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Merchant v. Workers' Compensation Appeal Board9/1/2000
eal Board (Hussey Copper), 645 A.2d 957 (Pa. Cmwlth. 1994). Where there is no obvious causal connection between the injury and the work-related cause, a claimant must present unequivocal medical testimony to establish that connection. Cromie v. Workmen's Compensation Appeal Board (Anchor Hocking Corp.), 600 A.2d 677 (Pa. Cmwlth. 1991). Whether medical testimony is unequivocal is a question of law, subject to this Court's review. Terek v. Workmen's Compensation Appeal Board (Somerset Welding & Steel, Inc.), 542 Pa. 453, 668 A.2d 131 (1995). With regard to the definition of unequivocal medical evidence, we have held that
here medical testimony is necessary to establish a causal connection, the medical witness must testify, not that the injury or condition might have or possibly came from the assigned cause, but that in his professional opinion the result in question did come from the assigned cause. Medical evidence which is less than positive or which is based upon possibilities may not constitute legally competent evidence for the purpose of establishing the causal relationship. Cardyn v. Workmen's Compensation Appeal Board (Heppenstall), 517 Pa. 98, 104, 534 A.2d 1389, 1391-92 (1987) (quoting Lewis v. Commonwealth, 508 Pa. 360, 365-366, 498 A.2d 800, 802 (1985)). In addition, in evaluating whether medical evidence is unequivocal, the doctor's testimony should be considered as a whole and the determination should not rest upon a few words taken out of context. See Anzaldo v. Workmen's Compensation Appeal Board (M & M Restaurant Supply Co.), 667 A.2d 488 (Pa. Cmwlth. 1995).
Claimant argues that the Board erred in finding Dr. Walczak's testimony equivocal where she opined that she believed that his diabetes insipidus was work-related. Claimant contends that Dr. Walczak's use of words such as "could well be" is not solely determinative as to whether her testimony is equivocal.
With regard to that causation, Dr. Walczak testified as follows:
[Claimant's counsel] Q. Doctor, based on your evaluation and treatment of this patient over a period of approximately six months, did you formulate an opinion as to the cause of his diabetes insipidus?
[Dr. Walczak] A. When he first got here, he was indeed still shaking from this episode of electric shock. And I did not quite understand that he had hit his head during the electric discharge. After I received a letter from the endocrinologist at Cleveland Clinic there, he describes that the patient actually had a fall and he hit his head got the electrocution. So it is well known that head injuries can cause diabetes insipidus.
Q. Doctor, I'm telling you that---I'd like to tell you that in the record of this case from the Claimant's testimony and our knowledge of his past medical history, he did not have a previous diagnosis of diabetes insipidus. He did not have any previous head injuries of any significance prior to the electrical injury in August of 1995. Now, with that in mind, Doctor, do you have an opinion as to the cause of his diabetes insipidus?
A. Then I would say it could well be the trauma that he received during that particular electrocution episode.
Q. Would it be fair to say that it probably did cause his diabetes insipidus?
A. Uh-huh (yes). (May 17, 1996 Deposition of Dr. Walczak, N.T. 24-25; R.R. 113-114)
TSL argues that the Board correctly determined that Dr. Walczak's testimony as to the causation of Claimant's diabetes insipidus was equivocal. TSL contends that the above-quoted testimony is less than positive and insufficient as a matter of law to support benefits. Further, TSL alleges that, even when taken as a whole, Dr.
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