Hill v. Department of Employment Services
| Decision Date | 28 April 2020 |
| Docket Number | 19-AA-350 |
| Citation | 272 A.3d 274 |
| Parties | Yul HILL, Petitioner, v. District of Columbia DEPARTMENT OF EMPLOYMENT SERVICES, Respondent, and Washington Metropolitan Area Transit Authority, Intervenor. |
| Court | D.C. Court of Appeals |
Krista N. DeSmyter and Kevin H. Stillman filed a brief for Petitioner.
Karl A. Racine, Attorney General for the District of Columbia, Loren L. AliKhan, Solicitor General at the time the statement was filed, Carl J. Schifferle, Acting Deputy Solicitor General, and Sonya L. Lebsack, Assistant Attorney General, filed a statement in lieu of brief for Respondent.
Sarah O. Rollman and Mark H. Dho filed a brief for Intervenor.
Before Glickman, Fisher, and McLeese, Associate Judges.
Petitioner Yul Hill seeks review of a Compensation Review Board (CRB) order which affirmed an Administrative Law Judge's (ALJ) decision to deny petitioner's claim for temporary total disability benefits relating to a mental-mental injury.1 We hereby affirm.
Mr. Hill began working as a bus operator for the Washington Metropolitan Area Transit Authority (WMATA) in 2009. While on duty on February 1, 2013, he suffered physical and mental injuries when he was attacked by a passenger. After the attack, he received treatment2 and eventually returned to full duty as a bus operator. Petitioner's doctors opined that the mental health symptoms he experienced after the 2013 attack were also related to injuries he sustained in a 2010 accident. Dr. Sussal explained that, as in 2010, petitioner insisted that he would "be fine" if he could return to work in a "non-operator position."
In late February 2017, petitioner suffered the sudden and tragic loss of his son. Petitioner took three days of bereavement leave before returning to work at the beginning of March. On March 3, 2017, petitioner had a public disagreement with a supervisor which — the petitioner alleges — exacerbated his existing mental injury. The petitioner sought care through the Employee Assistance Program (EAP) and received a referral for mental health treatment. While at EAP, petitioner filled out a sick leave form but did not claim an on-the-job injury or file a claim for workers' compensation.
Mr. Hill's WMATA supervisor, Amit Tonse, regularly contacted Mr. Hill during his prolonged leave. Repeatedly, Mr. Hill explained that he was "stressed out" because of his grief, without mentioning his discussions with the other supervisor. During his leave, Mr. Hill received mental health care from Therapist Alphonso Lewis to whom he had been referred by EAP. Therapist Lewis understood the reason for the referral to be petitioner's grief and opined that Mr. Hill's symptoms resulted from the traumatic loss
of his son and his premature return to duty. However, after first observing symptoms on April 11, 2017, Therapist Lewis made a "definite diagnosis" of PTSD on May 16, 2017. On November 30, 2017, Therapist Lewis produced a clinical summary of his treatment of Mr. Hill for acute symptoms of anxiety and depression and symptoms of PTSD.
Therapist Lewis eventually advised Mr. Hill "that he should not operate a bus based upon the continued chronicity of the symptoms of his PTSD[,]" expressing a concern that allowing Hill to return to work as a bus operator "could potentially place him and the public at risk." Lewis also shared this information with WMATA. Consequently, in a letter dated September 27, 2017, WMATA permanently disqualified Mr. Hill from operating a bus due to his "post-traumatic stress disorder
," effective June 20, 2017. According to petitioner, "[a]s of February 10, 2018, [WMATA] provided him with alternative employment outside of bus operation."
On September 26, 2017, petitioner filed for temporary total disability benefits and corresponding interest for the period of March 4, 2017, to February 9, 2018, stemming from the March 3, 2017, incident. This claim was later consolidated with a claim for temporary total disability and interest for the same period resulting from the September 2013 attack. Petitioner included a claim for payment of medical expenses from February 1, 2013, through December 6, 2017.3
On December 6, 2017, Dr. Cynthia Major-Lewis conducted an independent medical evaluation (IME) of Mr. Hill, during which she reviewed his medical records and conducted a mental health examination. Dr. Major-Lewis concluded that (1) Mr. Hill's PTSD diagnosis resulting from the 2013 attack was "pre-mature and incorrect," (2) Mr. Hill's resolving "[a]djustment [d]isorder with mixed anxiety and depression" symptoms was related to "non-work-related bereavement," and (3) there "is no chronic condition that should be considered employment related." In reference to the PTSD diagnosis, Dr. Major-Lewis explained that "[Therapist] Lewis did not document the symptoms required to make a DSM-V diagnosis of Posttraumatic Stress Disorder
."
An ALJ heard evidence on July 11, 2018. At the hearing, intervenor argued that there was no medical causal connection between petitioner's current symptoms and either the 2013 attack or the March 2017 incident. Intervenor relied primarily on the IME report to argue against medical causality. Intervenor further explained that, even if the ALJ found a compensable injury resulting from the March 2017 incident, relief should nevertheless be denied because petitioner did not give timely notice of a workplace injury. Finally, with regard to the payment of temporary total disability benefits, intervenor asserted that it was entitled to a credit for the payment of long term disability benefits4 that had occurred between September 4, 2017, and April 30, 2018.
In reference to the 2013 attack, the ALJ concluded that (1) Mr. Hill invoked the presumption of a medical-causal connection between the attack and his mental health complaints, (2) WMATA rebutted the presumption, and (3) Mr. Hill proved by a preponderance of the evidence "that there was a medical-causal connection between the 2013 attac[k] and his mental health complaints until December 6, 2017."
The ALJ found that Mr. Hill did not invoke the presumption for the March 2017 incident. Despite his finding that there was medical-causality from March 4, 2017, until December 6, 2017, the ALJ denied all "temporary total disability benefits [and corresponding interest] from March 4, 2017 through February 9, 2018." The ALJ did not address intervenor's notice and credit arguments as both were rendered moot by the total denial of benefits.
Petitioner sought review of the compensation order (CO) from the CRB. The CRB affirmed the CO in part and remanded after concluding that there was not substantial evidence to support a finding that the claimant failed to invoke the presumption of compensability for the March 2017 incident. The CRB did not address the discrepancy between the ALJ's findings and his denial of relief stemming from the 2013 injury. On remand, the ALJ found that, while the claimant did successfully invoke the presumption, the employer severed the presumption with Dr. Major-Lewis's IME report. The claimant then failed to carry his burden to prove "that there is a medical-causal connection between the 2017 encounter with his supervisor and the allegedly-related mental health complaints." In an order issued on April 9, 2019, the CRB affirmed the Compensation Order on Remand and regarded its earlier rulings as the law of the case, acknowledging petitioner's "arguments on appeal for preservation purposes and for further appeal to the District of Columbia Court of Appeals." Petitioner now seeks review.5
Petitioner argues that the underlying ALJ compensation orders were not based on substantial evidence. Specifically, he finds fault with the ALJ's reliance on Dr. Cynthia Major-Lewis's IME report.
"We affirm an administrative agency decision when (1) the agency made findings of fact on each contested material factual issue, (2) substantial evidence supports each finding, and (3) the agency's conclusions of law flow rationally from its findings of fact." Bowles v. District of Columbia Dep't of Emp't Servs. , 121 A.3d 1264, 1269 (D.C. 2015) (quoting Georgetown Univ. v. District of Columbia Dep't of Emp't Servs. , 971 A.2d 909, 915 (D.C. 2009) ). " Rodriguez v. Filene's Basement, Inc. , 905 A.2d 177, 181 (D.C. 2006) (quoting Gardner v. District of Columbia Dep't of Emp't Servs. , 736 A.2d 1012, 1015 (D.C. 1999) ). "Although our review in a workers' compensation case is of the decision of the CRB, not that of the ALJ, ‘we cannot ignore the compensation order which is the subject of the CRB's review.’ " Reyes v. District of Columbia Dep't of Emp't Servs. , 48 A.3d 159, 164 (D.C. 2012) (quoting Georgetown Univ. Hosp. v. District of Columbia Dep't of Emp't Servs., 916 A.2d 149, 151 (D.C. 2007) ).
Under the workers' compensation framework, there is a statutory presumption in favor of finding a medical-causal connection after the claimant presents "some evidence of a work-related event, activity or requirement which has the potential of resulting in or contributing to" a disability. Wash. Post v. District of Columbia Dep't of Emp't Servs. , 852 A.2d 909, 911 (D.C. 2004) (internal quotation marks omitted) (quoting Ferreira v. District of Columbia Dep't of Emp't Servs. , 531 A.2d 651, 655 (D.C. 1987) ). The employer may rebut that presumption, at which time "the statutory presumption drops out of the case entirely" and the burden shifts back to the claimant, who must prove by a preponderance of the evidence that "a work-related injury caused or contributed to his or her disability." Id. at 911.
In this case, petitioner argues that the CRB erred in affirming the ALJ's finding that the employer presented medical evidence "specific and...
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