Court Opinion

ID: 9569921
Source: CourtListenerOpinion
Date Created: 2023-08-21 20:18:33.782921+00
Date Added: 2024-06-11T12:04:17.119313
License: Public Domain

MOORE, Justice,
dissenting.
Today the court holds that the presumption provided in AS 23.30.120(a)(1) that shifts the burden of producing evidence of work-relatedness from an injured employee to his employer shifts the burden of persuasion on the ultimate question whether a claim should be paid. The court thus requires AWCB “to presume that [an] injured employee has a continuing, medically indicated need” for whatever treatment he might request more than two years after his injury. Majority op. at 664. Because AS 23.30.120(a)(1) is inapplicable to the question of compensability of continuing treatment, and the court today upsets the carefully engineered statutory scheme governing continuing treatment provided in AS 23.30.095, I respectfully dissent.1
I agree that the “process of recovery” language of AS 23.30.095(a) does not deny AWCB the power to authorize continued treatment or care, including purely palliative care, providing that it is indicated medically. Although AWCB appears to have believed that it was so constrained, its decision in this case clearly indicates that it also believed that the continued treatment requested by Carter was not indicated medically. That conclusion is reasonable. Because I believe AWCB was correct not to presume that Carter’s proposed treatment was indicated medically and that AWCB reasonably found that the treatment was not medically indicated, I would reverse the decision of the superior court and uphold AWCB’s decision.
AS 23.30.120(a) provides that “[i]n a proceeding for the enforcement of a claim for compensation under this chapter it is presumed, in the absence of substantial evidence to the contrary, that (1) the claim comes within the provisions of this chapter.” This presumption relieves the employee from his initial burden of production of evidence that his injury is work-related. Anchorage Roofing Co. v. Gonzales, 507 P.2d 501, 504 (Alaska 1973). For many years, we have referred to this as “the presumption of compensability.” See 507 P.2d at 503. While this name is convenient, the court errs in applying the name but not the statute.
The court ignores the statute by beginning its analysis with the assumption that the name “presumption of compensability” *668refers to a presumption that a claim for compensation should be paid. Thus presuming that a particular injury is work-related and therefore is merely “[t]he most typical application of the presumption.... ” Supra p. 664 n. 9. The court continues by casually observing that “[t]he text of AS 23.30.120(a) indicates that the presumption of compensability is applicable to all claims coming within the provisions of the Act.” Supra p. 665. In fact, the text indicates only that there is a presumption that all claims come within the provisions of the Act. Relying on this erroneous premise, the court concludes that since there is nothing inconsistent with applying the court’s presumption that all claims should be paid for continuing care, the presumption should be so applied. Supra p. 665. However, this result is absurd. AS 23.30.120(a) is facially inapplicable to claims for continuing care where, as here, there is no doubt that the Act applies.
The presumption of compensability, as understood until today, serves an important purpose, namely, to aid the employee who, while able to show she was disabled while physically present at work, is unable to demonstrate conclusively the cause of her injury.2 That purpose is irrelevant to the court’s holding today. The court instead seems to be motivated by a more general purpose of facilitating recovery by workers. The legislature has expressly disapproved of constructions of the Workers’ Compensation Act favoring workers over employers: “The legislature declares that the workers’ compensation law must not be construed by the courts in favor of any party. It is the specific intent of the legislature that workers’ compensation cases be decided on their merits except when otherwise provided by statute.” Ch. 79, § 1(b), SLA 1988. Today’s decision is exactly the type of decision that provoked this extraordinary declaration of legislative intent.
The court radically transforms the operation of the presumption of compensability. The language of AS 23.30.120 is borrowed from a New York statute. There, the presumption “cannot be used as a substitute for actual proof_ In truth, the presumption has no place in any case once the facts are fully developed; of necessity it fails in the presence of contrary evidence.’’ Wilson v. General Motors Corp., 298 N.Y. 468, 84 N.E.2d 781, 783 (1949). Until today, Alaska had the same rule: “the presumption of AS 23.30.120 places a burden on the employer to go forward with evidence .... Once competent evidence is introduced, the presumption drops put, and the final burden of proof ... as to all essential elements is on the claimant.” Anchorage Roofing, 507 P.2d at 504.
In this case, there was no shortage of evidence on whether Carter’s proposed treatment was indicated medically. In fact, medical experts were in substantial agreement that limited use of a hot tub might have some palliative effect, although greater use would be detrimental to Carter’s condition. Because the record contains substantial evidence, the presumption, if it is applicable at all, should “drop out.” I reject the court’s holding that the presumption should somehow apply even when there is substantial evidence in the record to support the Board’s decision.
The court’s holding today is also a direct assault on the compromise between workers’ and employers’ interests reflected in AS 23.30.095. That section creates a scheme under which employers are required to provide medical care for covered injuries for a period of two years. After two years, AWCB “may authorize continued treatment,” provided it is indicated medically, upon petition of the injured employee. The court turns this scheme on its head, requiring AWCB to presume that any continuing care requested by an employee is indicated medically and to order the employer to pay for it unless the employer can prove that the requested treatment is not indicated. I cannot agree with this interpretation.
I do, however, agree with the court’s discussion of the “process of recovery” lan*669guage in AS 23.30.095. Because denying AWCB the authority to authorize purely palliative care could lead to particularly harsh results in some cases, it is difficult to believe that the legislature intended “process of recovery” to be read so narrowly. Its inclusion in AS 23.30.095 of provisions for both “care” and “treatment” supports this interpretation. Like the court, I believe that AWCB has the discretion to authorize medically indicated continuing care or treatment, including purely palliative care.3 However, if the presumption of compensability is inapplicable, it is unnecessary to reach this question. I would, therefore, reverse the decision of the superior court and uphold AWCB’s decision.

. At the outset I think it necessary to state an assumption on which my dissent rests. I assume that when the court says that it will apply the presumption of compensability to whether continued treatment or care is indicated, it means whether such care is needed. I regret that unnecessary ambiguity in the court’s opinion dictates that I proceed on the basis of this assumption. If the court indeed means indicated, then I agree with the observations of my dissenting colleague on this issue.

. See Larson & Lewis, The Alaska Workers’ Compensation Law: Fact-Finding, Appellate Review, and the Presumption of Compensability, 2 Alaska L.Rev. 1, 11 (1985).

. It might not be an abuse of AWCB’s discretion invariably to refuse to authorize purely palliative care, but that question is best left for another day.