Wignall v. Elec. Boat Corp.
| Decision Date | 22 March 2023 |
| Docket Number | BRB 21-0613 |
| Parties | ERIC J. WIGNALL Claimant-Petitioner v. ELECTRIC BOAT CORPORATION Self-Insured Employer-Respondent |
| Court | Longshore Complaints Court of Appeals |
UNPUBLISHED OPINION
Appeal of the Decision and Order Granting Benefits of Noran J. Camp Administrative Law Judge, United States Department of Labor.
Lance G. Proctor (Attorney Lance G. Proctor, LLC), Groton Connecticut, for Claimant.
Edward W. Murphy (Morrison Mahoney LLP), Boston, Massachusetts, for Self-Insured Employer.
Before: GRESH, Chief Administrative Appeals Judge, BUZZARD and ROLFE, Administrative Appeals Judges.
DECISION AND ORDER
Claimant appeals Administrative Law Judge (ALJ) Noran J. Camp's Decision and Order Granting Benefits (2019-LHC-00722 and 2019-LHC-01368) rendered on claims filed pursuant to the Longshore and Harbor Workers' Compensation Act, as amended, 33 U.S.C. §901 et seq. (Act).[1] We must affirm the ALJ's findings of fact and conclusions of law if they are rational, supported by substantial evidence, and in accordance with applicable law. 33 U.S.C. §921(b)(3); O'Keeffe v. Smith, Hinchman & Grylls Associates, Inc., 380 U.S. 359 (1965).
Claimant filed two claims for injuries allegedly related to his employment with Employer: one on November 27, 2006, causing repetitive trauma to his cervical and lumbar spine, and one on December 14, 2007, where he slipped on ice, injuring his lumbar spine. Decision and Order Granting Benefits (D&O) at 2. Between 2009 and 2017, he underwent six surgeries to his lumbar, thoracic, and cervical spine. D&O at 4. After the first lumbar surgery, performed by Dr. Kenneth Paonessa on January 13, 2009, Claimant developed flatback syndrome, causing him to walk hunched over at a ninety-degree angle. D&O at 4, 6; Hearing Transcript (HT) at 41. He suffered from this syndrome for several years, until Dr. Rudolph Taddonio[2] surgically corrected the condition with fusion surgeries to his lumbar and thoracic spine, performed in 2012 and 2015. D&O at 6-8; HT at 41-42. Following the 2015 surgery, Claimant began complaining of neck pain and eventually underwent cervical spine surgeries in 2016 and 2017. D&O at 8-10. He also complained of worsening bowel and urinary incontinence. D&O at 6, 10-12. On September 13, 2018, Dr. Taddonio placed Claimant at maximum medical improvement (MMI) and opined he was totally disabled from all employment. D&O at 10.
The parties stipulated to the compensability of Claimant's 2007 lumbar spine injury, as well as his entitlement to permanent total disability (PTD) benefits from September 13, 2018, through the present and continuing. D&O at 3; HT at 6-9. The only issue before the ALJ was Claimant's entitlement to ongoing Section 7 medical benefits, 33 U.S.C. §907, for treatment of his cervical spine injury and his urinary and bowel issues, both of which Claimant alleged arose as sequelae of his 2007 lumbar spine injury.[3] D&O at 3. The ALJ weighed the medical evidence and found only Claimant's urinary and bowel symptoms related to his 2007 injury and subsequent surgical procedures, and therefore awarded reasonable and necessary medical benefits for that condition. D&O at 23-27. Neither party disputes Claimant's entitlement to medical benefits for his urinary and bowel symptoms; we therefore affirm the ALJ's finding as unchallenged. Scalio v. Ceres Marine Terminals, Inc., 41 BRBS 57 (2007).
As for his claim for medical benefits for his cervical spine, Claimant argued his neck symptoms developed because of his prolonged flatback syndrome, which required extension of his neck in order for him to be able to hold up his head so he could see where he was going while walking. D&O at 6-7. The ALJ weighed the medical testimony of Claimant's treating physician, Dr. Taddonio, who tentatively opined Claimant's cervical symptoms were indirectly related to his compensable lumbar spine injury, against the conflicting medical opinion of Employer's expert, Dr. Alan Daniels, who categorically denied the conditions were related. The ALJ gave greater weight to Dr. Daniels' opinion and denied Claimant's cervical spine medical benefits claim. D&O at 19-23.
Claimant appeals the denial of his claim for medical benefits for his cervical spine condition. He argues the opinion of Dr. Taddonio, as his treating physician, should have been accorded special weight in determining whether his cervical spine condition and treatment are related to his 2007 lumbar spine injury. Employer responds, urging affirmance.
At the outset, we note the ALJ erred by failing to apply the Section 20(a) presumption to determine the relatedness and compensability of Claimant's cervical spine condition to his original workplace injury. 33 U.S.C. §920(a); D&O at 4, 18-19. Before the ALJ can determine whether the requested medical treatment is related to the work injury under Section 7, he must determine whether the claimed injury itself is work-related within the framework established by Section 20(a) of the Act. Wendler v. Am. Nat'l Red Cross, 23 BRBS 408, 414 (1990); Romeike v. Kaiser Shipyards, 22 BRBS 57 (1989).
To be entitled to the Section 20(a) presumption linking his injury to his employment, a claimant must sufficiently allege: 1) he has sustained a harm; and 2) an accident occurred or working conditions existed which could have caused or aggravated the harm. Rose v. Vectrus Systems Corporation, 56 BRBS 27 (2022) (); see, e.g., American Stevedoring, Ltd. v. Marinelli, 248 F.3d 54, 35 BRBS 41(CRT) (2d Cir. 2001); O'Kelley v. Dep't of the Army/NAF, 34 BRBS 39 (2000). When a claimant claims a work-related primary injury as well as a secondary injury resulting from the primary injury, the Section 20(a) presumption applies to both. Metro Mach. Corp. v. Director, OWCP, 846 F.3d 680, 50 BRBS 81(CRT) (4th Cir. 2017); see also U.S. Ind./Fed. Sheet Metal, Inc. v. Director, OWCP, 455 U.S. 608, 14 BRBS 631(1982); but see Ins. Co. of the State of Pennsylvania v. Director, OWCP [Vickers], 713 F.3d 779, 47 BRBS 19(CRT) (5th Cir. 2013); see generally Port of Portland v. Director, OWCP [Ronne II], 192 F.3d 933, 33 BRBS 143(CRT) (9th Cir. 1999), cert. denied, 529 U.S. 1086 (2000).
Consequently, the ALJ should have analyzed whether Claimant's cervical spine condition is a work-related sequela within the framework of the Section 20(a) presumption. Seguro v. Universal Maritime Service Corp., 36 BRBS 28, 34 (2002); Bass v. Broadway Maintenance, 28 BRBS 11, 15 (1994). To be entitled to the Section 20(a) presumption linking this alleged secondary injury to his employment, Claimant must sufficiently allege the condition "(or its aggravation or hastening) could have naturally or unavoidably resulted from the primary injury." Metro Mach., 846 F.3d at 692-693, 50 BRBS at 88(CRT) (emphasis in original). As the Board explained in Rose, this is not a heavy burden. Rose, 56 BRBS at 38.[4]
If Claimant invokes the Section 20(a) presumption as to his secondary injury, Employer can rebut the presumption by submitting substantial evidence that the cervical spine condition is due to an intervening or independent cause or that it did not naturally and unavoidably result from his lumbar spine injury. Plappert v. Marine Corps Exchange, 31 BRBS 109 (1997); Bass, 28 BRBS at 15; Director, OWCP v. General Dynamics Corp., 769 F.2d 66, 68 (2d Cir. 1985); Cyr v. Crescent Wharf & Warehouse Co., 211 F.2d 454 (9th Cir. 1954). If Employer rebuts the Section 20(a) presumption, it no longer controls and the issue of causation must be resolved on the evidence as a whole, with Claimant bearing the burden of persuasion by a preponderance of the evidence. Rainey v. Director, OWCP, 517 F.3d 632, 634, 42 BRBS 11, 12(CRT) (2d Cir. 2008); Marinelli, 248 F.3d at 65, 35 BRBS at 49(CRT); Santoro v. Maher Terminal, Inc., 30 BRBS 171 (1996); see also Director, OWCP v. Greenwich Collieries, 512 U.S. 267, 28 BRBS 43(CRT) (1994).
In the instant case, we hold the Section 20(a) presumption applies as a matter of law to Claimant's alleged sequela injury, as it is undisputed Claimant suffered an injury to his lumbar spine in 2007 while working for Employer and subsequently sought treatment for his cervical spine. Moreover, the record contains medical opinions connecting this condition to Claimant's 2007 work-related injury and related spinal surgeries. Claimant's Exhibit (CX) 20 at 12-17, 35. We further hold Employer successfully rebutted the Section 20(a) presumption by presenting medical evidence showing Claimant's cervical spine condition is unrelated to and/or not naturally arising from his 2007 lumbar injury. Employer's Exhibit (EX) 1. As such, the presumption falls from the case, and the ALJ's failure to apply the presumption is harmless error, provided his conclusion as to the condition's non-compensability is supported by substantial evidence.[5] Suarez v. Serv. Employees Int'l, Inc., 50 BRBS 33 (2016); Pardee v. Army and Air Force Exchange Service, 13 BRBS 1130 (1981); Novak v. I.T.O. Corp. of Baltimore, 12 BRBS 127 (1979).
The record contains substantial evidence supporting the ALJ's conclusion that Claimant's cervical spine condition is not the natural and unavoidable sequela of his 2007 lumbar spine injury. Employer's expert orthopedic surgeon, Dr Daniels, unequivocally testified Claimant's cervical spine condition was not caused by either his flatback syndrome or by stress from fusion surgeries to other parts of his spine. EX 1; EX 12 at 18. Dr. Daniels based his conclusion on his examination of Claimant, his review of the medical records, and his "extensive experience treating, researching, and publishing on spinal deformity and spinal alignment." EX 12 at 18, 31. He explained Claimant required cervical surgery to correct diagnoses...
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