Opinion ID: 2327204
Heading Depth: 2
Heading Rank: 4

Heading: The WCA's Presumption of Compensability

Text: The WCA expressly establishes a presumption of compensability: In any proceeding for the enforcement of a claim for compensation under this chapter it shall be presumed, in the absence of evidence to the contrary: (1) That the claim comes within the provisions of this chapter; (2) That sufficient notice of such claim has been given; (3) That the injury was not occasioned solely by the intoxication of the employee and (4) That the injury was not occasioned by the willful intention of the injured employee to injure or kill himself or another. D.C.Code § 32-1521(1)-(4) (2001). The purpose of this section is to `advance the humanitarian goal of the statute and to provide compensation to employees for work-related disabilities reasonably expeditiously, even in arguable cases.' Mexicano v. District of Columbia Dep't of Employment Servs., 806 A.2d 198, 204 (D.C. 2002) (quoting Brown v. District of Columbia Dep't of Employment Servs., 700 A.2d 787, 791 (D.C.1997)). Thus, doubts about law or facts are generally to be resolved in the employee's favor. Safeway Stores, Inc. v. District of Columbia Dep't of Employment Servs., 832 A.2d 1267, 1271 (2003) (citations omitted). The case law interpreting § 32-1521(1), that is, the presumption that a claim comes within the WCA, however, makes clear that the provision was designed to establish a causal presumption between the claimant's injury and employment. [5] The presumption then operates to shift the burden to the employer to disprove the connection between the worker's injury and employment: To benefit from the statutory presumption, the employee need only show some evidence of a disability and a work-related event or activity which has the potential of resulting in or contributing to the disability. Such a showing effectuates the presumption, which operates to establish a causal connection between the disability and the work-related event, activity, or requirement, and shifts the burden of production to the employer to produce substantial evidence demonstrating that the disability did not arise out of and in the course of employment. The statutory presumption may be dispelled by circumstantial evidence specific and comprehensive enough to sever the potential connection between a particular injury and a job-related event. Mexicano, supra, 806 A.2d. at 204 (internal quotation marks and citations omitted). Should the employer succeed in dispelling the statutory presumption, the burden then shifts back to the claimant to show, by a preponderance of evidence, that the injury was in fact causally related to the petitioner's work. Washington Metro. Area Transit Auth. v. District of Columbia Dep't of Employment Servs., 827 A.2d 35, 40 (D.C.2003). Petitioner cites Brown v. District of Columbia Dep't of Employment Servs., 700 A.2d 787 (D.C.1997), as extend[ing] this presumption to questions of jurisdiction, but he misapprehends Brown's holding. Brown was a bus driver who injured his back three specific times during the course of his employment. Brown, supra, 700 A.2d at 789-90. The first two injuries occurred in the District; the last one in Virginia. Id. at 794. Following the third injury, Brown applied for workers' compensation in the District and was denied benefits on jurisdictional grounds. Id. at 789-90. The hearing examiner and the Director of DOES found that Brown had recovered completely from the first injury, that the injury that resulted in his seeking compensation was unrelated to that first injury, and that because the third injury occurred in Virginia, it was outside the jurisdiction of DOES. Id. at 790-91. Noting that a subsequent injury, whether an aggravation of the original injury or a new and distinct injury, is compensable if it is the direct and natural result of a compensable primary injury, id. at 792 (internal quotation marks omitted), this court held that DOES had failed adequately to consider the earlier injuries as aggravating factors with respect to the third injury and reversed the decision. The court emphasized that an employment injury need have ar[isen] only in part from the employment to be compensable under the District's statute. Id. at 792. The court added: In this case, because of the jurisdictional problem, that would mean that Brown would have to show that the injury occurred, in part, during the course of his employment in the District. In determining whether the injury arose in part out of, and in the course of, his employment as a bus driver in the District, the agency was required to apply the presumption of compensability. Id. Thus, Brown reversed the DOES decision denying benefits because of its failure to apply the presumption to the issue of causality. It concluded that the misapplication of the presumption on the issue of causality had led to what the court concluded was an erroneous finding of no jurisdiction, and ruled that it must overturn the jurisdictional determination. Id. at 794. Contrary to petitioner's argument, Brown did not apply the presumption to the issue of jurisdiction, but rather to the issue of compensability. Significantly, King, supra, 742 A.2d at 460, in its extensive discussion of the precedents dealing with time of injury in aggravation and cumulative trauma cases, does not once mention Brown, although the latter case was decided two years earlier. This makes sense, as the connection between one disabling injury and another is a wholly different inquiry than identifying the moment in time when an innumerable series of minor insults  none an injurious occasion in itself  finally add up to a compensable injury.