State v. Shea, Supreme Court No. S-15787

• Court: Alaska Supreme Court
• Writing for the Court: WINFREE, Justice.
• Citation: 394 P.3d 524
• Parties: STATE of Alaska, DEPARTMENT OF ADMINISTRATION, DIVISION OF RETIREMENT & BENEFITS, Appellant, v. Shirley SHEA, Appellee.
• Docket Number: Supreme Court No. S-15787
• Decision Date: 21 April 2017

394 P.3d 524

STATE of Alaska, DEPARTMENT OF ADMINISTRATION, DIVISION OF RETIREMENT & BENEFITS, Appellant,
v.
Shirley SHEA, Appellee.

Supreme Court No. S-15787

Supreme Court of Alaska.

April 21, 2017

Joan M. Wilkerson, Assistant Attorney General, and Craig W. Richards, Attorney General, Juneau, for Appellant.

Joseph A. Kalamarides and Randall S. Cavanaugh, Kalamarides & Lambert, Anchorage, for Appellee.

Before: Stowers, Chief Justice, Fabe, Winfree, Maassen, and Bolger, Justices.

OPINION

WINFREE, Justice.

I. INTRODUCTION

A state employee applied for occupational disability benefits, claiming that prolonged sitting at work aggravated a preexisting medical condition. The Division of Retirement and Benefits denied the claim. An administrative law judge affirmed that decision, determining that employment was not a substantial factor in causing the employee's disability.

394 P.3d 527

On appeal the superior court reversed the administrative law judge's decision. Because the administrative law judge's decision was supported by substantial evidence, we reverse the superior court's decision and thereby affirm the administrative law judge's decision.

II. FACTS AND PROCEEDINGS

A. Underlying Facts And Prior Proceedings

This case comes to us for a third time.¹ The underlying facts and proceedings relevant to this appeal are fully set forth in Shea II .²

In brief, Shirley Shea suffers from chronic pain and has been unable to work since 2001.³ Shea was granted non-occupational disability benefits in March 2003,⁴ but was denied occupational disability benefits because the Division of Retirement and Benefits' retained expert, Dr. William Cole, concluded after reviewing Shea's medical record that "[t]here is not evidence from the record that the pain was caused by her occupation."⁵ In response Shea underwent a series of medical exams between August 2003 and August 2005 seeking to determine the connection, if any, between prolonged sitting at her employment and her chronic pain.⁶ The Division found the new information unconvincing:

In August 2005, at the Division['s] request, Dr. William Cole reviewed all the information in Shea's medical record, including the opinions and medical reports Shea had obtained since Dr. Cole's opinion in March 2003. After considering this information, Dr. Cole maintained his opinion that "there is not a substantial presentation of an argument to support [Shea's] claim that her job activities were [a] significant contributing factor to this condition, no more than the rest of the activities of daily living of her life were." As a result, the Division affirmed its denial of Shea's claim for occupational disability benefits.^{[7 ]}

Shea appealed this decision to the Office of Administrative hearings, and a hearing was held in March 2006.⁸ Both Dr. Michael Smith, whom Shea had seen in 2004 for an opinion on causation,⁹ and Dr. Joella Beard, whom Shea had seen in 2001 for a disability impairment rating,¹⁰ testified at the hearing.¹¹

The Administrative Law Judge (ALJ) found by a preponderance of the evidence that Shea "suffered some form of injury to her ilioinguinal nerve in the course of the 1984 procedure, resulting in long-term unresolved ilioinguinal neuralgia." But he defined her "disabling condition [as] chronic pain syndrome, primarily resulting from the nerve injury in 1984, and referred and secondary pain related to that injury." He also found that the initial trauma from 1984 left Shea "with a vulnerable nerve, which intermittently flared up ... as a result of the activities of everyday life, leading eventually to secondary bursitis and referred pain in a variety of areas." He noted that Shea's bursitis, however, "is not disabling, and the chronic pain she suffers has many sources other than her working conditions.... Her claim for disability benefits rests on whether, in light of the record as a whole, her employment was a substantial factor in a complex chronic pain syndrome."

The ALJ found that Shea "did not prove by a preponderance of the evidence that her employment was a substantial factor in her disability" and affirmed the Division's denial

394 P.3d 528

of Shea's occupational disability claim;¹² Shea appealed to the superior court, and it affirmed the ALJ's decision.¹³ Shea appealed to this court, and we reversed the superior court's decision upholding the ALJ's decision and remanded for proceedings consistent with our explanation of the appropriate causation standard.¹⁴

B. The ALJ's Decision On Remand

The ALJ issued his decision on remand in February 2013. No new evidence was considered, but the ALJ did consider the parties' briefs and our Shea II decision, which authorized the ALJ to "reevaluate the evidence ... as he deem [ed] necessary."¹⁵ The sole issue again was whether Shea's employment was a substantial factor in causing her disabling pain.

The ALJ examined evidence indicating that prolonged sitting at work was a substantial factor in causing Shea's disabling pain. Among this evidence was: "(1) Dr. Smith's opinion [at the hearing] that prolonged sitting aggravated a physical condition and her pain symptoms, ... (2) sitting was painful to her, (3) her job duties involved long periods of sitting, and (4) during the time she worked for the State of Alaska, her pain symptoms increased."

The ALJ also considered evidence indicating that Shea's employment was not a substantial factor in her disability:

(1) Ms. Shea on multiple occasions prior to becoming disabled reported that her pain was caused by a wide variety of common, every-day activities, including walking, and physical activity in general; (2) Ms. Shea did not identify sitting as a causal factor until February, 1999, after her symptoms had become highly problematic; (3) Ms. Shea in 1998, and again in 1999, reported no significant or particular aggravating or alleviating factors; (4) Ms. Shea did not herself identify working conditions as a causal factor until 2003, long after she had ceased working; (5) Dr. Beard's expert medical opinion that prolonged sitting did not permanently aggravate the underlying physical condition; and (6) Dr. Beard's observation that Ms. Shea's pain symptoms could have been a result, in some degree, of psychological factors.

The ALJ determined that Shea had proved prolonged periods of sitting at work were a but-for cause of her disability. But the ALJ concluded that reasonable persons would not attach responsibility to the State for Shea's disability because her employment conditions were not a sufficiently "significant and important a cause" of her disability; the ALJ therefore found Shea had not proved that prolonged sitting at work was a substantial factor in causing her disability. Shea then appealed the ALJ's decision to the superior court.

C. Appeal To The Superior Court

The superior court issued its decision in December 2014, reversing the ALJ's decision after determining that it was not supported by substantial evidence. The superior court determined that "the factual findings upon which the ALJ based his conclusion that reasonable persons would not attach responsibility to Shea's employer for her injury were not adequate to support his conclusion." This determination was driven in part by the notion that "[t]he ALJ cannot find on one hand that Dr. Smith's testimony was substantial evidence establishing actual cause but not substantial evidence supporting the causal component of proximate cause."

The State appeals the superior court's decision.

III. STANDARD OF REVIEW

When the superior court acts as an intermediate court of appeal in an administrative

394 P.3d 529

matter, we independently review the merits of the agency's decision.¹⁶ We review a board's factual findings "to determine whether they are supported by substantial evidence," which is "such relevant evidence as a reasonable mind might accept as adequate to support the board's conclusion."¹⁷ "[W]e view the evidence in favor of the findings,"¹⁸ and we will not choose between competing inferences or evaluate the strength of the evidence.¹⁹ We will look only to determine if substantial evidence exists in the record, taking into account evidence in the record detracting from the supporting evidence's weight.²⁰ "The conclusion that a work-related injury or hazard is not a substantial factor in causing an employee's disability must be supported by substantial evidence. It is a legal question whether the quantum of evidence is substantial enough to support such a conclusion in the contemplation of a reasonable mind."²¹

IV. DISCUSSION

To qualify for occupational disability benefits, Shea had the burden of proving²² that her employment was "terminated because of a total and apparently permanent occupational disability."²³ An "occupational disability" is

a physical or mental condition that, in the judgment of the administrator, presumably permanently prevents an employee

...