Opinion ID: 2350712
Heading Depth: 4
Heading Rank: 2

Heading: The ALJ must reevaluate the evidence in light of the substantial factor causation standard.

Text: Shea claims she met her burden of proving causation simply by demonstrating that employment aggravated her chronic pain. She argues that [t]he evidence before the ALJ proved that the demands of [her] work materially and substantially aggravated her condition. And she emphasizes the ALJ's statement that, It is clear from the testimony and the medical records that Ms. Shea's symptoms substantially worsened during the time that she was employed by the [S]tate. Although the ALJ found that Shea's pain worsened during the time she was employed by the State, it does not necessarily follow that her employment was the cause. Shea's pain may have worsened over this period for a variety of reasons, such as new or increased activities outside of her job or as the natural progression of her underlying condition. Shea's conclusion regarding causation does not follow from the mere fact that her condition worsened. The State argues that prolonged sitting was not a substantial factor because sitting at work was no more of an aggravating factor than any of the other activities of her everyday life. The ALJ found: Ms. Shea did not tell a doctor that sitting was triggering pain until 1999, and she mentioned sitting only intermittently after that until her claim for occupational disability benefits had been denied. If prolonged sitting at the office was a substantial factor in her chronic pain syndrome, it is reasonable to expect that Ms. Shea would have told at least one of her doctors that prolonged sitting was a trigger for her pain at some point prior to 1999 and would regularly have reported sitting as an aggravating factor after she began her extensive search for pain relief, before she quit working in 2001. The ALJ went on to conclude: [Shea] reported that her pain was made worse by sitting, standing, walking, and physical activity generally. Nothing in that recitation or in the medical records generated before she had to stop working suggests that prolonged sitting at the office was a particular source of pain in comparison to other factors. To the contrary, the medical records both preceding and following the date of disability indicate that many of the ordinary activities of everyday life were pain triggers, and that if sitting at work was an aggravating factor, it was no more or less so than anything else Ms. Shea was doing during the period of her employment. The ALJ's emphasis on the word substantial might suggest that he did not find sitting to be a substantial cause, or one to which reasonable people would attach responsibility. This is also suggested by the ALJ's conclusion that prolonged sitting was not of particular causal significance with respect to [Shea's] chronic pain syndrome. On the other hand, the ALJ's finding that prolonged sitting was no more or less [of a contributor] than anything else Ms. Shea was doing during the period of her employment implies that the ALJ thought Shea was required to show sitting was the substantial factor of her disabilitymeaning more of a contributor than her other daily activities. And the ALJ's conclusion that Dr. Smith's estimated five to ten percent contribution is not a substantial proportion of a whole could mean the ALJ ruled that five to ten percent is not substantial (i.e., reasonable persons would not regard the injury as a cause of the disability or attach responsibility to it), or it could mean the ALJ required sitting to be more than 51 percent of the total causation before awarding benefits (i.e., the substantial factor). In Alaska, a prolonged work-related factor could contribute to a person's disability in equal proportions to her other daily activities and still be considered a substantial factor; even a five to ten percent contribution could suffice if reasonable persons would regard the injury as a cause of the disability and attach responsibility to it. [41] Given the ALJ's findings, we must remand this case to the superior court with instructions to remand to the ALJ. The ALJ should reconsider his decision in light of the causation standard explained in this opinion and clarify whether Shea's prolonged sitting at work was a substantial factor in causing her disability. The ALJ may reevaluate the evidence or allow for supplemental evidence and hearings, as he deems necessary.