Court Opinion

ID: 9439936
Source: CourtListenerOpinion
Date Created: 2023-08-03 07:00:49.028303+00
Date Added: 2024-06-11T17:26:49.263748
License: Public Domain

LYNCH, Circuit Judge,
dissenting.
The record in this ease sets forth substantial evidence to support the Board’s finding that the employer, which had rebutted the § 920(a) presumption that asbestos exposure caused claimant’s lung cancer, did not rebut the § 920(a) presumption that asbestos exposure contributed to claimant’s lung cancer. I would affirm the Board.
The employer’s evidence all went to initial causation with one exception. That exception was the testimony of its lead expert, Dr. Cadman, and it tended to support claimant on the contribution issue. In testimony introduced at the hearing, Dr. Cadman was invited and refused to testify that he could say to a reasonable medical probability that asbestos had not contributed to Harford’s cancer. Rather; Dr. Cadman testified that 10-15% of people with occupational exposure to asbestos who develop lung cancer do not experience fibrosis in the lungs. He specifically stated (after a direct question on whether asbestos could have contributed to Har-ford’s cancer) that asbestos exposure “may be contributing,” even in the absence of asbestos-caused fibrosis, “although at a very small level, because he does not have fibrosis.”
There is a crucial difference, acknowledged in our case law, between employment-related injuries that are the primary cause of a disability and those which aggravate or contribute to a pre-existing condition. See Director, O.W.C.P. v. Bath Iron Works Corp., 129 F.3d 45, 50 (1st Cir.1997); Bath Iron Works Corp. v. Director, O.W.C.P., 109 F.3d 53, 55 (1st Cir.1997). Under the “aggravation rule,” even a small contribution by a work-related condition to the claimant’s disability is sufficient to trigger full recovery under the LHWCA; primary causation need not be shown. See Hensley v. Washington Metro. Area Transit Auth., 655 F.2d 264, 268 (D.C.Cir.1981). The aggravation rule embodies the essentially humanitarian purposes of the LHWCA. It assures that a claimant is compensated where employment-related injury is not the sole cause of the claimant’s disability. Here, Dr. Cadman testified that the absence of asbestos-caused fibrosis is not sufficient evidence to support the conclusion that asbestos exposure did not contribute to Harford’s cancer. BIW therefore did not rebut the presumption that asbestos exposure contributed to Harford’s lung cancer. The absence of fibrosis proves nothing on the contribution issue.
The ALJ erroneously conflated the primary causation and contribution analyses and incorrectly concluded that where there was no primary causation there was no contribution, either. The Board, performing these analyses separately, recognized the significance of Dr. Cadman’s testimony as to contribution. Because Dr. Cadman expressly stated that asbestos exposure could have contributed to the cancer in the absence of *677fibrosis, the Board correctly reversed. In light of the purposes of the Act, manifested by the § 920(a) presumption, and the precedent that close questions should be decided in favor of the claimant, see Bath Iron Works Corp. v. White, 584 F.2d 569, 574 (1st Cir.1978), I respectfully dissent.