Opinion
W.C. No. 3-109-015
December 27, 1995
FINAL ORDER
The claimant seeks review of a final order of Administrative Law Judge Martinez (ALJ) which denied her claim for death benefits. We affirm.
The ALJ found that the decedent was a miner who spent many years working in various mines in Colorado. His last Colorado employment was at the Eula Bell mine near Uravan, Colorado, from April 1961 to November 1963. Thereafter, the claimant worked at a molybdenum mine in California until he had a heart attack in 1974 or 1975. Following the heart attack, the claimant did not work.
The claimant died in Colorado on January 28, 1991. At that time, the ALJ found that the claimant was suffering from cardiac disease including ischemic congestive heart failure, congestive cardiomyopathy, and two prior myocardial infarctions. The ALJ also found that the claimant had pulmonary disease. A portion of the pulmonary condition was "restrictive disease" attributable to the claimant's occupational exposure to dust. The other portion of the disease was chronic obstructive pulmonary disease (COPD) attributable to the claimant's smoking history.
Shortly before his death, the claimant was admitted to the hospital primarily for "cardiac problems." Nevertheless, the ALJ noted that the claimant's treating physician, Dr. Hansen, opined that the claimant's death was fifty percent attributable to the occupational pulmonary disease and fifty percent to non-occupational causes. The ALJ also noted that Dr. Vall-Spinosa opined that the decedent died from cardiac rather than pulmonary problems.
Relying on § 8-41-301(1)(c), C.R.S. (1995 Cum. Supp.), the ALJ concluded that the claimant was required to prove that the decedent's death was "proximately caused" by his occupational lung disease. However, the ALJ stated that the claimant did not satisfy her burden to prove the requisite causal connection by a preponderance of the evidence. Specifically, the ALJ stated that the medical evidence did not "fulfill" the burden of proof, and that neither the testimony of Dr. Hansen, nor the medical records or reports established causation. Consequently, the ALJ denied the claim for death benefits.
On review, the claimant's principal contentions are that the ALJ's findings do not support the order, and that the denial of compensation is not supported by substantial evidence in the record. The claimant argues that if the decedent's occupational lung disease "contributed" to his death then she demonstrated the requisite causal connection, even if other factors also contributed to the death. Moreover, the claimant asserts that contrary to the ALJ's findings, all of the medical evidence establishes that the occupational lung disease was a proximate cause of the death. We reject the claimant's arguments.
The ALJ correctly held that, in order to recover death benefits, the claimant was required to prove that the decedent's death was proximately caused by his occupational disease. Section 8-41-301(1)(c); Rumsey v. State Compensation Insurance Fund, 162 Colo. 545, 427 P.2d 694 (1967). In order to be a "proximate cause" it is not necessary that the occupational disease have been the only cause of death, but it must have been a significant cause in that it bore a direct causal relationship to the death. See Seifried v. Industrial Commission, 736 P.2d 1262 (Colo.App. 1986). Put another way, the occupational disease must have been a "precondition or trigger" of the death. See Subsequent Injury Fund v. State Compensation Insurance Authority, 768 P.2d 751 (Colo.App. 1988), aff'd. 793 P.2d 580 (Colo. 1990).
The question of whether the claimant proved causation is one of fact for determination by the ALJ. F. R. Orr Construction v. Rinta, 717 P.2d 965 (Colo.App. 1985). Similarly, the question of whether the claimant carried her burden of proof to establish causation is also a question of fact. Eisnach v. Industrial Commission, 633 P.2d 502 (Colo.App. 1981).
Because these matters are factual, we must uphold the ALJ's findings if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. (1995 Cum. Supp.). In this regard, we note that the ALJ is not bound to accept medical testimony even if it is unrefuted or uncontroverted. Cary v. Chevron, U.S.A., Inc., 867 P.2d 117 (Colo.App. 1993). Rather, it is the ALJ's province to assess the credibility and probative value of medical testimony concerning causation. Rockwell International v. Turnbull, 802 P.2d 1182 (Colo.App. 1990). Further, to the extent medical testimony contains internal inconsistencies or is subject to various interpretations, it is for the ALJ to resolve such matters. Colorado Springs Motors, Ltd. v. Industrial Commission, 165 Colo. 504, 441 P.2d 21 (1968).
Insofar as the claimant is contending that the ALJ made insufficient findings concerning the testimony of Dr. Hansen, we are not persuaded. An ALJ is not held to a crystalline standard in expressing his findings, and need not make findings on every piece of evidence. Riddle v. Ampex Corp., 839 P.2d 489 (Colo.App. 1992). Here, the ALJ expressly recognized that Dr. Hansen was of the opinion that the decedent's death was, at least in part, attributable to his occupational lung disease. However, the ALJ's finding that the claimant failed to satisfy her burden of proof indicates that the ALJ did not find Dr. Hansen's opinion sufficiently persuasive.
Moreover, we reject the claimant's argument that all of the medical evidence compels the conclusion that occupational lung disease contributed to the decedent's death. First, the ALJ need not have been persuaded by Dr. Hansen's testimony. As was pointed out during cross-examination, Dr. Hansen listed the decedent's pneumoconiosis as the cause of death on the death certificate, but did not list it in the discharge summary. Dr. Hansen also conceded that the drugs the decedent was being given for his non-occupational COPD could have complicated the decedent's heart condition. Dr. Hansen also admitted that the decedent's COPD could have contributed to the decedent's right-sided heart failure, and that the decedent's left-sided heart failure could have contributed to his right-sided heart failure. Put another way, Dr. Hansen testified to many facts and opinions which, under the circumstances, call into question his overall opinion concerning the cause of the decedent's death.
Moreover, the record contains additional medical evidence which supports the ALJ's determination that the claimant failed to prove proximate cause. Dr. Vall-Spinosa stated that it "appears that [the decedent] died of cardiac disease." Although Dr. Vall-Spinosa also stated that the claimant's "compromised pulmonary function" was a "contributory factor" to the death, it was for the ALJ to resolve this inconsistency. Moreover, Dr. Good stated in his report of May 16, 1995, that "it would appear that [the decedent's] pneumoconiosis certainly contributed to chronic hypoxemia but that the terminal event appears to be one of more congestive heart failure secondary to an ischemic cardiomyopathy."
This case presents complicated factual issues involving medical causation. The mere fact that some of the medical evidence supports a finding that the occupational lung disease contributed to the death is immaterial on review, and we decline the claimant's invitation to substitute our judgment for that of the ALJ. May D F v. Industrial Claim Appeals Office, 752 P.2d 589 (Colo.App. 1988).
We recognize the claimant's argument that it is appropriate to "apportion" death benefits under principles set forth in Anderson v. Brinkhoff, 859 P.2d 819 (Colo. 1993). However, we need not determine whether death benefits might be, under some circumstances, apportioned under Anderson. Anderson assumes that, to some degree, the claimant has proven a work-related disease which is causing disability. Here, the ALJ was not persuaded that the occupational disease had anything to do with the claimant's death. See Cowin Co. v. Medina, 860 P.2d 535 (Colo.App. 1992).
We note that certain pages appear to be missing from the copy of Dr. Hansen's deposition in the record. However, the parties have raised no issue concerning this matter, and therefore, we consider the record to be complete.
In light of this disposition, we need not consider the claimant's argument that the ALJ erred in concluding that the claim is barred under § 8-41-204, C.R.S. (1995 Cum. Supp.).
IT IS THEREFORE ORDERED that the ALJ's order, dated July 25, 1995, is affirmed.
INDUSTRIAL CLAIM APPEAL PANEL
___________________________________ David Cain
___________________________________ Bill WhitacreNOTICE
This Order is final unless an action to modify or vacate the Order is commenced in the Colorado Court of Appeals, 2 East 14th Avenue, Denver, Colorado 80203, by filing a petition to review with the court, with service of a copy of the petition upon the Industrial Claim Appeals Office and all other parties, within twenty (20) days after the date the Order was mailed, pursuant to §§ 8-43-301(10) and 307, C.R.S. (1995 Cum. Supp.).
Copies of this decision were mailed December 27, 1995 to the following parties:
Lorene G. Tibbets, 1770 Rampart, Cortez, CO 81321
Union Carbide Metals Division, 2754 Compass Dr., Ste. 280, Grand Junction, CO 81506-8728
Colorado Compensation Insurance Authority, Attn: C. Kriksciun, Esq. (Interagency Mail)
Scot Houska, Esq., 744 Horizon Ct., Ste. 360, Grand Junction, CO 81506
(For the CCIA Respondents)
Subsequent Injury Fund — Interagency Mail
Robert C. Dawes, Esq., 572 E. Third, Ave., Durango, CO 81301
(For the Claimant)
Attorney General's Office, Attn: J. Anthony Ogden, Esq., 1525 Sherman St., 5th Flr., Denver, CO 80203
(For SIF)
By: _______________________