Bath Iron Works v. Dept. of Labor ( 1998 )


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    UNITED STATES COURT OF APPEALS
    FOR THE FIRST CIRCUIT

    ____________________

    No. 96-2163

    BATH IRON WORKS CORPORATION and
    COMMERCIAL UNION INSURANCE COMPANY,

    Petitioners, Appellants,

    v.

    DIRECTOR, OFFICE OF WORKERS' COMPENSATION PROGRAMS,
    UNITED STATES DEPARTMENT OF LABOR,

    Respondents, Appellees.

    ____________________


    ON PETITION FOR REVIEW OF A DECISION

    OF THE BENEFITS REVIEW BOARD

    ____________________

    Before

    Torruella, Chief Judge, ___________

    Aldrich, Senior Circuit Judge, ____________________

    and Lynch, Circuit Judge _____________

    ____________________


    Kevin M. Gillis with whom Troubh, Heisler & Piampiano was on _______________ ___________________________
    brief for petitioners.
    G. William Higbee with whom McTeague, Higbee, MacAdam, Case, _________________ ________________________________
    Watson & Cohen was on brief for respondents. ______________

    ____________________

    March 06, 1998
    ____________________



















    ALDRICH, Senior Circuit Judge. Russell E. Harford, ____________________

    Jr., a long time insulation installer for defendant Bath Iron

    Works Corp. (BIW), had to quit work because of shortness of

    breath. Suit is brought on his behalf by the Director,

    Office of Workers' Compensation Programs, U.S. Department of

    Labor, under the Longshore and Harbor Workers' Compensation

    Act (LHWCA), 33 U.S.C. 901 et seq., for work-related __ ____

    disability due to "Asbestosis and related diseases." It is

    undisputed that Harford developed lung cancer, and further

    that his smoking two plus packs of cigarettes a day for 32

    years was a basic cause. It is also undisputed that, though

    he did not work with asbestos, he was exposed to the dust

    from neighboring workplaces. He seeks to bring in this

    exposure as a contributor to his cancer in order to charge

    the employer and its insurer.

    Trial was had before an ALJ on letters and

    depositions of medical experts. In his decision, the ALJ

    stated that the asbestos did not have to be the "sole cause"

    of the cancer for claimant to recover. Rather, the entire

    disability would be compensable if the asbestos contributed

    to, combined with, or aggravated it.1 In short, the ultimate

    ____________________

    1. We note that the Board, similarly to the ALJ, viewed the
    issue as whether "claimant's exposure to asbestos did . . .
    cause or contribute to his lung cancer." The parties share
    this conception. Thus, we understand "aggravate" to be
    essentially synonymous with "contribute," and to refer to the
    cancer. No claim has been made for aggravation of associated

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    question was whether there was a "causal relationship between

    Claimant's employment and his lung cancer." The first issue,

    however, was whether the employer had met the statutory

    presumption in claimant's favor. Title 33 U.S.C. 920(a)

    presumes, "in the absence of substantial evidence to the

    contrary-- (a) That the claim comes within the provisions of

    [the Act]." After extensive review and discussion of the

    evidence, the ALJ found that the presumption was rebutted,

    which caused it to "fall". See Sprague v. Director, ___ _______ _________

    O.W.C.P., 688 F.2d 862, 865 (1st Cir. 1982). Weighing the ________

    evidence without the presumption, he found there was no

    causal relationship between claimant's employment and his

    cancer. It is to be stressed that this was not for lack of

    proof by the claimant, but by belief of affirmative evidence

    submitted by the employer. Claimant did not, he found,

    contract asbestosis, and asbestos without asbestosis did not

    cause or contribute to the cancer.

    The Benefits Review Board reversed the ALJ's

    finding that the presumption in claimant's favor had been

    rebutted, thereby ending the defense. We reverse.

    Decision of the Benefits Review Board _____________________________________

    With reference to the presumption, the Board

    stated, "[The] employer's burden on rebuttal [is] to present

    ____________________

    symptoms. Cf. Gardner v. Director, O.W.C.P., 640 F.2d 1385, ___ _______ __________________
    1389 (1st Cir. 1981).

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    specific and comprehensive evidence sufficient to sever the

    causal connection between the injury and the employment." It

    added, "The unequivocal testimony of a physician that no

    relationship exists . . . is sufficient to rebut the

    presumption." This positive language it recast as

    "unequivocally severs." "Unequivocal," on a search of

    dictionaries, universally means "not doubtful," or the like,

    which we take to mean certainty. That the Board so intended

    is inescapably confirmed by its response to employer's

    expert, Dr. Cadman's unwillingness to be absolutely certain.

    Because Dr. Cadman, in the Board's words, conceded that

    "asbestos may have contributed to claimant's lung cancer and

    that he could not exclude that exposure as having

    contributed" to it, the Board thought his testimony

    insufficient to rebut the presumption.

    As we have previously held, the presumption is

    overcome with substantial evidence of non-causation. See ___

    Sprague, 688 F.2d at 865. Substantial evidence is "such _______

    relevant evidence as a reasonable mind might accept as

    adequate to support a conclusion." Id. (quotations and ___

    citation omitted). This means "reasonable probabilities."

    Cf. DaSilva v. American Brands, Inc., 845 F.2d 356, 361 (1st ___ _______ ______________________

    Cir. 1988); Bath Iron Works Corp. v. Director, O.W.C.P., 109 _____________________ ___________________

    F.3d 53, 56 (1st Cir. 1997); Oberlander's Case, 348 Mass. 1, _________________

    7, 200 N.E.2d 268 (1964) (Workmen's Compensation). Dr.


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    Cadman's medical opinion was found insufficient by the Board,

    however, because he could not exclude possibilities -- a

    typical expert opinion. This put an impossible burden on the

    employer.

    We have, therefore, two questions. Did the

    employer submit substantial evidence, when properly defined?

    (A question of law for the court, not dependent on

    credibility. See Sprague, 688 F.2d at 865; CNA Ins. Co. v. ___ _______ _____________

    Legrow, 935 F.2d 430, 433-34 (1st Cir. 1991)). At the same ______

    time, we may ask whether the ALJ was warranted in his

    substantive findings. In this connection we note 33 U.S.C.

    921(b)(3),

    The findings of fact in the decision
    under review by the Board shall be
    conclusive if supported by substantial
    evidence in the record considered as a
    whole.

    This means, obviously, that the ALJ's choice of inferences is

    to be respected. See Sprague, 688 F.2d at 866 ("In reviewing ___ _______

    for substantial evidence it is immaterial that the facts

    permit diverse inferences as long as those drawn by the ALJ

    are supported by evidence.").

    The ALJ's Decision __________________

    The ALJ's conclusions are backed by an extensive

    discussion of the several experts. One or more of BIW's

    experts testified that current medical evidence indicates

    that a finding of interstitial fibrosis is necessary to reach


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    a diagnosis of asbestosis. There was testimony that tissue

    samples and x-ray analyses produced no evidence that Harford

    had asbestosis; that he did not have fibrosis at the time of

    his surgery, and that the alveolar damage found in a biopsy

    some months later was caused by radiation and chemotherapy

    rather than by asbestos exposure.

    Two experts testified on causation of the cancer.

    Dr. Cadman's conclusion was,

    [C]urrent evidence evaluating the
    association of asbestos exposure, lung
    fibrosis and lung cancer strongly suggest
    [sic] that the excess lung cancer ___________________________
    attributable to asbestos is associated _________________________________________
    with fibrosis. Therefore, lung cancer in _____________
    the absence of pulmonary fibrosis is most
    likely lung cancer which developed either
    from the effects of smoking alone or it
    arose unrelated to any known carcinogen
    as occurs in the non-smoker. . . . I
    believe that in the absence of fibrosis,
    that [Mr. Harford's] lung cancer was most
    likely the result of prior smoking
    history. (emphasis added).

    The ALJ concluded,

    Based on the record medical evidence, I
    determine that the employer/carriers have
    produced specific objective clinical
    evidence and soundly reasoned medical
    opinions sufficient to sever the causal
    nexus and have thereby rebutted the
    Section 20 presumption.

    Since the ALJ had stated earlier that cause included

    contribution, we find that the ALJ was warrantably covering

    both in this finding. Dr. Cadman reasonably could be found

    as of the opinion that diffuse interstitial fibrosis (and


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    therefore asbestosis) is generally present when asbestos

    exposure is a contributing cause to lung cancer. Viz., the

    probability is against asbestos, in the absence of

    asbestosis. In other words, asbestos exposure had had no

    belated, contributory, effect, as well as no original effect.

    We believe, following Dr. Cadman's reference to "excess" lung

    cancer, particularly when there had been negative evidence

    covering the period between surgery and the subsequent

    biopsy, that his last quoted sentence is not to be read as

    limiting his opinion to the original cancer. In short, Dr.

    Cadman's opinion is substantial evidence of non-causation,

    sufficient both to rebut the presumption and to support a

    finding for BIW.

    Next? _____

    First, an observation. Harford's claim was filed

    on March 20, 1989, just short of nine years ago. The ALJ's

    unfavorable decision on the merits was filed on June 10,

    1991; the Board's remand for a hearing on damages on November

    23, 1993. BIW's petition for review of the ALJ's damage

    finding was filed July 7, 1994. This finding was affirmed

    automatically under the statute, Omnibus Consolidated

    Rescissions and Appropriations Act of 1996, Pub. L. No. 104-

    134, 101(d), 110 Stat. 1321, 1321-219 (1996), because of

    the Board's not having passed on the petition before

    September 12, 1996. We believe the time has come to resolve


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    matters. If we remand the case to the Board to review the

    ALJ's decision on the merits, it will be bound by his

    findings in the absence of error. See 33 U.S.C. 921(b)(3). ___

    Why the unnecessary steps? The short answer is that we

    should take over finally now. And, indeed, we have already

    reviewed the ALJ's detailed and careful opinion. Substantial

    evidence supports the ALJ's conclusion that there was no

    causal relationship. We find no error.

    The decision of the Benefits Review Board is ___________________________________________________

    reversed, and the denial of claim of Russell E. Harford, Jr. _____________________________________________________________

    is reinstated. ______________





    - Dissent follows -
























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    LYNCH, Circuit Judge, dissenting. The record in LYNCH, Circuit Judge, dissenting. ______________

    this case sets forth substantial evidence to support the

    Board's finding that the employer, which had rebutted the

    920(a) presumption that asbestos exposure caused claimant's ______

    lung cancer, did not rebut the 920(a) presumption that

    asbestos exposure contributed to claimant's lung cancer. I ___________

    would affirm the Board.

    The employer's evidence all went to initial

    causation with one exception. That exception was the

    testimony of its lead expert, Dr. Cadman, and it tended to

    support claimant on the contribution issue. In testimony

    introduced at the hearing, Dr. Cadman was invited and refused

    to testify that he could say to a reasonable medical

    probability that asbestos had not contributed to Harford's ___________

    cancer. Rather, Dr. Cadman testified that 10-15% of people

    with occupational exposure to asbestos who develop lung

    cancer do not experience fibrosis in the lungs. He

    specifically stated (after a direct question on whether

    asbestos could have contributed to Harford's cancer) that

    asbestos exposure "may be contributing," even in the absence

    of asbestos-caused fibrosis, "although at a very small level,

    because he does not have fibrosis."

    There is a crucial difference, acknowledged in our

    case law, between employment-related injuries that are the

    primary cause of a disability and those which aggravate or


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    contribute to a pre-existing condition. See Director, ___ _________

    O.W.C.P. v. Bath Iron Works Corp., 129 F.3d 45, 50 (1st Cir. ________ ______________________

    1997); Bath Iron Works Corp. v. Director, O.W.C.P., 109 F.3d _____________________ __________________

    53, 55 (1st Cir. 1997). Under the "aggravation rule," even a

    small contribution by a work-related condition to the

    claimant's disability is sufficient to trigger full recovery

    under the LHWCA; primary causation need not be shown. See ___

    Hensley v. Washington Metro. Area Transit Auth., 655 F.2d _______ ______________________________________

    264, 268 (D.C. Cir. 1981). The aggravation rule embodies the

    essentially humanitarian purposes of the LHWCA. It assures

    that a claimant is compensated where employment-related

    injury is not the sole cause of the claimant's disability.

    Here, Dr. Cadman testified that the absence of asbestos-

    caused fibrosis is not sufficient evidence to support the

    conclusion that asbestos exposure did not contribute to

    Harford's cancer. BIW therefore did not rebut the

    presumption that asbestos exposure contributed to Harford's

    lung cancer. The absence of fibrosis proves nothing on the

    contribution issue.

    The ALJ erroneously conflated the primary causation

    and contribution analyses and incorrectly concluded that

    where there was no primary causation there was no

    contribution, either. The Board, performing these analyses

    separately, recognized the significance of Dr. Cadman's

    testimony as to contribution. Because Dr. Cadman expressly


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    stated that asbestos exposure could have contributed to the

    cancer in the absence of fibrosis, the Board correctly

    reversed. In light of the purposes of the Act, manifested by

    the 920(a) presumption, and the precedent that close

    questions should be decided in favor of the claimant, see ___

    Bath Iron Works Corp. v. White, 584 F.2d 569, 574 (1st Cir. ______________________ _____

    1978), I respectfully dissent.






































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