Court Opinion

ID: 9560179
Source: CourtListenerOpinion
Date Created: 2023-08-21 17:44:56.524598+00
Date Added: 2024-06-11T09:12:16.928161
License: Public Domain

RABINO WITZ, Chief Justice,
dissenting.
I dissent from the court’s holding that there is substantial evidence to support the decision of PERB that “Hester’s work conditions did not cause his Crohn’s disease to advance from a dormant to an acute state” and that “the very nature of [Crohn’s] disease was such that in its natural course it recurs with episodes of flare-up not necessarily or even probably attributable to stress.”8 At 476-477.
In the case at bar the majority affirms the denial by PERB of benefits to Hester on the basis of (1) the testimony of Dr. Cates; (2) the opinion of the DRB; (3) the testimony of Dr. Andrews; and (4) Dr. Citron’s acknowledgement that Crohn’s disease flare-ups can recur for reasons other than stress. Id. at 476.
Based on my review of the record, I conclude that the denial by PERB of benefits is not supported by substantial evidence. First, Dr. Cates’ testimony is less reliable than the testimony this court disregarded in Black v. Universal Servs., Inc., 627 P.2d 1073, 1076 (Alaska 1981).9 Dr. Cates is a general practitioner, who over the last 10 years hadn’t treated, or operated on anyone with Crohn’s disease. Furthermore, he never saw, treated, or examined Hester until the proceedings before the PERB were commenced. Dr. Cates acknowledged his lack of specialized expertise in the treatment of Crohn’s disease and his limited knowledge of the medical literature in the field. He admitted that stress plays some role in flare-ups. Finally, I think it significant to note that Dr. Cates’ testimony is contrary to the testimony of all of Hester’s treating physicians, who expressed the opinion that stress exacerbated Hester’s Crohn’s disease.
Second, I don’t believe that significant weight should be attached to the decision *478of the DRB. Dr. Cates was both a witness and the only member of the DRB who is a physician.
Third, the majority cites Dr. Andrews’ testimony for the proposition that “the stress of police work is not a causal link to Hester’s condition.’’ On the other hand, the record discloses that Dr. Andrews stated that stress exacerbated the disease.
The role of stress is controversial to this condition, but I believe that stress undoubtedly exacerbates its progression. Relief of the stressful situation makes management of the condition much more successful. I do not feel the stress of police work [sic] is a causal link to this condition.
(Emphasis added). Dr. Andrews’ finding that reducing Hester’s stress makes his condition more manageable indicates that work related stress exacerbated the disease.
Finally, the PERB relied on Dr. Citron’s acknowledgement that Crohn’s disease flare-ups can recur for reasons other than stress. It should be noted that Dr. Citron, a gastroenterologist, who has treated 800 to 1000 eases of Crohn’s disease, stated in part:
I don’t think there is a gastroenterologist that would not admit that there is an association between aggravation of the disease and stress situations.... I don’t think there is ... much doubt ... that there is a relationship between stress and exacerbation of the disease.
In brief, based on the testimony of Dr. Jones,10 Dr. Stevenson,11 Dr. Doolittle,12 and the testimony mentioned above, I conclude that the decision of the PERB denying Hester benefits lacks substantial evidence.

. In determining whether there is substantial evidence, a court "must take into account whatever in the record fairly detracts from its weight." Delaney v. Alaska Airlines, 693 P.2d 859, 863-64 n. 2 (Alaska 1985) overruled on other grounds 741 P.2d 634, 639 (Alaska 1987) (quoting Universal Camera Corp. v. NLRB, 340 U.S. 474, 71 S.Ct. 456, 95 L.Ed. 456 (1950)).

. In Black v. Universal Servs., Inc., this court reversed the denial of continuing compensation by the Workers Compensation Board despite the testimony of a doctor supporting the Board’s ruling. 627 P.2d 1073 (Alaska 1981). We reasoned that "Dr. Pennell [the doctor relied upon by the Board] had no opportunity to examine Black in any depth, and because his conclusions are contrary to those of the numerous physicians who treated her, we have concluded that a 'reasonable mind’ would not accept his diagnosis.” Id. at 1075-76 (footnote omitted). Dr. Pennell’s examination of Black lasted only twenty minutes. Id. at 1075 n. 9. Thus, in Black we concluded that “Dr. Pennell’s knowledge of the case is so slight as to make his report worthless. After reviewing the record, we are unable to accept Dr. Pennell's report as 'substantial evidence’ in support of the Board's conclusion_” Id. at 1075.

. In his physician's statement, Dr. Jones states that Hester's condition was "aggravated by emotional stress.”

. In his physician’s statement, Dr. Stevenson writes in part that Hester's disease was “exacerbated by stress."

. Throughout his extensive testimony before the PERB, Dr. Doolittle, Hester’s primary treating physician, related exacerbation of Hester’s Crohn’s disease to work connected stress.