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    Does A Medical Expert’s Mere Offering Of Alternative Analyses With Respect To Causation Of A Pennsylvania Work Injury Render The Expert’s Testimony Equivocal?

    No! In Manitowoc Co., INC. v. Workers’ Compensation Appeal Board (Cowan), No. 472 C.D. 2013, the Commonwealth Court of Pennsylvania correctly determined that the mere offering of alternative theories as to how an injured worker died after a fall didn’t render that opinion equivocal.

    This matter involved a fatal claim petition stemming from a fall from a crane platform without harnesses. (remember- in workers’ compensation fault is not an issue) The platform was about 6 feet from the ground and had no handrails. While in a crouched position, Claimant said to his son/co-worker, “Hold it. Wait a minute.” The son saw his father’s eyes roll back, and his father fell off the platform. Claimant’s medical expert, Thomas R. Stoner, D.O., board certified in internal medicine, opined that the death was a result of falling on his head and that Claimant didn’t experience cardiac arrest at the time of the fall and that he couldn’t be sure of the Claimant’s state of consciousness at the time of the fall because he was not hooked up to any monitors.

    Employer presented the testimony of Paul M. Shipkin, M.D., a board certified neurologist, opined that Claimant lost consciousness before he fell because he went limp and fell without trying to catch himself, and that based on his pre-existing mitral valve disease and the fact that he turned blue quickly, that it was highly possible that a cardiac episode cause Claimant to lose consciousness.

    Both medical experts believed that Claimant suffered brain death. But Dr. Stoner disagreed with Dr. Shipkin that a cardiac event was the primary cause of the death because Claimant had no cardiac arrhythmia while he was hospitalized until he was disconnected from life support.

    Employer also presented the testimony of Joseph Gascho, M.D., a board certified cardiologist who opined that Claimant had cardiac arrhythmia and that was the cause of the loss of consciousness.

    The Workers’ Compensation Judge granted Claimant’s Petition, crediting Dr. Stoner’s opinions that Claimant was injured in the course of employment and that the death was caused by the fall and resulting head trauma. Employer appealed, alleging that Dr. Stoner’s testimony was equivocal because he offered alternate theories regarding the exact cause of the death. The Workers’ Compensation Appeal Board disagreed and so did the Commonwealth Court.

    To succeed on a fatal claim petition, claimant has the burden of proving that the employee sustained a work-related injury and that the injury was a substantial, contributing cause of the employee’s death. Where the causal connection between the work injury and the death is not obvious, the claimant must present unequivocal medical evidence establishing the connection.

    In this case, at the hearing, Dr. Stoner set forth four possible explanations (see Decision for more detail) regarding the connection between the fall and the death- however, under each scenario, Dr. Stoner’s ultimate conclusion was that the fall and blunt-force trauma caused Claimant’s death.

    The mere offering of alternate analyses regarding a work injury does not render the testimony equivocal. To be unequivocal, the Court noted, “the expert need only state that in his or her professional opinion, the result in question came from the assigned cause”. (citing Corcoran v. Workers’ Compensation Appeal Board (Capital Cities/Times Leader), 725 A.2d 868, 872 (Pa.Cmwlth. 1999). The Commonwealth Court found that expert testimony is competent “even if the witness admits to uncertainty, doubt, reservation, or a lack of information with regard to certain medical details, as long as the witness does not recant the opinion first expressed.”

    This a good decision for the claimant’s bar. Medicine is not an exact science and doctors have to extrapolate from the data given to them.  In this case, Dr. Stoner, while having different theories about the specific chain of bodily events that caused the death, kept coming to the same conclusion, that it was the fall and blunt-force trauma that caused the death. The Commonwealth Court Decision here affirms the idea that a medical expert does not have to be 100% certain as to his or her opinion- indeed, the standard is “reasonable medical certainty” and the WCJ, Appeal Board, and Commonwealth Court also correctly found that Dr. Stoner’s opinion was unequivocal as he never recanted his opinion that the fall caused the death.

    For more information about fatal claim petitions in Pennsylvania Work Comp, evidence, medical testimony, or just general PA Work Comp Info, call or email Certified PA Work Comp Attorney Michael W. Cardamone at 215 206 9068 or Michael@cardamonelaw.com

    PA Work Injury Info

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