Opinion ID: 1223875
Heading Depth: 3
Heading Rank: 1

Heading: Dr. Smith's testimony regarding Tabieros's impairment ratings

Text: Over Clark's objections, the plaintiffs' medical expert, Robert L. Smith, M.D., testified during the trial regarding impairment ratings that he had assigned Tabieros based upon the injuries that Tabieros had sustained as a result of the accident involving the straddle carrier. [40] Dr. Smith's calculation of Tabieros's degree of impairment was initially performed in connection with a workers' compensation evaluation designed to quantify the extent of Tabieros's compensable workrelated disability. See supra note 40. On appeal, Clark urges, pursuant to HRE 403, see supra note 22, that Dr. Smith's testimony regarding Tabieros's impairment ratings should have been excluded as needless and confusing. In substance, Clark contends that disability, as a legal term of art, is generally intended to measure a person's loss of earning capacity [41] and that Dr. Smith's testimony was therefore extremely prejudicial because it utilized the terms disability and impairment as though they were interchangeable and thus conveyed the impression [to the jury] that disability existed where there was none. For the reasons discussed below, we disagree. Unquestionably, the terms disability and impairment often overlap. Disability is defined medically as [a]ny restriction or lack of ability to perform an activity in the manner and within the range considered normal for a human being. Taber's Cyclopedic Medical Dictionary 512 (16th ed.1989). In turn, impairment means [a]ny loss or abnormality of psychological, physiological, or anatomical structure or function. Id. at 897. In their legal senses, however, the distinction between the terms blurs. As used in connection with workers' compensation acts, disability is a composite of (1) actual incapacity to perform the tasks usually encountered in one's employment and the wage loss resulting therefrom ( i.e., impairment of earning capacity ), and (2) physical impairment of the body that may or may not be incapacitating. Black's Law Dictionary 461 (6th ed.1990) (emphases added). Thus, it is not surprising that, during the trial, the circuit court at times referred to Tabieros's impairment ratings as disability ratings. Moreover, the record suggests that both Dr. Smith and the plaintiffs' counsel employed the terms disability and impairment fungibly, as exemplified by the following exchange: [Plaintiffs' counsel:] Did you come to an opinion as to what the percentage of disability was for [Tabieros's] lower extremities based on standards and guidelines which you testified to a few minutes ago? [Dr. Smith:] Yes, I did. Q. And what is your opinion as to his disability in his lower extremities based on those guidelines? A. Combining both the right and the left, I came to the conclusion that he had 30 percent impairment of the lower extremities. Q. Does that translate to some impairment of the whole body? A. Yeah, it's twelve percent whole body or whole person. We use that term whole person. (Emphases added.) As we will demonstrate  given Tabieros's permanent partial disability rating , the usage by Dr. Smith, the plaintiffs, and the circuit court of the terms disability and impairment was neither unfairly prejudicial nor confusing. Under the Hawai`i Workers' Compensation Law, HRS ch. 386 (1993 & Supp. 1996), ` [d]isability' means loss or impairment of a physical or mental function, HRS § 386-1 (1993) (emphases added), thereby suggesting substantial synonymy between the terms. On the one hand, pursuant to HRS § 386-1, `[t]otal disability' means disability of such an extent that the disabled employee has no reasonable prospect of finding regular employment of any kind in the normal labor market. Thus, workers' compensation benefits for total disability  whether temporary or permanent  presuppose an impairment of a physical or mental function that results in a loss of earning capacity. Cuarisma v. Urban Painters, Ltd., 59 Haw. 409, 420-21, 583 P.2d 321, 326-27 (1978) ([T]emporary total disability benefits [are] compensation to replace current loss of wages.... [T]he award for permanent total disability is [also] regarded as compensation for loss of earning capacity[.] (Citation and internal quotation marks omitted.)); HRS §§ 386-31(a) and (b) (1993). [42] Moreover, employees who may have or have suffered permanent disability as a result of work injuries, and who are likely candidates therefor, are eligible for such physical and vocational rehabilitation services as are feasible. HRS § 386-25(b) (1993). The purposes of vocational rehabilitation are to restore an injured workers' earning capacity as nearly as possible to that level which the worker was earning at the time of injury and to return the injured worker to suitable work in the active labor force as quickly as possible in a cost-effective manner. HRS § 386-25(a) (1993) (emphasis added). On the other hand, partial disability is not expressly defined by the Hawai`i Workers' Compensation Law. However, as we recognized in Cuarisma, the relevant legislative history establishes that, consistent with the recodification of the Hawai`i worker's compensation statute recommended by Professor Stefan A. Riesenfeld, `[c]ompensation for permanent partial disability compensates the worker for loss of bodily integrity rather than for loss of earnings'; accordingly, `[p]ermanent partial disability compensation is an indemnity payment for the loss or impairment of a physical function and ... is not compensation to replace current loss of wages.' Cuarisma, 59 Haw. at 419-20, 583 P.2d at 326-27 (quoting 1963 L.R.B. Rep. No. 1, at 106, and Hse. Stand. Comm. Rep. No. 193, in 1969 House Journal, at 702) (emphasis added). Therefore, within the context of a permanent partial disability, the degree of impairment is important in determining workers' compensation for an injury even if it is unrelated to future working capacity. HRS § 386-32(a) (1993 & Supp.1996), governing workers' compensation for permanent partial disability, is illustrative of the foregoing principles; the statute provides in relevant part: In ... cases of permanent partial disability resulting from the loss or loss of use of a part of the body or from the impairment of any physical function, weekly benefits shall be paid at the rate and subject to the limitations specified in this subsection.... In cases in which the permanent partial disability must be rated as a percentage of the total loss or impairment of a physical or mental function of the whole person, the maximum compensation shall be computed on the basis of the corresponding percentage of the product of three hundred twelve times the effective maximum weekly benefit rate prescribed in section 386-31. (Emphases added.) In Cuarisma, we characterized HRS § 386-32(a) as incorporat[ing] a schedule of benefits for a specific list of injuries, which benefits consist of weekly sums computed as a percentage of the worker's average weekly wages and are to be paid for designated numbers of weeks regardless of earnings subsequent to the injury.  59 Haw. at 412, 583 P.2d at 323 (emphasis added). Thus, quoting with approval the Report of the National Commission on State Workmen's Compensation Laws (1972), we noted that, with respect to workers' compensation for permanent partial disability, there is no exact relationship between degree of impairment and the extent of wage loss. Some workers with only minor permanent impairments have substantial wage losses. The concert pianist who loses part of one finger is the classic example. Other workers may suffer serious impairments and experience only limited disability. A lawyer might, for example, lose an arm without permanent loss of earning capacity. Id. In tort, once liability is established, an injured plaintiff, such as Tabieros, is entitled to damages in compensation for his or her loss. [T]he general rule in measuring damages is to give a sum of money to the person wronged which as nearly as possible, will restore him [or her] to the position he [or she] would be in if the wrong had not been committed. Nobriga v. Raybestos-Manhattan, Inc., 67 Haw. 157, 162, 683 P.2d 389, 393, reconsideration denied, 67 Haw. 683, 744 P.2d 779 (1984) (quoting Rodrigues, 52 Haw. at 167, 472 P.2d at 517) (internal quotation marks omitted). Such compensatory damages include general damages, embracing items not subject to precise mathematical calculations, such as permanent injuries [and] pain and suffering. Franco, 47 Haw. at 424, 390 P.2d at 750 (citation and internal quotation marks omitted) (emphasis added). Correlatively, tort law recognizes that an injured plaintiff is entitled to compensatory damages where an injury is objective in nature and it is plainly apparent from the injury itself that the harm is permanent or that the injured person will necessarily undergo pain and suffering[.] Larsen, 74 Haw. at 44, 837 P.2d at 1295 (emphasis added). The extent to which Tabieros was permanently disabled or impaired by the accident was obviously relevant to his compensatory damage claim. In this connection, Clark does not contend on appeal, nor did it at trial, that Dr. Smith lacked the expert qualifications to render an opinion regarding the extent, if any, to which Tabieros suffered a permanent disability or impairment as a result of the accident involving the straddle carrier. [43] Moreover, the circuit court expressly ruled that Dr. Smith was qualified to render such an opinion and allowed all parties to explore the reliability of the impairment ratings that he assigned to Tabieros by questioning him regarding the foundation and methodology on the basis of which he arrived at his conclusions. In fact, Clark cross-examined Dr. Smith extensively regarding the bases for and method of calculating the impairment ratings. Our review of the record convinces us that the jury could not have been confused or Clark unfairly prejudiced concerning the significance, with respect to Tabieros's pain and suffering, of the impairment ratings following that cross-examination. We are likewise convinced that Dr. Smith's expert testimony was of the sort that would probably aid the trier of fact in arriving at the truth. Wallace, 80 Hawai`i at 419 n. 37, 910 P.2d at 732 n. 37 (citation and internal quotation marks omitted). Consequently, we hold that the circuit court did not abuse its discretion in permitting the testimony in question. See Samonte, 83 Hawai`i at 532-34, 928 P.2d at 26-28; Wallace, 80 Hawai`i at 406, 910 P.2d at 719; Maelega, 80 Hawai`i at 180, 907 P.2d at 766.