispute about Stephens's actual work conditions, however, does not mean the Board erred by ruling that ITT overcame the presumption of compensability. The physicians based their opinions on a state of facts, which, although disputed, could be permissibly resolved in favor of the employer. The physicians' conclusions favoring the employer, and the permissible fact assumptions underlying those conclusions, standing alone, constitute sufficient evidence to rebut the presumption of compensability. It has always been possible to rebut the presumption of compensability by presenting a qualified expert who testifies that, in his or her opinion, the claimant's work was probably not a substantial cause of the disability. Big K Grocery, 836 P.2d at 942. [I]t is not the function of this court to reweigh the evidence but only to determine whether such evidence exists. Gillispie, 881 P.2d at 1109 (quoting Kessick, 617 P.2d at 757). We give deference to the Board's determination of a witness's credibility. AS 23.30.122. Thus, we conclude that the Board's finding that ITT rebutted the presumption of compensability was based on substantial medical evidence which eliminated all reasonable possibilities that the heart attack was work-related.