This appeal arises out of the denial of benefits to the survivors of David Eugene Miller by the Alaska Workmen's Compensation Board. The superior court upheld the Board's determination. We affirm.
David E. Miller collapsed on January 20, 1975, while employed by ITT Arctic Services on a project at Fort Wainwright near Fairbanks; he died at a nearby hospital within one and one-half hours of being stricken. Miller had been making "cross connections" for communications circuitry on the third floor of a building. Although testimony of witnesses before the Board is not entirely in agreement regarding details of the day's work, it appears that Miller had been doing primarily fine hand work for nine or ten hours — making electrical connections and wrapping the wires around terminals with an electric "gun" weighing a pound or less. No heavy lifting or other vigorous exertion was involved. At about 5:15 p.m., the crew cleaned up the area, carried tools or other items down the 44 steps of the building, and loaded them into a pickup truck. One of Miller's co-workers testified that Miller made two or three trips down the stairs with boxes of equipment and materials and that Miller last carried a box of spare iron parts from the "cable rack." The "nonworking foreman" for the job testified that Miller made only one trip from the third floor to the pickup — carrying his toolbox weighing 30-35 pounds. Miller lifted the box onto the tailgate of the pickup and immediately slumped over the box. He was carried back inside the building by the other members of the crew and subsequently was taken by ambulance to Bassett Army Hospital at Fort Wainwright where he died.
Miller's widow, son and stepdaughter filed a claim for workmen's compensation benefits, and a hearing was held before the Alaska Workmen's Compensation Board.
In deciding that the presumption of compensability had been rebutted, the Board relied upon testimony of Miller's co-worker and foreman that the work performed by
Miller's survivors appealed the decision of the Alaska Workmen's Compensation Board, and the superior court affirmed.
Miller's survivors contend that the statutory presumption of compensability was not overcome because no substantial evidence was introduced to show that Miller's death was not work-connected. They also argue for application of the rule that doubts as to the substance of medical testimony must be resolved in favor of claimants; and with respect to testimony in the case at bar, this rule requires the conclusion that no substantial evidence was introduced to overcome the presumption of compensability.
The Alaska Workmen's Compensation Act contains a presumption that an injury is work-connected in the absence of substantial evidence to the contrary.
In Fireman's Fund American Insurance Cos. v. Gomes, 544 P.2d 1013 (Alaska 1976) (unexplained murder of bartender at his place of employment), we explained two possible ways of overcoming the presumption of compensability: (1) by affirmative evidence showing that the death was not work-connected, or (2) by eliminating all reasonable possibilities that the death was work-connected.
Unlike the situation in Gomes, appellees in the case at bar have introduced affirmative evidence in the form of expert testimony that Miller's death was not work-related. The question remains, however, whether the evidence was sufficient to constitute substantial evidence for purposes of rebutting the statutory presumption of compensability.
The adequacy of evidence introduced to overcome the statutory presumption was addressed by this court in Employers Commercial Union Co. v. Libor, 536 P.2d 129 (Alaska 1975). In Libor, the Board had awarded compensation based upon its conclusion that a work-related back injury was the cause of a subsequently discovered herniated disc. We upheld the award and concluded that substantial evidence against the presumption of compensability had not been produced even though one of the two medical experts testified that the initial injury could not, with a reasonable degree of medical certainty, be said to be the cause of the condition for which the claimant sought compensation. However, the witness gave no opinion that the subsequent disability was not work-related. Under those circumstances, we held that the presumption of compensability had not been overcome. The mere inability to state that the disability was work-related did not constitute substantial evidence.
Thornton v. Alaska Workmen's Compensation Board, 411 P.2d 209 (Alaska 1966), also presented the question whether the presumption of compensability had been overcome by substantial evidence that the employee's death was not work-related. We concluded, in part, that the presumption had not been overcome because neither of the two medical witnesses testified that the employee's exertion had not contributed to his death.
In the case at bar, three physicians testified as to the cause of Miller's death. All three agreed that a ruptured berry aneurysm was the most likely cause of death.
Dr. Partnow, the physician who treated Miller in the hospital emergency room, stated that causes of ruptured berry aneurysms are not well understood. He explained that such aneurysms are statistically more likely to rupture during periods of activity than during periods of repose, but he also noted that people are active for the largest proportion of each day. In Dr. Partnow's opinion, the rupture of a berry aneurysm might be caused by an increase in intracerebral blood pressure due to physical straining; loading a box on the back of a pickup truck was the kind of activity which would result in a noticeable increase in blood pressure. However, he declined to state categorically whether the rupture was related to physical activity:
The third medical expert, Dr. Wilson, stated, "[I]t's only the occasional case where it seems that the specific act of physical activity immediately preceded the bleed... . Most of these occur ... at random ... with respect to activity." Dr. Wilson also stated that ordinary physical activity does not increase blood pressure — although "an enormously heavy amount of lifting... might make the blood pressure go up a little bit." He stated that a single act of lifting a moderately heavy tool box would not alter blood pressure at all. Although Dr. Wilson agreed with the claimant's counsel on cross-examination that no absolutes exist "in this thing," he stated categorically that no relation existed between Miller's effort and the apparent rupture:
The instant case differs from Libor and Thornton because Dr. Wilson expressly stated that in his opinion Miller's exertion at work "had nothing whatsoever to do with" Miller's death. His opinion was based upon accurate and complete information concerning the circumstances surrounding Miller's death. Nor was Dr. Wilson's expertise or the reliability of his testimony undercut by the testimony of other experts or by cross-examination. Under such circumstances, we conclude that substantial evidence — which a reasonable mind might find adequate to support a conclusion that Miller's death was not related to his employment — had been introduced and that the presumption of compensability was overcome. In the absence of the presumption, the claimants must prove all elements necessary to establish the claim.
Appellants also argue that the presumption should be sustained because the experts' testimony indicates uncertainty among the medical profession as to the causes of aneurysm rupture. They contend that the rule resolving doubts as to the substance of medical testimony in favor of claimants requires resolving uncertainty in medical evidence in favor of Miller's survivors and, accordingly, no substantial evidence exists to rebut the presumption.
On several occasions we have stated that any doubt as to the substance of medical testimony should be resolved in favor of the claimant.
In the case at bar, Dr. Wilson's testimony that Miller's death was unrelated to his employment cannot be characterized as doubtful or ambiguous. Since the substance of Dr. Wilson's testimony was not in doubt, there was no need for the Board to resolve any questions regarding its content. The Board properly declined to apply the rule to the medical testimony before it.
Although we have concluded that the employer introduced substantial evidence to overcome the presumption of compensability, the question remains whether the Board's denial of workmen's compensation benefits to Miller's widow and children was correct. In reviewing a determination of the Alaska Workmen's Compensation Board, the applicable standard of review is again the substantial evidence test.
Since the statutory presumption of compensability has been overcome, it is the applicants' burden to prove all elements necessary to support their claim. The Board considered both testimony of medical experts and testimony of Miller's co-workers and determined that the applicants had failed to show a work-connection. We have carefully reviewed the entire record and have concluded that the same evidence introduced to rebut the presumption of compensability is also adequate to support the Board's decision. Even if the substance of testimony given by Dr. Partnow and Dr. Mead is viewed as being in doubt — such that it should be resolved in favor of Miller's widow and children — substantial evidence remains upon which the Board could reasonably have based its conclusion. The evidence well might support a different decision by the Board; indeed, the cases cited in appellants' brief illustrate the diverse positions taken by workmen's compensation boards and courts in cases where employees have died as a result of aneurysm rupture. However, as a reviewing court, we may not reweigh the evidence or draw our own inferences from it.
See Fireman's Fund Am. Ins. Cos. v. Gomes, 544 P.2d 1013, 1015 (Alaska 1976); Beauchamp v. Employers Liab. Assurance Corp., 477 P.2d 993 (Alaska 1970).
In the case at bar, appellees argue that any competent affirmative evidence should be sufficient to rebut the presumption of compensability. This court previously has required more than mere competence. The evidence not only must be competent but also must be such that a reasonable mind might accept it as adequate to support a conclusion. Fireman's Fund Am. Ins. Cos. v. Gomes, 544 P.2d 1013, 1016 (Alaska 1976). Professor Larson's view is similar:
1 Larson, Workmen's Compensation Law § 10.33(b), at 3-128 (1978).
Several other opinions of this court which consider the presumption of compensability are also useful in evaluating the amount of evidence necessary to be substantial. See, e.g., Anchorage Roofing Co., Inc. v. Gonzales, 507 P.2d 501, 505-06 (Alaska 1973); Beauchamp v. Employers Liab. Assurance Corp., 477 P.2d 993 (Alaska 1970).