Opinion ID: 2264572
Heading Depth: 2
Heading Rank: 2

Heading: The Examiner's Findings

Text: The Hospital next argues that the examiner's finding of a causal relationship between the work-related lifting incident and Ms. Callier's disability was not supported by substantial evidence, and that the Director therefore erred in not reversing the compensation order. Although, for reasons discussed hereafter in part III, we remand this case for reconsideration by the Director, we cannot agree with the Hospital's contention that the Director should have reversed the hearing examiner's decision on this ground. Notwithstanding the statutory presumption of compensability, the burden ultimately falls on the claimant to show by a preponderance of the evidence that his or her disability was caused by a work-related injury. See, e.g., Stewart v. District of Columbia Dep't of Employment Services, 606 A.2d 1350, 1351 (D.C.1992). Thus the presumption may be rebutted if the employer proves by substantial evidence that the disability did not arise out of and in the course of employment. Baker, 611 A.2d at 550; see also Ferreira v. District of Columbia Dep't of Employment Services, 667 A.2d 310, 312-313 (D.C. 1995) ( Ferreira II ). The evidence offered in rebuttal must be specific and comprehensive enough to sever the potential connection between the disability and the work-related event. Ferreira I, 531 A.2d at 655 (quoting Swinton v. J. Frank Kelly, Inc., 180 U.S.App.D.C. 216, 224, 554 F.2d 1075, 1083, cert. denied, 429 U.S. 820, 97 S.Ct. 67, 50 L.Ed.2d 81 (1976)); accord, e.g., Parodi, 560 A.2d at 526. The only evidence offered by the Hospital to rebut the presumption of compensability was the testimony of Dr. Sewell, who maintained that Ms. Callier's condition was aggravated gradually, over an extended period of time, and that her disability was not attributable to a single incident. According to Dr. Sewell, if Ms. Callier's condition had been aggravated by the lifting episode on May 13, the lifting would have caused a traumatic tearing of the surrounding tissues, whereas aggravation resulting from repetitive lifting over time would be manifested by a gradual stretching and loosening of those tissues. From his review of the medical records, Dr. Sewell concluded that no tissue tearing had occurred. On cross-examination, Dr. Sewell was questioned extensively about the possibility that Ms. Callier's condition might have been slowly aggravated over an extended period of time, but did not progress to the point of requiring surgery until it was further aggravated on May 13 when she lifted an extremely heavy patient, straining her back and causing something to drop in her lower abdomen. In a contentious exchange, Dr. Sewell steadfastly refused to make this concession. Paradoxically, however, he did acknowledge that Ms. Callier's condition would have been aggravated by heavy lifting, and that at some point during this gradual process her symptoms would become so severe that she would seek medical attention. The doctor tenaciously clung to his opinion that the May 13 lifting incident was not the point at which this happened, but he was unable to offer any explanation for that opinion. Although the compensation order is not as clear as one might wish, the examiner apparentlyand permissiblyaccepted the greater part of Dr. Sewell's testimony, but rejected his ultimate conclusion. Given the logical inconsistencies in Dr. Sewell's opinion, we cannot say that this decision was erroneous. Contrary to Dr. Sewell's belief (and the Hospital's contention), the success of Ms. Callier's claim was not dependent on the existence or non-existence of evidence of torn tissue, [9] which would indicate a single traumatic event. As the examiner implicitly recognized, the theory advanced by Ms. Callier was entirely consistent with Dr. Sewell's testimony. Her claim was that her pre-existing condition was gradually aggravated over the nine-year period during which she worked for the Hospital until it finally reached the point of requiring surgery. Dr. Sewell testified that Ms. Callier's work-related lifting activities, not just the incident on May 13 but her other duties as well, would have gradually aggravated her condition until it eventually reached some point at which she would need surgery. Since the doctor admitted that he had no basis for comparing the severity of Ms. Callier's condition before and after the lifting incident, the examiner could reasonably conclude that the doctor's opinion that the lifting was not the cause of her disability was ultimately based on nothing more than speculation. There was no reason for the examiner to be bound by the doctor's puzzling refusal to acknowledge the logical conclusion of his own testimony. Additionally, we hold that the Hospital's challenge to the examiner's finding of a causal relationship between the lifting incident and the inguinal hernia is without merit. As the examiner recognized, there was no evidence that Ms. Callier had an inguinal hernia before May 13, 1990, and the strain experienced by Ms. Callier on that date certainly had the potential of causing such a hernia. Thus the statutory presumption of compensability was properly triggered, and the Hospital failed to rebut it. See Parodi, 560 A.2d at 525-526 (evidence was sufficient to establish the work-relatedness of employee's hernia discovered six months after a lifting incident at work). In order to defeat Ms. Callier's claim, the Hospital would have had to show that Ms. Callier's present condition was solely the natural result of her pre-existing condition, or of other causes unrelated to her employment. Davis-Dodson, 697 A.2d at 1219 (claimant's pre-existing degenerative lumbar disc disease aggravated by prolonged sitting at desk); cf. Ferreira II, 667 A.2d at 311 (compensation denied upon finding that claimant's condition had been steadily deteriorating for four years prior to the commencement of employment, and six years prior to the alleged traumatic incident).