'[A] finding of heightened causation under § 1(7A) must be supported by medical opinion that addresses -- in meaningful terms, if not the statutory language itself -- the relative degree to which compensable and noncompensable causes have brought about the employee's disability.' Stewart's Case, 74 Mass. App. Ct. 919, 920 (2009). 'The insurer must raise § 1(7A) as a defense and produce evidence to trigger its application.

The administrative judge credited the doctors’ opinions that the employee suffered from degenerative arthritis, which was "traumatic[ally] aggravat[ed]" by the March 30, 2014 work injury. See Stewart's Case, 74 Mass. App. Ct. 919, 920 (2009) (ruling based on medical opinion addressing "the relative degree to which compensable and noncompensable causes have brought about the employee's disability"). We conclude that the administrative judge's thorough findings satisfied the requirements of § 1 (7A). It was within his discretion to credit the medical opinions presented by the employee, and to reject those presented by Massport.

The board concluded that the expert medical evidence established only that an aggravation of the preexisting condition had occurred, and that even Dr. Kim's determination directly attributing Aleman's ongoing pain to the 2012 injury was insufficient for § 1(7A) purposes, as it failed to address “ ‘the relative degree to which compensable and noncompensable causes ha[d] brought about the employee's disability.’ Stewart's Case, [74 Mass.App.Ct. 919,] 920 [2009].” Relying on Castillo v. Cavicchio Greenhouses, Inc., 66 Mass.App.Ct. 218, 219–221 (2006), the board determined that “[a]lthough the adopted evidence of aggravation satisfies the ‘combination injury prong of § 1(7A), it does not support a finding that the compensable injury remains a major cause of the employee's disability or need for treatment.”

Second, the Court finds that the proffered expert testimony is helpful in assessing the relevant issues in instant case, even if the language of Dr. Herrick's opinion does not precisely map onto the legal standard. Stewart's Case, 74 Mass. App. Ct. 919, 919 (2009). Additionally, the Court finds that Dr. Herrick's proposed expert testimony is sufficiently reliable for the purposes of FRE 702. Not only is Herrick qualified to offer an expert opinion regarding Westport's remediation efforts and the health threat posed by PCBs at WMS, but he has grounded his opinion in relevant scientific data and drawn his conclusions from that data based on his relevant experience.

The reviewing board simply determined that the employee failed to meet his burden of proving 'major' causation in light of the impartial's testimony. Compare Stewart's Case, 74 Mass. App. Ct. 919, 920 (2009) (expert witness need not use 'magic words' of § 1(7A); opinion expressed in terms substantially equivalent to those of statute will suffice). The employee also argues that the administrative judge erred in not allowing his motion to open the medical record because of the complexity of the issues presented (the judge took no action on it). The employee did not raise this issue before the reviewing board.

While Dr. Gore did not use the "magic words" of G. L. c. 152, § 1 (7A), namely that the heavy exertion was a "major, but not necessarily predominant" cause of his death, an opinion that expresses the functional equivalent of such words is nonetheless sufficient. See Stewart's Case, 74 Mass. App. Ct. 919, 920 (2009). Therefore, where the administrative judge credited Dr. Gore's medical opinion that he had "no doubt" that the heavy exertion was the cause of Cournoyer's death, and that "[t]o suggest some other possible cause of the cardiac arrest is not reasonable," we discern no error in the administrative judge's determination that the claimant has satisfied the heightened causation standard of G. L. c. 152, § 1 (7A).

While it is not necessary for an impartial medical examiner to use the "magic words" of the statute, the opinion must be "expressed in terms substantially equivalent to those of the statute." Stewart's Case, 74 Mass. App. Ct. 919, 920 (2009). We have previously held that the predominant contributing cause is the equivalent of the primary cause.

The insurer argues that the board's decision to affirm was arbitrary, capricious, and contrary to the law because the judge imposed upon it a new burden of production under § 1(7A) and failed to make findings regarding the nature of the employee's preexisting condition. The judge held that "[o]riginal Section 1(7A) causation was satisfied by the [l]ump [s]um [a]greement" and that, "[i]n order to avoid re-litigating the same causation ground repeatedly, ... the [i]nsurer must meet a new burden of production under" Stewart's Case , 74 Mass. App. Ct. 919 (2009). The board held that the insurer's claim of error in this analysis was "mooted by the judge's adoption of [the IME's] resounding opinion that the 2005 work injury remains a major cause of the employee's disability and need for treatment," and that "[t]his opinion clearly satisfies the employee's burden of proof under § 1(7A), regardless of what the insurer's burden of production was."

Pursuant to G.L.c. 152, § 1(7A), “[i]f 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.” The employer raised § 1(7A) as an affirmative defense and now argues that Dr. Green's opinion provided insufficient support for the judge's conclusion that the work incident is a major cause of disability or need for treatment. The employer points to Stewart's Case, 74 Mass.App.Ct. 919 (2009), where we remanded to the administrative judge for further findings because the IME was never asked and failed to opine whether the work injury was a major cause of the employee's condition when considered in relation to the employee's preexisting conditions. Here, however, counsel for the employer inquired extensively at Dr. Green's deposition as to whether the workplace injury was “the major cause” or “a major cause” of the employee's disability.

See also Cruz v. Smith Wesson, 24 Mass. Workers' Comp. Rep. 117, 121-122 (2010)(doctor's opinion that work was "not a major" cause clearly insufficient to support compensability under § 1[7A]). See Stewart's Case, 74 Mass. App. Ct. 919, 920 (2009)(§ 1[7A] combination injury cases need some indication of "the relative degree to which compensable and non compensable causes have brought about the employee's disability"). Contrast Lesoine v. Corcoran Mgt. Co., 22 Mass. Workers' Comp. Rep. 153, 159 (2008) (doctor misunderstood the legal meaning of "a major"; but his opinion that industrial accidents were forty percent of the cause satisfied "a major cause" standard).