Opinion ID: 4107550
Heading Depth: 2
Heading Rank: 3

Heading: Internal inconsistencies.

Text: Dr. Roseman’s report contains a number of internal inconsistencies, which make it difficult to comprehend and which rob it of substance. Several examples of those inconsistencies follow. Dr. Roseman initially postulated that Eddie’s chest pain Was the result of GERD but then stated that the pain was angina. Dr. Roseman stated, “The anatomic findings in the setting of sudden cardiac death involves either ‘acute changes in coronary plaque morphology, such as thrombus, plaque disruption, or both in >50% of cases of sudden death,”’ but then stated that Eddie’s death could not have been the result of ruptured plaque and thrombosis. Dr. Roseman stated that “only about 6-17% of all sudden deaths occur in association with exertion,” but then stated that “physical stress with vigorous exercise . . . has been shown to trigger acute cardiovascular events” and “a third of the acute myocardial infarction[s] were preceded by physical activity.” Dr. Roseman stated that Eddie’s death was the result of angina (chest pain due to inadequate blood flow to the heart) that triggered an arrhythmia. He then stated that Eddie’s stress and exertion had nothing to do with his death and that the angina-arrhythmia could have occurred anywhere. However, as noted 16 above Dr. Roseman stated that angina “is typically aggravated by exertion or emotional stress . . . .” Because of these inconsistencies, along with Dr. Roseman’s inaccurate understanding of the facts and his misunderstanding of the law, Dr. Roseman’s opinion lacks the “relevant consequence to induce conviction in the minds of reasonable men.” Smyzer, 474 S.W.2d at 369. Therefore, his opinion is not evidence of substance and the Court of Appeals correctly reversed the Board and remanded to the ALJ for an award of benefits.