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Young v. District of Columbia Dep't of Employment Services1/6/2005
ippo] had rebutted the presumption [of compensability]," she must have reached this decision because she proceeded to "the next required analytical step when the presumption is rebutted." Instead of remanding the case, however, the Director concluded that Mr. Young's medical evidence failed to demonstrate, by a preponderance of the evidence, that his "current shoulder complaints were [causally] related to the July 24, 2000 work injury." As such, the Director found that Mr. Young failed "to sustain his burden of proof after the presumption rebutted," and he was therefore not entitled to be reimbursed for the medical expenses associated with his shoulder injury.
ANALYSIS
Mr. Young claims that the Director of the Department of Employment Services effectively substituted his own findings of fact for those of Judge Calmeise. Because we agree with Mr. Young, we reverse and remand.
In reviewing an agency decision, we are guided by several well-established principles. "In workers' compensation cases, we defer to the decision of the agency director provided that the decision flows rationally from facts supported by substantial evidence in the record." Marriott Int'l v. District of Columbia Dep't of Employment Servs., 834 A.2d 882, 885 (D.C. 2003) (citing Clark v. District of Columbia Dep't of Employment Servs., 772 A.2d 198, 201 (D.C. 2001)). The director "conducts a limited review of decisions of a hearing examiner to determine whether the examiner's findings are supported by substantial evidence in the record." Landesberg v. District of Columbia Dep't of Employment Servs., 794 A.2d 607, 612 (D.C., 2002) (citing Children's Def. Fund v. District of Columbia Dep't of Employment Servs., 726 A.2d 1242, 1247 (D.C. 1999)) (quotations omitted). "Substantial evidence is defined as such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Ferreira v. District of Columbia Dep't of Employment Servs., 667 A.2d 310, 312 (D.C. 1995) (citing James v. District of Columbia Dep't of Employment Serv., 632 A.2d 395, 397 (D.C. 1993)) (quotations omitted).
Furthermore, we have stated that "the director may not consider the evidence de novo and make factual findings different from those of the examiner." Marriott, 834 A.2d at 885 (citing Canlas v. District of Columbia Dep't of Employment Servs., 723 A.2d 1210, 1211 (D.C. 1999)). "Indeed, the director is bound by the hearing examiner's findings of fact even though the director may have reached a contrary result based on an independent review of the record." Marriott, 834 A.2d at 885. "If substantial evidence exists to support the hearing examiner's findings, the existence of substantial evidence to the contrary does not permit the director to substitute his judgment for that of the examiner." Id.
Under the Workers' Compensation Act, once a claimant demonstrates a work-related event and a corresponding disability, there is a presumption that the claim comes within the provisions of the Act. See D.C. Code ยง 36-321 (1). To rebut the presumption that there is a causal connection between the disability and the work related event, "the employer must show by substantial evidence that the disability did not arise out of and in the course of the employment." Ferreira, 667 A.2d at 312 (citation omitted). If the employer is able to rebut the presumption of compensability, the burden shifts to the worker to show by a preponderance of the evidence a causal connection between the disability and the work related event. Washington Metro. Area Transit Auth. v. District of Columbia Dep't of Employment Servs., 827 A.2d 35, 40 (D.C. 2003).
The Director essentially rejected Judge Calmeise's conclusion that
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