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Lindhag v. State10/7/2005
y, in July 1997 the employer controverted Lindhag's entitlement to benefits.
The Alaska Workers' Compensation Board appointed Dr. Allene Scott to perform a second independent medical evaluation (SIME). Dr. Scott obtained assistance from at least six specialists in conducting her evaluation. In June 1998 Dr. Scott concluded that Lindhag had a number of medical conditions, but that no condition could be linked, within a reasonable degree of medical certainty, to her toxic exposures during employment. For example, she concluded that the likely primary contributing factor behind Lindhag's sinusitis and rhinitis was her allergy to common household dust mites. (Lindhag tested positive for this allergy in an intradermal allergy test performed by Dr. Scott.) She concluded that Lindhag had suffered from asthma prior to the office move. She also found no evidence of sick building syndrome, and found that any diagnosis of MCSS would have been inappropriate, in part because Lindhag had suffered similar symptoms prior to the exposure. Finally, Dr. Scott expressed uncertainty on Lindhag's neurological symptoms and recommended a PET scan and further diagnostic testing.
Dr. Wu completed the PET scan and found the results consistent with encephalopathy associated with toxic exposure. Another doctor concurred. Accordingly, in October 1999 Dr. Scott amended her opinion and found that Lindhag's exposure to chemicals while working for DNR had caused "toxic encephalopathy." Her opinions about the non-encephalopathic symptoms remained unchanged.
Lindhag had Dr. Scott's initial report reviewed by another expert, Dr. Heuser, in April 1999. After reviewing medical records, Dr. Heuser concluded that (1) toxic encephalopathy was present; (2) workplace exposures significantly aggravated conditions like bronchitis and asthma; and (3) exposures caused significant chemical injury, including sick building syndrome and eventually MCSS.
B. Proceedings
Based on Dr. Scott's opinions, the state agreed to pay benefits for Lindhag's encephalopathic symptoms. However, the issue of benefits for non-encephalopathic symptoms went before the board. The employer relied on evidence from the SIME physician, Dr. Scott. Lindhag relied on testimony by her treating physician, Dr. Steiner, and toxicology consultant, Dr. Heuser.
The board issued its order on May 8, 2000, denying Lindhag's claim for non-encephalopathic-related benefits. It reached this conclusion after utilizing the three-part analysis for determining whether an employee's claim is compensable: It first found that Lindhag established a preliminary link that the exposures substantially caused her medical conditions, which created the presumption of compensability. It then found that the state successfully rebutted this presumption by presenting substantial evidence that the disability was not work-related. Finally, it concluded that Lindhag failed to prove her claim by a preponderance of the evidence. The board found that the exposures caused merely a "temporary aggravation" of a pre-existing condition, and the persisting conditions were caused "by non-work-related factors, including dust mites."
The board also commented on its reliance upon the expert witnesses:
In reaching this conclusion, we rely primarily upon Dr. Scott's experience and expertise as our SIME physician and on the exhaustive nature of her evaluation of the employee, as well as her firm understanding of the voluminous medical records. Consequently, we will give the most weight to the reports and testimony of our own independent expert when assessing the preponderance of the evidence. In sum, we find our second independent medical eva
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