A Difficult Lesson in Sustantial Evidence
Thursday, October 11, 2012 | 0
Substantial that's the evidentiary standard that governs the vast majority of workers' compensation litigation.
The
standard of substantial evidence means that the evidence upon which the
trier of fact relies can reasonably support the proposition for which
it is raised, regardless of what other evidence is out there, and
whether or not other evidence may be more persuasive.
In other words, the substantial evidence standard simply asks if the evidence relied upon by the judge is "good enough."
Which
is why, in most circumstances, if one is not happy with the trial
judge's decision based on the evidence, one should not make an
evidentiary challenge unless one can prove fraud, bias or a clearly
erroneous conclusion. Attempting to challenge substantial evidence is
nearly always an expensive loser.
A Louisiana employer found that out and paid an additional penalty for doing so.
Dustin
Estis claimed he injured his back when he fell down a flight of stairs
while working for Ambar Lone Star Fluid Service. Estis called a
co-worker to assist him after he was unable to get up after the fall.
The co-worker called Estis' supervisor, who took Estis to a company
physician.
Dr. Gregory Gidman noted tenderness in Estis' back,
but found no bruises. An MRI showed a herniated disc and a lumbar bulge.
Gidman referred Estis to a neurosurgeon. Estis also visited a
physician's assistant and a doctor at Teche Occupational Medical Clinic.
Both professionals observed contusions consistent with a fall. Estis
chose Dr. John Cobb as his orthopedic surgeon and continued treatment
for his injury.
At a contested case hearing Ambar disputed that
Estis suffered a work-related injury. A workers' compensation judge
found in favor of Estis and awarded $8,000 in penalties and $12,000 in
attorney fees.
On Ambar's appeal, the 3rd Circuit Louisiana Court
of Appeals noted that Dr. Gidman's report finding no bruises on Estis'
back was rebuffed by two other medical professionals, and concluded that
the judge's decision to find a compensable injury was not erroneous. In
other words, the workers' compensation judge's findings were supported
by substantial evidence (the appellate court does not use this term in
its opinion, but it is clearly the evidentiary standard that is applied
on review).
Similarly, the appellate court was not swayed by the
employer's argument that Estis' claim should have been rejected because
his story of events varied slightly over time, and Dr. Gidman's initial
report showed no contusions, scrapes or scratches. The court said that
Estis' version of events was corroborated by Ambar's safety officer, and
the two medical professionals at Teche Occupational Medical Clinic
found bruises consistent with a fall:
"The record reveals that
Ambar has substituted suspicion and innuendo for facts and evidence.
Unfortunately, neither of those imposters are sufficient to reasonably
controvert Estis' claim."
Ambar was upset that the workers'
compensation judge awarded Estis' attorney $12,000 in fees. Big mistake.
The employer's appeal cost it an additional $16,000 in fees payable to
the claimant's attorney for a total attorney fee award of $28,000.
Lesson for employers/carriers - don't mess with substantial evidence.
Case: Estis v. Ambar Lone Star Fluid Service, Nos. 12-206, consolidated with 12-207, 10/03/2012.
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