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Washington Post v. District of Columbia Department of Employment Services6/3/2004
Argued March 17, 2003
This appeal presents a single issue that recurs frequently in our workers' compensation cases: whether an employer has presented sufficient evidence to overcome the statutory presumption of a causal relationship between an employee's disability and an injury the employee sustained at work. We hold that an employer has met its burden to rebut the presumption of causation when it has proffered a qualified independent medical expert who, having examined the employee and reviewed the employee's medical records, renders an unambiguous opinion that the work injury did not contribute to the disability. The petitioner in this case, The Washington Post, presented such an expert opinion regarding the disability claim of its employee, the intervenor Raymond Reynolds. We therefore remand for the administrative law judge, as the trier of fact, to weigh the conflicting evidence on causation and resolve the issue anew without relying on the statutory presumption.
I.
It is useful to begin by describing the applicable legal framework. The District of Columbia Workers' Compensation Act provides, in pertinent part, that " n any proceeding for the enforcement of a claim for compensation . . . it shall be presumed, in the absence of evidence to the contrary. . . hat the claim comes within the provisions of this chapter. . . ." D.C. Code § 32-1521 (1) (2001) (emphasis added). This statutory presumption is "designed to effectuate the humanitarian purposes of the statute reflects a strong legislative policy favoring awards in arguable cases." Ferreira v. District of Columbia Dep't of Employment Servs., 531 A.2d 651, 655 (D.C. 1987) (internal quotation marks and citations omitted). To invoke the presumption, an employee seeking compensation merely has to present "some evidence" of "a work-related event, activity, or requirement which has the potential of resulting in or contributing to" the employee's disability. Id. (emphasis in the original). Upon that minimal showing, the statutory presumption "operates to establish a causal connection between the disability and the work-related event, activity, or requirement," such that the disability is compensable. Id.
This presumption operates, though, only "in the absence of evidence to the contrary." D.C. Code § 32-1521. "Once the presumption is triggered, the burden is upon the employer to bring forth 'substantial evidence' showing that death or disability did not arise out of and in the course of employment." Ferreira, 531 A.2d at 655 (citation omitted). The employer's evidence simply needs to be "specific and comprehensive enough," id. (citation omitted), that "a reasonable mind might accept as adequate" to contradict the presumed causal connection between the event at work and the employee's subsequent disability. See, e.g., Safeway Stores, Inc. v. District of Columbia Dep't of Employment Servs., 806 A.2d 1214, 1219-20 (D.C. 2002). Accordingly, while we have said that " he presumption of compensability cannot be overcome merely 'by some isolated evidence,'" Whittaker v. District of Columbia Dep't of Employment Servs., 668 A.2d 844, 847 (D.C. 1995) (citation omitted), neither is the presumption "so strong as to require the employer to prove that causation is impossible in order to rebut it." Washington Hosp. Ctr. v. District of Columbia Dep't of Employment Servs., 744 A.2d 992, 1000 (D.C. 2000) (emphasis in the original).
If the employer succeeds in proffering substantial evidence of non-causation, the statutory presumption drops out of the case entirely. The burden then reverts to the claimant to prove by a preponderance of the evidence, without the aid of the presumption, that a work-related injury cau
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