Newport News Shipbuilding and Dry Dock Company v. Larry D. Ward Director, Office of Workers' Compensation Programs, United States Department of Labor

WIDENER, Circuit Judge,

dissenting:

I respectfully dissent.

I.

I disassociate myself from the remarks made in the majority decision concerning the weight of the evidence from two physicians involved in this case, Drs. Reid and Gamer. The attempt by the majority at *444the conclusion of its opinion, to resurrect those physicians, indeed emphasizes the correctness of their opinions. Dr. Garner, a neurosurgeon who had twice operated on Ward, for example, obviously knew as much or more than anyone in the world about Ward’s back. The failure to credit his report, and that of Dr. Reid, a treating physician, is simply not realistic. Neither, in my opinion, is it good law.

II.

In the most general terms, I think our court is making a huge mistake in not recognizing that the Longshore and Harbor Workers Compensation Act is simply a federal substitute for ordinary Workers Compensation laws which are very nearly universal in this country except under the federal or similar statutes I have just mentioned. Those eases, as every practicing lawyer knows, are decided almost wholly upon forms and written reports completed by physicians and like experts, affidavits from those engaged in the occupation of the injured employee, and such evidence. Little oral testimony is taken, either before administrative law judges or the courts. Deciding these cases on the hyper-technical rules set out in Carmines and Harcum I and Harcum II, which I suggest are not fully understood by anyone, would do credit to a full-fledged case complete with judge, jury, discovery, and pre-trial, the entire legal process, instead of the administrative process which initially, I am sure, was calculated to see that injured employees receive prompt compensation and that employers remain able to assert their statutory rights without the requirement of extended litigation. If we want to impose some kind of a rule that each or all of these successive injuries, which always must be present for 8(f) relief, must be quantified under the AMA Guidelines to the Evaluation of Permanent Impairment, we should just say so, rely on addition and subtraction, and be done with it, instead of relying on the highly technical and little understood Carmines and Harcum rules which have used as their shelters here a failure to credit two perfectly reliable physicians who were the source of all the medical and related evidence which the record shows could have been gathered about these injuries. With respect to the downgrading of a physician’s written report because it comes from a “company doctor,” no more reason exists to downgrade that report than was our “close scrutiny of the record” justified by findings of fact prepared by an attorney for one of the parties, which the Court forbade in Anderson v. City of Bessemer City, 470 U.S. 564, 571-73, 105 S.Ct. 1504, 84 L.Ed.2d 518 (1985).

III.

To get to the case at hand. That Newport News met the first two elements required for § 8(f) relief is undisputed in this court.

At issue here is whether Newport News met the third, or contribution, element.1 In its petition for § 8(f) relief, Newport News submitted the opinions of two physi-*445dans as evidence that Ward’s 1987 injury and surgery made his ultimate disability materially and substantially greater than it otherwise would have been. First, the employer submitted the May 1, 1997 letter report of Dr. Reid, a Newport News staff physician who was an examining and treating physician with respect to each of the injuries involved here. Dr. Reid’s report speaks to the contribution element of Newport News’ claim for 8(f) relief as follows:

May 1, 1997
Re: Larry D. Ward; [SSN omitted on the account of privacy concerns]
Dear Ms. Massenberg:
At your request, I have reviewed Mr. Ward’s clinic records, as well as his outside medical records which are contained in his clinic chart. In addition, I have treated Mr. Ward for his injury. I can provide the following medical history and opinions, stated with a reasonable degree of medical certainty.
1. Mr. Ward had injured his back on December 11,1987 and he had an aggravation injury on June 16,1989.
2. Mr. Ward first injured his back on December 11, 1987. Mr. Ward missed three weeks of work and then required work restrictions (Exhibit 1). Mr. Ward ultimately in March, 1988 required a laminectomy for a herniated disc (Exhibit 2). Such an injury and surgery leaves the back permanently weakened and thus significantly more susceptible to further injury, and with the resultant disability being substantially greater. For this reason, such an injury and surgery under the AMA Guides rates a minimum 5% permanent disability rating. Indeed, Mr. Ward missed six more months of work, and required work restrictions (Exhibit 3). Mr. Ward in late 1988 and 1989 missed 6 more months of work, and returned to work on work restrictions (Exhibit 4). Mr. Ward rein-jured his back no approximately June 16, 1989 while pulling on heavy welding lines (Exhibit 5). Mr. Ward had a second herniated disc injury and required a second surgery (Exhibit 6).
3. Mr. Ward reached maximum medical improvement from his back injury on or before November 20, 1992 when he was permanently passed out of the Shipyard due to his back disability.
4. Mr. Ward’s pre-existing condition of chronic back disability was permanent and serious. A cautions employer would not hire a worker for heavy manual labor, such as at the Shipyard, if he had the back injury and surgery he had in 1987-1988.
5. Mr. Ward’s pre-existing condition of chronic back disability was manifest to the Shipyard based on its own records.
6. Mr. Ward’s disability is not caused by his December 11, 1987 back injury alone, but rather his disability is materially contributed to, and made materially and substantially worse by his aggravation injury, on June 16, 1989. Mr. Ward originally injured his back on December 11, 1987. Mr. Ward required disc surgery and his back was left in a permanently weakened condition. Nevertheless, he was able to perform light duty Shipyard work. The June 16, 1989 injury permanently and substantially aggravated and worsened his weakened defective back structure, been able to return to light duty Shipyard work. However, the combination of the two injuries and two surgeries, and their cumulative effect, have disabled Mr. Ward from even light duty Shipyard work.
If I may provide you any further information, please do not hesitate to call me.
*446Sincerely,
/s/ James W. Reid, M.D.
James Reid, M.D.
Enclosures (Exhibits 1-6)

Thus, Dr. Reid states that Ward’s 1987 injury helped cause his 1989 injury and that, without Ward’s 1987 injury, his 1989 injury and surgery would have left Ward able to perform light duty at the shipyard, just as Ward had returned to light duty after the 1987 injury.

The employer also submitted reports from Dr. Garner, Ward’s treating neurosurgeon, who signed, in addition, a one-line statement, without explanation, stating, “I agree with Dr. Reid’s opinion as expressed in his May 1, 1997 report concerning Mr. Ward.” More importantly, Dr. Reid’s report includes, in addition, a letter and three office memos from Dr. Garner which were never mentioned by the Board and the substance of which was not considered by the ALJ.

The Director did not present to the ALJ any evidence relating to the contribution element of Newport News’ § 8(f) claim.

The Board, following the ALJ, found that Newport News failed to prove the contribution element of the claim “because' it did not quantify disability due to the June 1989 injury alone.” In reaching its conclusion, the Board found the ALJ could not “examine the logic” and “evaluate the evidence” under Carmines. The ALJ also disregarded as carrying no probative weight Dr. Garner’s letter agreeing with Dr. Reid. The Board agreed and affirmed.

At bottom, the decision of the Board is based on the fact that both the ALJ and the Board either did not believe the two physicians whose reports are a part of the record, or they discounted those reports, or both. It is my opinion that they arrived at their conclusions without any careful examination of those reports.

Dr. Reid was a 1963 graduate of the School of Medicine of Tulane University. He had served as a resident in internal medicine at the National Naval Medical Center and at the Naval Hospital. Additionally, he had served at the Naval Hospital in what the American Medical Association refers to as a flexible or transitional year. His major professional activity is that of full time staff at a hospital.

Dr. Garner was a 1967 graduate of the Medical School of the University of Virginia. His residency included the University of Virginia Medical Center in neurological surgery, University of Virginia in neurology, and the University of Virginia Medical Center in general surgery. He is Board certified by the American Board of Neurological Surgery.

No one can suggest anyone in the world who was more familiar with Ward’s back than Dr. Reid and Dr. Garner. Dr. Reid was and had been one of Ward’s examining and treating physicians on account of both injuries involved in this case while Ward worked for Newport News. Additionally, Dr. Garner had operated on Ward’s back twice for the very injuries at issue here, performing a laminectomy for excision of a herniated disc at L4-L5 in March 1988, and another laminectomy for another herniated next lower disc at L5-S1 in August 1989. Both surgeries included post-operative examinations by Dr. Garner, so, absent an examination or operation on Ward’s back by some unknown physician whom I am sure the Director would have produced, it is safe to say that Dr. Garner knew more about Ward’s back than anyone in the world. I add that it is not possible to say that Dr. Garner was not professionally qualified to make the reports which he did. Also, Dr. Garner was perfectly capable of reading the letter report of Dr. Reid which appears earlier in this opinion and *447expressing his opinion with respect to that letter.

In Director, OWCP v. Newport News Shipbuilding, 8 F.3d 175 (4th Cir.1993) (Harcum I), in a similar fact situation involving an initial permanent partial disability followed by a second injury causing additional permanent partial disability, we held that the ultimate permanent partial disability must materially and substantially exceed the disability as would have resulted from the subsequent work-related injury alone. To show this, we held that “an employer must present evidence of the type and extent of disability that the claimant would suffer if not previously disabled when injured by the same work-related injury.” Harcum I, 8 F.3d at 185. We continued “[o]nce the employer establishes the level of disability in the absence of a pre-existing permanent partial disability, an adjudicative body will have a basis on which to determine whether the ultimate permanent partial disability is materially and substantially greater.” Harcum I, 8 F.3d at 185-186. We repeated that direction in Newport News Shipbuilding v. Director, OWCP, 131 F.3d 1079, 1081, 1082 (4th Cir.1997) (Harcum II), and in neither of those decisions did we require that which is called quantification be limited to the disability percentages such as appear in the American Medical Association Guidelines to the Evaluation of Permanent Impairment or like medical guidelines.

The record at hand includes a stipulation that Ward injured his back in his employment on December 11, 1987 and that he had back surgery and returned to light duty work. It was also stipulated that Ward reinjured his back June 16, 1989 in the course of his employment, that the “1989 injury aggravated] his pre-existing weakened back, required a second back surgery and ... [Ward] has been unable to return to shipyard work since then.” Dr. Reid’s report of May 1, 1997 reports that Ward missed three weeks of work on account of his first injury and then required work restrictions of no vertical ladders, no lifting over 30 pounds, no work in tight spaces, and no stooping. One of the restrictions was to expire after 14 days and the others 19 days after January 4th, and Ward was to return to the clinic on January 21,198[8] for an evaluation.

Dr. Reid’s report continues that Ward required a laminectomy for that herniated disc which was performed by Dr. Garner, whose reports appear in the record. That report notes that Ward was discharged on the 4th post-op day and notes relief of the leg pain. He was instructed regarding care of the low back and told to return to Dr. Garner in three weeks after April 7, 1988. Dr. Reid’s description of this injury is that:

Such an injury and surgery leaves the back permanently weakened and thus significantly more susceptible to further injury and with the resultant disability substantially greater.

Dr. Reid’s letter continues that under the American Medical Association Guidelines the injury and surgery described would rate a minimum 5% permanent disability rating. It continues that Ward missed six months of work and required work restrictions which are corroborated by the medical report from Dr. Reid dated September 15, 1988 showing that Ward was convalescing and continuing the restrictions of not lifting objects heavier than 30 pounds, no repeated bending or twisting or working in tight or cramped spaces, and no vertical ladders.

Ward returned to light work and rein-jured his back on June 16, 1989. This June 1989 injury was another herniated disc injury for a different disc, L5-S1, and required a second surgery. The second surgery was also performed by Dr. Garner and three of Dr. Garner’s office memos appear in the record with respect to that *448injury and operation. In Dr. Garner’s opinion, Ward was left with an AMA 17% permanent partial disability rating on account of the back problem with permanent restrictions which include no lifting heavier than 40 pounds, no overhead work, no working in a kneeling or squatting position, no repeated or continued bending or twisting and no working in tight spaces. It shows that he returned to work with these restrictions on April 16, 1990, but no job could be found in the shipyard with those restrictions. As noted, he is not totally and permanently disabled for all purposes, however, because he is employable at $102 per week.

Dr. Reid’s letter report includes the following statements by himself as an examining and treating physician, which certainly qualify as “medical evidence or otherwise,” Harcum II, 131 F.3d at 1082 (italics in original), which Dr. Garner was certainly qualified to examine and upon which express an opinion. Additionally, this evidence is certainly evidence with respect to which the ALJ could “examine the logic” and “evaluate.” Carmines, 138 F.3d at 140. The fact that neither the Board nor the ALJ did examine the logic nor evaluate the evidence is no fault of Newport News.

Mr. Ward ultimately, in March 1988, required a laminectomy for a herniated disc (Exhibit 2).
Such an injury and surgery leaves the back permanently weakened and thus significantly more susceptible to further injury and with the resultant disability being substantially greater.
Mr. Ward had a second herniated disc injury and required a second surgery. Mr. Ward’s disability is not caused by his December 11,1987 back injury alone, but rather his disability is materially contributed to and made materially and substantially worse by his aggravation injury on June 16,1989.
Mr. Ward originally injured his back on December 11, 1987. Mr. Ward required disc surgery and his back was left in a permanently weakened condition. Nevertheless, he was able to perform light duty shipyard work.
The June 16, 1989 injury permanently and substantially aggravated and worsened his weakened defective back structure, resulting in another herniated disc, the need for a second surgery, and his current disability.
Neither the 1987 injury, nor the 1989 injury, alone would have disabled Mr. Ward from performing light duty shipyard work.
He performed such work after the 1987 injury. If he had had a normal back when he suffered the 1989 injury, he likewise would have been able to return to fight duty shipyard work.

As I have pointed out, both the opinions of Dr. Reid and Dr. Garner were documented with contemporaneous written records which are nowhere contradicted, and no justification appears in the record for the failure of both the Board and the ALJ to “examine the logic” and “evaluate” those records. Neither the evidence of Dr. Reid nor Dr. Garner was testimony of a “non-examining, non-treating physician” which “should be discounted and is not substantial evidence.” Carmines, 138 F.3d at 140, n. 5.

The combination of the two injuries and two surgeries and the cumulative effect disabled Mr. Ward from even fight duty shipyard work. Taken together or one at a time, the above items from Dr. Reid’s report which are agreed to by Dr. Garner fit within the requirement of quantification that has been imposed on Newport News.

Newport News has shown “evidence of the type and extent of disability that the claimant would suffer if not previously disabled when injured by the same work-*449related injury.” Harcum II, 131 F.3d at 1081, 1082. “Neither the 1987 injury, nor the 1989 injury, alone would have disabled Mr. Ward from performing light duty shipyard work. He per-formed such work after the 1987 injury. If he had had a normal back when he suffered the 1989 injury, he likewise would have been able to return to light duty shipyard work.” J.A. 11 (italics added). And it is admitted that he is now completely disabled from shipyard work. Thus, complete disability for shipyard work is certainly materially and substantially greater than a light duty disability for shipyard work.2

Accordingly, I would grant the petition for review of Newport News and require the Board to see that relief is awarded to Newport News under 33 U.S.C. § 908(f)(1).

. The ALJ also found Newport News ineligible for relief on alternate grounds, rejecting as not supported by substantial evidence the stipulation that Ward had reached maximum medical improvement on or before November 13, 1995. Because the ALJ rejected this stipulation, the ALJ found that Ward’s condition was not permanent, a finding that made Newport News ineligible for § 8(f) relief. The Board reversed the ALJ's finding that the permanency of Ward's disability had not been established as of November 13, 1995, and concluded that the employer therefore would have been eligible for relief had it proved the contribution element. The Director accepts the Board’s conclusion that Newport News had established the permanency of Ward’s disability.

. Newport News does not take the 5% AMA disability mentioned by Dr. Reid, J.A. 19, and subtract it from the 17% AMA disability mentioned by Dr. Garner, J.A. 27, to arrive at its sought for result. Carmines, 138 F.3d at 143, precludes this method. But how this law of the circuit fits our insistence on quantification is nowhere explained.