WILLIAM GOODWIN'S CASE

SUPREME COURT CASES

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State: Massachusetts

Court: First Circuit Court of Appeals Clerk

Docket No: 11-P-2088

Case Date: 10/15/2012

Specialty: Workers' Compensation Act, Findings by administrative judge, Impartial medical examiner, Judicial review, Proximate

Preview:WILLIAM GOODWIN'S CASE
WILLIAM GOODWIN'S CASE.
No. 11-P-2088.
Suffolk. September 11, 2012. - October 15, 2012.
Workers' Compensation Act, Findings by administrative judge, Impartial medical examiner, Judicial review, Proximate
cause. Administrative Law, Agency's interpretation of statute, Judicial review.
APPEAL from a decision of the Industrial Accident Reviewing Board.
W. Todd Huston for the employer.
Joseph P. McKenna, Jr., for the employee.
Present: Meade, Sikora, & Wolohojian, JJ.
MEADE, J.
National Grid, formerly KeySpan New England, LLC (self-insurer), appeals from a decision of the reviewing board of
the Department of Industrial Accidents (board) affirming the award of temporary disability and medical benefits to
William Goodwin (employee). At issue in this appeal is the application of the "major cause" standard of G.L. c. 152, §
1(7A), when an industrial injury combines with a noncompensable preexisting condition to cause the employee's
disability. [FN1] On appeal, the self-insurer claims that (1) the board's decision, which failed to treat the impartial
medical examiner's opinion on causation as binding in the absence of any countervailing medical evidence, was
arbitrary and capricious, and (2) the board's interpretation of the statutory phrase "a major ... cause" was contrary to
law. We affirm.
1. Background. The employee was fifty-five years old at the time of the 2010 hearing before the administrative judge.
He had worked his entire career for the self-insurer and its predecessors. During the prior seventeen years, he had
worked as a pipefitter, which involved heavy physical labor. On December 29, 2008, while working overhead with two
wrenches to repair a gas leak, the employee felt a "pop" in the back of his neck. Although he had experienced neck
pain before, this pain was different, radiating down his right arm and much worse than the pain he had experienced in
the past; he also experienced numbness in the arm. An MRI (magnetic resonance imaging) examination of his cervical
spine revealed extensive degenerative disc disease and disc degeneration at multiple levels, with osteophyte formation,
facet changes, and impingement of the thecal sac at the C4, C5, and C6 vertebrae, primarily on the right side. Surgery
eventually provided relief, and the employee returned to work on a full duty basis on February 1, 2010.
An impartial medical exam was performed by Dr. Nabil Basta pursuant to G.L. c. 152, § 11A. He diagnosed a cervical
strain and aggravation of preexisting cervical spondylosis. Dr. Basta opined that the work injury was responsible for
forty percent of the employee's disability and sixty percent was attributable to the employee's preexisting degenerative
condition. His written report concluded that the work injury was not a "major cause" of the employee's disability or
surgery, but only a "minor component." Dr. Basta's conclusion, as he later explained at his deposition, was based on
his belief that to be a "major cause," the work injury must account for more than fifty percent of the disability. The
administrative judge, who had no other medical expert testimony before him, adopted the medical findings in Dr.
Basta's report, but concluded the doctor used an improper legal standard in reaching his conclusion that the injury was
not a "major cause." The administrative judge found and ruled, based on all the evidence before him, that forty percent
"is sufficient to be a major cause of the employee's disability and need for treatment." The self-insurer appealed to the
reviewing board, which affirmed in a written decision that is now before us.
2. Standard of review. The Supreme Judicial Court has summarized the guiding principles as follows:
"An aggrieved party may seek judicial review of a decision of the board concerning workers' compensation benefits.
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G.L. c. 152, § 12(2). As specified in ... § 12(2), we review the board's decision in accordance with the standards set
forth in G.L. c. 30A, § 14(7)(a )-(d ), (f ), and (g ). Scheffler's Case, 419 Mass. 251, 257-258 (1994). Pursuant to these
statutory standards, we may reverse or modify the board's decision when it is '[i]n violation of constitutional
provisions,' '[i]n excess of the statutory authority or jurisdiction of the agency,' '[b]ased upon an error of law,' '[m]ade
upon unlawful procedure,' '[u]nwarranted by facts found ... where the court is constitutionally required to make
independent findings of fact,' or is '[a]rbitrary or capricious, an abuse of discretion, or otherwise not in accordance
with law.' G.L. c. 30A, § 14(7)(a )-(d ), (f ), and (g ). Under these standards, in determining whether the board
properly affirmed the administrative judge's findings, we consider 'whether the decision is factually warranted and not
"[a]rbitrary or capricious," in the sense of having adequate evidentiary and factual support and disclosing reasoned
decision making.' Scheffler's Case, supra at 258.... Where a statute is involved, '[a]lthough "[t]he interpretation of a
statute by the agency charged with primary responsibility for administering it is entitled to substantial deference,"
Gateley's Case, 415 Mass. 397, 399 (1993), ultimately the "duty of statutory interpretation is for the courts." Slater's
Case, 55 Mass.App.Ct. 326, 330 (2002).' Moss's Case, 451 Mass. 704, 709 (2008)."
Carpenter's Case, 456 Mass. 436, 439 (2010). In addition, we "give due weight to the experience, technical
competence, and specialized knowledge of the agency, as well as to the discretionary authority conferred upon it."
G.L. c. 30A, § 14, as amended by St.1973, c. 1114, § 3. See Murphy's Case, 53 Mass.App.Ct. 424, 427 (2001).
3. Discussion. The self-insurer claims the board's decision, which failed to defer to Dr. Basta's opinion on causation,
was arbitrary and capricious. We disagree. "Findings of fact, assessments of credibility, and determinations of the
weight to be given the evidence are the exclusive function of the administrative judge." Pilon's Case, 69 Mass.App.Ct.
167, 169 (2007). Dr. Basta opined that because the work injury was responsible for only forty percent of the
employee's disability while sixty percent was attributable to the employee's preexisting degenerative condition that was
not job-related, the work injury was not a "major cause" under G.L. c. 152, § 1(7A). The administrative judge was
under no obligation to adopt all of Dr. Basta's opinion, especially because (as we discuss below) his conclusion was
based on a legal misunderstanding of what qualifies as a "major cause." See Clarici's Case, 340 Mass. 495, 497 (1960)
(single member and reviewing board free to adopt any portions of medical testimony they deem credible). In other
words, as the board stated, it was not within the purview of the impartial medical examiner to define the legal scope of
G.L. c. 152, § 1(7A). As the board determined, in light of Dr. Basta's misunderstanding of the meaning of "major
cause," the administrative judge, who applied the correct standard to Dr. Basta's assessment of the work injury as a
forty percent cause, was warranted in concluding that the employee had met his burden of proof under § 1(7A).
Indeed, where there are two identified causes of an employee's disability, a forty percent cause may be a "major
cause." As such, the board's decision was not arbitrary and capricious.
The self-insurer also claims that the board's interpretation of the phrase "major cause" was contrary to law. More
specifically, the self-insurer claims that the board's conclusion that a "major cause" can be less of a factor than the
most important cause was erroneous and inconsistent with the plain meaning of the statute. We disagree.
In interpreting a statute, we look first to its language as "the principal source of insight into legislative intent." Water
Dept. of Fairhaven v. Department of Envtl. Protection, 455 Mass. 740, 744 (2010), quoting from Providence &
Worcester R.R. v. Energy Facilities Siting Bd., 453 Mass. 135, 142 (2009). Where the meaning of the language is plain
and unambiguous, we will not look to extrinsic evidence of legislative intent "unless a literal construction would yield
an absurd or unworkable result." Boston Hous. Authy. v. National Conference of Firemen & Oilers, Local 3, 458
Mass. 155, 162 (2010) (interpreting G.L. c. 150E, § 7[a ], which was later amended by St.2011, c. 198, § 1). See
Halebian v. Berv, 457 Mass. 620, 630 (2010).
Section 1(7A) of c. 152, as amended by St.1991, c. 398, § 14, provides in pertinent part:
"If a compensable injury or disease combines with a pre-existing condition, which resulted from an injury or disease
not compensable under this chapter, to cause or prolong disability or a need for treatment, the resultant condition shall
be compensable only to the extent such compensable injury or disease remains a major but not necessarily
predominant cause of disability or need for treatment."
This provision of c. 152 "imposes a heightened proof of causation on an employee who claims benefits in a situation
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where the claimed injury may be owing to a resultant condition arising from a combination of injuries, the claimed
compensable injury and a prior noncompensable injury. In those instances where the statute applies, as part of his
proof of causation the employee must prove that the 'compensable injury or disease remains a major but not
necessarily predominant cause of disability or need for treatment.' G.L. c. 152, § 1(7A)." (Emphasis supplied.)
MacDonald's Case, 73 Mass.App.Ct. 657, 659 (2009). The emphasized language of § 1(7A) is clear: "a major ... cause"
need not be the "major ... cause." See Commonwealth v. Mandell, 61 Mass.App.Ct. 526, 528 (2004), quoting from
Pyle v. School Comm. of S. Hadley, 423 Mass. 283, 285 (1996) ("[W]here the language of a statute is clear and
unambiguous, it is conclusive as to legislative intent"). The Legislature's choice of the article "a," rather than "the," to
precede "major ... cause" implies that there may be more than one major cause. See May's Case, 67 Mass.App.Ct. 209,
212 (2006). In addition, the accompanying language ("but not necessarily predominant") makes it explicit that a major
cause need not be the superior or greatest cause, i.e., one that is more than fifty percent of the cause of the disability. If
we were to adopt the self-insurer's interpretation that a major cause cannot be less than the most important cause, we
would render meaningless the Legislature's choice of articles as well as the explicit caveat regarding predominance.
This we cannot do. See Halebian v. Berv, 457 Mass. at 628 ("We give effect to each word and phrase in a statute, and
seek to avoid an interpretation that treats some words as meaningless"). There was no error. [FN2]
Decision of reviewing board affirmed.
FN1. In such cases the statute, quoted more fully infra, provides that "the resultant condition shall be compensable
only to the extent [the] compensable injury or disease remains a major but not necessarily predominant cause of
disability or need for treatment" (emphases supplied). G.L. c. 152, § 1(7A), as amended by St.1991, c. 398, § 14. This
part of the statute is also known as the "combination injury" provision. See Carpenter's Case, 456 Mass. 436, 438 n. 3
(2010); Cornetta's Case, 68 Mass.App.Ct. 107, 117 (2007).
FN2. Relying on selected parts of Dr. Basta's deposition testimony, the self-insurer also argues that "there was no
medical evidence ... to support a finding of anything more than a simple aggravation" of the employee's preexisting
condition. The argument is without merit. The administrative judge quite evidently did not credit this portion of the
testimony, as was his prerogative. The remaining evidence, including the written report, amply supported his findings.
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