Akamine v. Hawaiian Packing & Crating Co.

• Decision Date: 07 April 1972
• Docket Number: No. 5096,5096
• Citation: 53 Haw. 406,495 P.2d 1164
• Parties: , 53 Haw. 592 Dependents of Edward K. AKAMINE, Deceased, Claimants-Appellants, v. HAWAIIAN PACKING AND CRATING CO., LTD., Employer-Appellee, and Theo H. Davies and Company, Ltd., Insurance Carrier-Appellee.
• Court: Hawaii Supreme Court

Page 1164

495 P.2d 1164

53 Haw. 406, 53 Haw. 592

Dependents of Edward K. AKAMINE, Deceased, Claimants-Appellants, v.HAWAIIAN PACKING AND CRATING CO., LTD., Employer-Appellee and Theo H. Davies and Company, Ltd., InsuranceCarrier-Appellee.

No. 5096.

Supreme Court of Hawai'i.

April 7, 1972.

Rehearing Denied July 28, 1972.

Syllabus by the Court

1.The presumption that a claim for compensation is for a work-connected injury may be rebutted only by substantial evidence that it is unrelated to the employment activity.

2.The presumption imposes upon the employer the burden of going forward with the evidence and the burden of persuasion.

3.If the employer fails to adduce substantial evidence to the contrary, the presumption mandates that the claimant must prevail.

4.Because of the relatively higher degree of uncertainty surrounding causation of heart diseases, the strength of the presumption is especially formidable.

5.Medical testimony that heart diseases originate relatively early in one's life, that the deceased's pre-existing pathological condition must have spurred the attack, and that work activity which is not 'extremely exertional' will not precipitate a heart attack, does not constitute substantial evidence to overcome the presumption.

6.Medical testimony that the deceased's heart attack could have occurred elsewhere or while sleeping in bed, is legally irrelevant in determining the question of work-connection.

7.Medical testimony by the deceased's examining physician expressing pervading doubt as to the cause of the deceased's death represents a salient index of the absence of substantial evidence necessary to overcome the presumption.

James A. King, Honolulu (Bouslog & Symonds, Honolulu, of counsel) for appellants.

Donald A. Beck, Honolulu (Cades, Schutte, Fleming & Wright, Honolulu, of counsel), for appellees.

Before RICHARDSON, C. J., and MARUMOTO, ABE, LEVINSON and KOBAYASHI, JJ.

RICHARDSON, Chief Justice.

On January 19, 1968, Edward K. Akamine reported for work at his place of employment, Hawaiian Packing and Crating Company.He was working the 4:00 p. m. to 12:30 a. m. shift.His duties that evening consisted of unloading, stacking and handtrucking fifteen to twenty pounds of cargo from container trucks to bays approximately fifty feet away.About 9:30 or 10:00 p. m., Mr. Akamine collapsed while pushing a loaded handtruck.Upon collapsing, he grasped one of his thighs and was unable to respond to inquiries made by one of his co-workers.He was taken by ambulance to Queen's Medical Center where he was pronounced dead on arrival.No autopsy was performed and Dr. H. Uchiyama, who signed the death certificate, attributed the death to acute coronary insufficiency.

Mr. Akamine's dependents filed a claim for workmen's compensation which was denied by the Labor and Industrial Relations Appeals Board.The Board reasoned that Mr. Akamine's death was due to his cardiovascular disease of long standing and that it was not attributable to his employment with Hawaiian Packing and Crating Company.

Mr. Akamine's dependents, the claimants-Appellants, appellants, appealed the Board's decision by direct appeal to this court, pursuant to HRS § 386-88 (Supp.1971).¹

The major issue in this case is whether the employer- appellee, Hawaiian Packing and Crating Company, and its insurance carrier, Theo H. Davies and Company, adduced substantial evidence to overcome the presumption in HRS § 386-85(1)² that a causal connection in fact exists between the injury or death and the employment activity.Review of the record convinces us that appellees failed to adduce substantial evidence to rebut the presumption and thereby dictates that the claimants-appellants must prevail.

The viability of the subject statutory presumption has been firmly established and its meaning clearly articulated by this court.Highly instructive also are the interpretations given by the federal courts to the presumption in the Longshoremen's and Harbor Workers' Compensation Act,33 U.S.C.A. § 920(a)(1970), whose language is almost identical to that in the presumption in the Hawaii statute.

The presumption is not a mere procedural device that disappears upon the introduction of contrary evidence.Corden v. Paschoal's Limited, 52 Haw. 242, 244, 473 P.2d 561(1970).It imposes upon the employer the burden of going forward with the evidence and the burden of persuasion.It may be rebutted only by substantial evidence that it is unrelated to the employment.Hancock v. Einbinder, 114 U.S.App.D.C. 67, 310 F.2d 872, 876(1962);Robinson v. Bradshaw, 92 U.S.App.D.C. 216, 206 F.2d 435, 438(1953).Substantial evidence is 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.Accoustic, Insulation and Drywall, Inc. v. Labor & Industrial Relations App. Bd., 51 Haw. 312, 316, 459 P.2d 541(1969).See alsoS & W Crane Service, Inc. v. Dependents of Berard, 53 Haw. 161, 489 P.2d 419(1971);Royal State Nat'l Ins. Co. v. Labor & Industrial Relations App. Bd., 53 Haw. 32, 38, 487 P.2d 278(1971).The presumption is further strengthened by a finding that the death or injury occurred in the course of employment.Robinson v. Bradshaw, supra, 206 F.2d at 439.If the employer fails to adduce substantial evidence to the contrary, the presumption mandates that the claimant must prevail.Acoustic, Insulation and Drywall, Inc. v. Labor & Industrial Relations App. Bd., supra51 Haw. at 316, 459 P.2d 541.

The legislature indeed has cast a heavy burden on the employer in workmen's compensation cases.In its wisdom in formulating public policy in this area of the law, the legislature has decided that work injuries are among the costs of production which industry is required to bear; and if there is reasonable doubt as to whether an injury is work-connected, the humanitarian nature of the statute demands that doubt be resolved in favor of the claimant.

Operation of the statutory presumption is crucial in cardiac cases where the causes of heart disease are not readily identifiable.'The presumption has been of substantial aid to claimants in obtaining awards in cardiac cases by enabling them to connect up a death involving some from of cardiac disorder with the work.On the other hand, dependents of workmen who have died on the job of an unwitnessed attack have frequently failed to recover compensation where no such presumption was operative.'McNiece, Heart Disease and the Law 22 (1961).Because of the relatively higher degree of uncertainty surrounding causation of heart diseases, the strength of the presumption is especially formidable.The court in Wheatley v. Adler, 132 U.S. App.D.C. 177, 407 F.2d 307, 313(1968) pointedly stated:

Rebutting evidence may be hard to develop, given the limits of medical ability to reconstruct why 'something unexpectedly goes wrong within the human frame.'But that is precisely why the presumption was inserted by Congress.It signals and reflects a strong legislative policy favoring awards in arguable cases.

As noted earlier, the presumption may be overcome only by substantial evidence to the contrary.To be substantial, the evidence, as a minimum requirement, must be credible and relevant.The Board indicated in its Decision and Order that medical testimony by two expert witnesses produced the requisite substantial evidence.However, a study of the record reveals that certain portions of the testimony of the two expert witnesses on cardiac diseases were irrelevant or entitled to very little probative weight.The net weight of the medical testimony did not amount to substantial evidence.

That the testimony of one of the medical witnesses is entitled to very little probative weight issues from the problem involving the distinction which must be made between etiology of heart disease and legal causation.Elucidation on etiology of heart disease is sought from medical experts.The meaning and boundaries of legal causation are established by the legislature and courts; and finding legal causation in a given case is the function of the Board and not that of medical witnesses.To allow a medical expert to give his opinion as to whether legal causation existed in a particular case could lead to an unjust result.For 'a medical man may give a generalized opinion that there was no connection between an incident at work and a heart attack, and, in his own mind, may mean thereby that a pre-existing pathological condition was the overwhelming factor in bringing about the attack and that the part played by the work was insignificant.But, while it may be sound medically to say that the work did not 'cause' the attack, it may be bad law, because, an general, existing law treats the slightest factor of aggravation as an adequate 'cause'.'McNiece, Heart Disease and the Law 135 (1961).See alsoSmall, Gaffing at a Thing Called Cause: Medico-Legal Conflicts in the Concept of Causation, 31 TexasL.Rev. 630(1953).In the instant case Dr. Berk, one of the medical experts, in his unequivocal testimony that there was no connection between Mr. Akamine's death and his employment, relied heavily on his belief that heart diseases originate relatively early in one's life ³ and Mr. Akamine's pre-existing pathological condition was the sole cause of death.⁴ The doctor's medical testimony is that physical exercise prolongs the life of one with a cardiac condition.⁵ In addition, work activity which is not 'extremely exertional' most probably will not precipitate a heart attack.Hence, in the present case, since Mr. Akamine was engaging in physical exercise on the job which was not 'extremely exertional' when he collapsed and died, there was no relation between death and employment.The legal consequence of accepting such medical testimony is that application of the usual strain rule would result in the following: Every time a...