Opinion ID: 2198399
Heading Depth: 2
Heading Rank: 2

Heading: Rebuttal of the Statutory Presumption

Text: When an employee presents evidence demonstrating that an injury was potentially caused or aggravated by a work-related activity, a presumption arises that the injury is work-related and therefore compensable under the Workers' Compensation Act. Washington Hosp. Ctr., 744 A.2d at 996 (citing D.C.Code § 36-321(1) (1998), recodified as D.C.Code § 32-1521 (2001)). To rebut the presumption the employer must show by substantial evidence that the disability did not arise out of and in the course of the employment. Waugh v. District of Columbia Dep't of Employment Servs., 786 A.2d 595, 600 (D.C.2001) (quoting Baker v. District of Columbia Dep't of Employment Servs., 611 A.2d 548, 551 (D.C.1992)). Substantial evidence is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion, Davis-Dodson v. District of Columbia Dep't of Employment Servs., 697 A.2d 1214, 1218 (D.C.1997) (citations and internal quotations omitted), and it must be `specific and comprehensive enough to sever the potential connection' between the disability and the work-related event. Waugh, 786 A.2d at 600 (quoting Ferreira v. District of Columbia Dep't of Employment Servs., 531 A.2d 651, 655 (D.C.1987)); see also Whittaker v. District of Columbia Dep't of Employment Servs., 668 A.2d 844, 847 (D.C.1995) (presumption of compensability cannot be overcome by some isolated evidence). There is no question that Watson made an initial showing of medical evidence sufficient to invoke the presumption of compensability as he presented Dr. Dorn's reports that his right knee disability was related to the September 1998 work injury. The only issue is whether Dr. Danzinger's report constituted substantial evidence specific and comprehensive enough to sever the presumed causal connection. Safeway asserts that the hearing examiner erred in characterizing Dr. Danzinger's report as contradictory, when in fact it clearly and unequivocally indicates that Dr. Danzinger did not believe that claimant's right knee problems are causally related to his 9/24/98 injury. Safeway claims this opinion was sufficient to rebut the presumption. We agree that it was. [4] Although we have declined to establish a precise quantum of proof needed to meet the substantial evidence threshold, we have emphasized that [o]ur cases ... require an employer only to offer `substantial evidence' to rebut the statutory presumption, not to disprove causality with an absolute certainty. Washington Hosp. Ctr., 744 A.2d at 1000. Moreover, we have indicated that the statutory presumption is not so strong as to require the employer to prove causation is impossible in order to rebut it. Id. Thus, we have reversed the Director's decision for imposing too heavy a burden on the employer by requiring that the employer demonstrate that the employee's injury could not have been caused by the work-related incident. Id. at 999-1000. Dr. Danzinger determined that Watson's right knee was minimally symptomatic... other than the patellofemoral joint. He diagnosed Watson with patellofemoral syndrome in his right knee and observed the presence of a questionable medial meniscal tear. Dr. Danzinger found absolutely no evidence of causal relationship between the right knee injury and the work injury to the left knee. He did acknowledge that the patellofemoral syndrome could be caused by transfer of weight, but clearly stated that it was in no way related to the work injury and found the syndrome much more related to Watson's longstanding osteoarthritis. As for the questionable meniscal tear, Dr. Danzinger expressed scepticism concerning Dr. Dorn's claim that it could have resulted from a transfer of weight and without an antecedent injury. Based on Dr. Danzinger's extensive diagnosis, which provided a detailed explanation supporting his conclusions, we cannot agree with the Director's decision that it was insufficient to rebut the presumption of compensability. Although we defer to the Director's characterization of Dr. Danzinger's opinion as inconsistent in that Dr. Danzinger observed that the patellofemoral syndrome in Watson's right knee had the potential to be caused by transfer of weight, we note that the inconsistency, if any, was minor, as the doctor unequivocally stated his opinion that the work injury was not the precipitating cause in this case, pointing to long-standing osteoarthritis and the original injury of 1990 to the left knee. Similarly, Dr. Danzinger's opinion regarding the cause of the possible meniscal tear in Watson's right knee cast doubt on Dr. Dorn's explanation for that injury. In dismissing Dr. Danzinger's opinion as insufficient, the Director effectively required Safeway to disprove causality with an absolute certainty which we have said is too heavy a burden to place upon the employer to rebut the presumption of compensability. See Washington Hosp. Ctr., 744 A.2d at 1000; see also Washington Hosp. Ctr. v. District of Columbia Dep't of Employment Servs., 746 A.2d 278, 281-82 (D.C.2000) (reversing Director's decision where examiner failed to account for significant parts of testimony by employer's physician which was evidence sufficient to rebut the presumption); cf. Parodi v. District of Columbia Dep't of Employment Servs., 560 A.2d 524, 526 (D.C.1989) (affirming Director's decision where employer's medical evidence not only failed to rebut the presumption but was consistent with the employee's medical evidence). It is sufficient for the employer to present substantial medical evidenceas opposed to unequivocal medical evidenceto rebut the statutory presumption. We therefore reverse and remand so that the examiner can proceed to the second step in the consideration of all evidence, giving due weight to the opinion of the treating physician.