Opinion ID: 2585250
Heading Depth: 2
Heading Rank: 3

Heading: The ICA failed to apply the proper standard of review and to give due deference to the Board's expertise in weighing the credibility of the evidence.

Text: In order to overcome the HRS § 386-85(1) presumption of work-relatedness, the employer must introduce substantial evidence to the contrary. The term `substantial evidence' signifies a high quantum of evidence which, at the minimum, must be `relevant and credible evidence of a quality and quantity sufficient to justify a conclusion by a reasonable man that an injury or death is not work connected.' Korsak, 94 Hawai`i at 307-08, 12 P.3d at 1248-49 (quoting Chung, 63 Haw. at 650, 636 P.2d at 726). The ICA's opinion did not address whether Employer adduced substantial evidence to overcome the presumption of compensability. Rather, the ICA held that the Board erred in reversing Claimant's PPD award because, under Chung, 63 Haw. at 652, 636 P.2d at 727, the conflict between Claimant's and Employer's medical evidence must, as a matter of law, be resolved in Claimant's favor. ICA's opinion at 30-31. We hold that the ICA erred insofar as it failed to apply the proper standard of review, and we now address Employer's argument that it adduced substantial credible evidence that Claimant did not suffer any permanent impairment as a result of the 1991 work accident. The Board relied upon the medical opinions of Drs. Nicholson and Bergmanis in concluding that Claimant was not permanently physically impaired as a result of his 1991 work injury and the opinion of Dr. Bussey in concluding that he was not permanently psychologically impaired as a result of the work injury. In his December 4, 1993 report, Dr. Nicholson stated that there was no basis to relate any aggravation of the right frontal lobe lesion to the accident of October 3, 1991. In a February 25, 1996 report, Dr. Nicholson opined that Claimant's headaches had a psychological or nonorganic basis, based in part on the fact that the headaches persisted despite surgical removal of the cyst. He also emphasized that, although Claimant reported neck and back symptoms, none of the medical reports shortly after his injury reflected these symptoms. Dr. Nicholson stated that he, Dr. Bergmanis, and Robert Anderson, Ph.D., a neuropsychologist, agreed that the 1991 work injury was a minor injury and that Claimant had not suffered a ratable impairment as a result of the work injury. Further, he stated that the rating of Thomas Sakoda, M.D., was completely inconsistent with the injury. Dr. Nicholson noted probable malingering and stated that [a] 1 lb. pot falling 1.5 feet would certainly not produce a significant injury. In fact, he opined that it was completely irrational to be treating [Claimant] for his multitude of complaints on the basis of the minor injury that he sustained. In an April 22, 1994 report, Dr. Bergmanis opined that Claimant suffered a mild, rather non-specific, head injury in the work-related incident of 10/3/91. Although he acknowledged that even minor scalp injuries can lead to post-traumatic headaches[,] he opined that Claimant's headaches were greatly aggravated by pre-existing current psychological and stress factors . . . . He also stated that the cyst on Claimant's right frontal lobe was compatible with old trauma, was probably associated with the 1975 injury, and did not show evidence of recent hemorrhaging. Further, in his opinion, bleeding was far more likely to be caused by a major head injury than by a minor one. Dr. Bussey ultimately concluded that Claimant did not have any psychiatric impairment as a result of the work injury. He characterized Claimant's psychiatric impairment as mild and opined that it was related to his underlying organic personality disorder related to his 1975 injury. The ICA also cited the reports of Mark Stitham, M.D., and Dr. Anderson. ICA's opinion at 26-27. Dr. Stitham's September 19, 1993 report indicated that he did not anticipate that Claimant would suffer any permanent impairment as a result of the work injury. He diagnosed Claimant as exhibiting an [a]djustment disorder with mixed emotional features secondary to protracted legal battle; care of ill mother; and difficulty accepting return to work and noted probable symptom exaggeration. Dr. Anderson also noted that Claimant's personality profile indicated that he might be presenting an exaggerated picture of his present situation. He opined that it was unlikely that the accident had caused a brain injury because the pot weighed only one pound and fell only approximately one-and-one-half feet. All of the doctors relied upon by Employer both examined Claimant and reviewed his medical records. Further, Drs. Nicholson, Bergmanis, and Bussey all directly addressed the issue before the Board, i.e., whether Claimant had suffered any permanent impairment that was related to the 1991 work injury, as compared to other factors, and did not give only generalized medical opinions. Compare Korsak, 94 Hawai`i at 308, 12 P.3d at 1249 (doctors' reports only gave generalized medical opinions and did not address whether the claimant's physical therapy session aggravated his back condition). We hold that Employer adduced relevant and credible evidence of a quality and quantity sufficient for a reasonable person to conclude that Claimant's permanent partial disability was not work-related. However, Dr. Sakoda's report indicated that he diagnosed Claimant as suffering from an arteriovenous (AV) malformation that preexisted the work injury and stated that the cyst was associated with the malformation. [3] According to Dr. Sakoda, the results certainly indicate that the AV malformation was somehow aggravated by the trauma and there most likely ... was some bleeding into the cyst at that time. This did cause some problems mentally and symptomatically. Postoperatively, he is much improved and this certainly supports the diagnosis of Dr. Hosobuchi. Dr. Sakoda also opined that Claimant suffered a hyperextension injury to his neck when struck by the large pot and noted that another doctor had diagnosed a cervical spine strain. [4] Dr. Sakoda opined that Claimant had suffered an eleven percent impairment of the whole person as a result of his head injury and a twelve percent impairment of the whole person as a result of the neck injury. Dr. Sakoda did not apportion Claimant's impairment between the work injury and the 1975 injury. Shepard Ginandes, M.D., a psychiatrist, opined that Claimant had suffered a thirty-five percent psychiatric impairment of the whole person, five percent of which was attributable to the 1975 injury and thirty percent of which was attributable to the work injury. Dr. Ginandes did not observe evidence of malingering or conscious exaggeration of symptoms. The ICA also cited the June 28, 1992 report of James Pierce, M.D., a neurologist, who opined that Claimant's headaches were not related to his 1975 injury. Although he noted that Claimant's records showed that he suffered headaches before the work injury, they took a rather dramatic change since his accident of October.... [T]he accident combined with the associated stressors are responsible for the majority of his headache problems now. Drs. Sakoda, Ginandes, and Pierce reported that they had each examined Claimant and reviewed his medical records. [5] Drs. Sakoda and Ginandes specifically addressed the question whether Claimant suffered permanent impairment as a result of the work injury and did not merely present general medical opinions. However, as noted supra, Dr. Sakoda did not address whether any of his impairment ratings were attributable to the 1975 injury. Once the trier of fact determines that the employer has adduced substantial evidence to overcome the presumption, it must weigh the evidence elicited by the employer against the evidence elicited by the claimant. Acoustic, 51 Haw. at 317, 459 P.2d at 544. In the present case, the Board did not expressly address whether Employer had successfully adduced substantial evidence to overcome the presumption of compensability. However, the Board found, based on the opinions of Drs. Nicholson and Bergmanis, that Claimant did not sustain any permanent physical impairment as a result of the October 3, 1991 work accident and expressly rejected Dr. Sakoda's opinion on this issue. The Board also found, based on the opinion of Dr. Bussey, that Claimant did not sustain any permanent psychological impairment as result of the accident and expressly rejected the opinion of Dr. Ginandes. The Board clearly found Employer's medical evidence to be substantial and more credible than Claimant's medical evidence. [6] It is well established that courts decline to consider the weight of the evidence to ascertain whether it weighs in favor of the administrative findings, or to review the agency's findings of fact by passing upon the credibility of witnesses or conflicts in testimony, especially the findings of an expert agency dealing with a specialized field. In re Application of Hawaiian Elec. Co., Inc., 81 Hawai`i 459, 465, 918 P.2d 561, 567 (1996) (quoting In re Application of Hawai`i Electric Light Co., 60 Haw. 625, 629, 594 P.2d 612, 617 (1979)). Therefore, we will not pass upon the doctors' relative credibility. [7] Giving due deference to the Board's expertise in this area, we hold that there are no grounds upon which to reverse the Board's ruling that Claimant did not sustain any permanent impairment as a result of a work-related injury. Because we hold that the ICA erred in reversing the Board's denial of PPD benefits, we do not reach Employer's remaining argument that the ICA improperly reversed certain Board findings that were not at issue on appeal. [8]