Parsons v. Workforce Safety & Insurance Fund

CROTHERS, Justice,

dissenting.

[¶ 26] I respectfully dissent.

[¶ 27] Parsons experienced a workplace injury. The ALJ so stated, finding, “On or about October 12, 2010, Warren Parsons was injured while working for Ames Construction.” Majority opinion at ¶ 16. The ALJ also found, “[t]he injury caused cervical strain and a microscopic tear to his disc at C4-C5 or C5-C6, resulting in discogenic and myofascial pain.” Id. However, for compensability by WSI, the question is not whether a worker was injured or affected by injury. Rather, the question is whether the worker sustained a “compensable injury.” N.D.C.C. § 65-01-02(10). The majority states agreement with this construct. See Majority opinion at ¶ 14 (“The disposi-tive issue is whether Parsons sustained a compensable injury under N.D.C.C. § 65-01-02(10).”).

[¶ 28] The majority reverses the ALJ’s decision, holding:

“Under N.D.C.C. § 65-01-02(10), a com-pensable injury does not include an injury attributable to a preexisting condi*413tion, including when the injury merely triggers symptoms in the preexisting condition. Id. However, if a preponderance of the evidence shows the medical condition for which benefits are being sought is causally related to a work injury and is not attributable to a preexisting condition, the preexisting condition analysis does not apply. See N.D.C.C. § 65-01-02(10).”

Majority opinion at ¶ 18.

[¶ 29] Under the statutory framework applicable here, any relationship between a work injury and a compensable injury necessarily includes a determination whether the claimant has a preexisting condition. Whether the claimant has a preexisting injury or condition is a fact question. Bergum v. N.D. Workforce Safety and Ins., 2009 ND 52, ¶¶ 9-10, 26, 764 N.W.2d 178; Elliott v. N.D. Workers Comp. Bureau, 435 N.W.2d 695, 699 (N.D.1989) (“[I]ssue of whether a preexisting disabling condition was sufficiently established to serve as a basis for apportionment is a question of fact.”).

[¶ 30] The definition of compensable injury provides:

“ ‘Compensable injury’ means an injury by accident arising out of and in the course of hazardous employment which must be established by medical evidence supported by objective medical findings.”

N.D.C.C. § 65-01-02(10). The legislature specified that “compensable injury” does not include:

“(7) Injuries attributable to a preexisting injury, disease, or other condition, including when the employment acts as a trigger to produce symptoms in the preexisting injury, disease, or other condition unless the employment substantially accelerates its progression or substantially worsens its severity.”

N.D.C.C. § 65 — 01—02(10)(b)(7) (2009).

[¶ 31] “We are required to construe and apply statutes by looking first at the words used in the statute, giving them their plain, ordinary, and commonly understood meaning.” Chamley v. Khokha, 2007 ND 69, ¶48, 730 N.W.2d 864 (Croth-ers, J., concurring in part and dissenting in part); N.D.C.C. § 1-02-02. Reading this statute as a whole, a claimant must start by proving he sustained “an injury by accident arising out of and in the course of hazardous employment.” N.D.C.C. § 65-01-02(10). When the injury is “attributable to a preexisting injury, disease, or other condition,” the claimant also must prove that the employment substantially accelerated or substantially worsened the severity of the preexisting injury, disease or other condition. N.D.C.C. § 65-01-02(10)(b)(7).

[¶ 32] Here, the ALJ looked to both parts of section 65-01-02(10). Doing so, the ALJ correctly applied the law, as evidenced by his November 28, 2012 Findings of Fact, Conclusions of Law and Order on Remand:

“Both before and after Mickelson [v. N.D. Workforce Safety Ins., 2012 ND 164, 820 N.W.2d 333], Parsons’ argument has been that if a work injury causes an asymptomatic preexisting condition to become symptomatic, then the preexisting condition has automatically been made substantially worse for purposes of N.D.C.C. § 65-01-02(10)(b)(7). In another version of the same argument, he says that if the clinical picture after a work injury is worse for someone with a preexisting condition, then once again the preexisting condition has been made substantially worse. While these factual scenarios are relevant in considering whether a preexisting condition is *414substantially worse after a work injury, they are not controlling. Nowhere in Mickelson, or any other Supreme Court opinion for that matter, does the Court say that a preexisting condition going from asymptomatic before a work injury to symptomatic after a work injury is unavoidably a compensable injury.
“Under N.D.C.C. § 65-01-02(10)(b)(7), a compensable injury does not include injuries attributable to a preexisting condition, including when the employment acts as a trigger to produce symptoms in the preexisting condition, unless the work injury substantially accelerates the progression or substantially worsens the severity of the preexisting condition. The distinction between ‘a preexisting condition’ and ‘symptoms of the preexisting condition’ has led some to suggest they are treated differently under (10)(b)(7). The suggestion seems to be that if a work injury only triggers symptoms in a preexisting condition, that ends the inquiry and there is no reason to further consider whether the symptoms triggered by the work injury amount to a substantial acceleration or worsening of the preexisting condition. Such a reading of (10)(b)(7), however, is more in the mind of the reader than inherent in the language of the statute. Whether it is the condition itself or the symptoms of the condition that are being looked at, the question remains the same under (10)(b)(7): has the work injury substantially accelerated the progression or substantially worsened the severity of the preexisting condition?1 An example, making use of the concept of a ‘set’ borrowed from set theory, might help to explain this. The word ‘including’ in the sentence ‘We saw a bunch of dogs at the park, including a Dalmatian and a German Shepherd.’ signals that what follows the word ‘including’ is part of the set of dogs. What follows the word ‘including’ in that sentence specifically lists and identifies something ‘included’ in the set of dogs. The word ‘including1 in (10)(b)(7) functions in the same way. In effect it says that the set of ‘injuries attributable to a preexisting condition’ includes “when the employment acts as a trigger to produce symptoms in the preexisting injury.’ Thus, when the focus is on the symptoms triggered in a preexisting condition by a work injury, the question then becomes ‘have the symptoms which were triggered by the work injury substantially accelerated or substantially worsened the severity of the preexisting condition?’ This also fits with the statement in Geek v. North Dakota Workers Compensation Bureau, 583 N.W.2d 621 (N.D.1998), that pain can be a symptom which aggravates a preexisting condition. When the court in Geek remanded the case to the hearing officer, it was to allow the hearing officer to decide whether the pain in that case amounted to a substantial aggravation of a preexisting condition, or in other words, whether the pain symptoms substantially accelerated or substantially worsened the severity of the preexisting condition,
fn. 1 “As stated in the original decision in this matter, ‘Just as a work injury may trigger symptoms in a preexisting condition which do not make it substantially worse, a work injury also may produce symptoms in a preexisting condition which do make it substantially worse. So pain can be an aggravation of an underlying condition, as the Court stated in Geek. But in order to be com-pensable, it must amount to a “substantial aggravation” [ ] of a preexisting condition.’ P14.”

Additional quotations from the ALJ’s decisions could be cited to demonstrate what I *415believe is a correct application of N.D.C.C. § 65-01-02(10)(b)(7). However, those additional citations only would confirm that the ALJ’s legal analysis is both a correct reading and a correct application of the law. The question therefore becomes whether the ALJ’s findings of fact should be sustained.

[¶ 33] The majority concludes the ALJ’s fact findings are not supported by sufficient evidence. The majority reverses, stating:

“Although there was evidence Parsons’ preexisting condition made him more vulnerable to the work injury, the preponderance of the evidence established the pain was not a symptom of Parsons’ preexisting condition and the injury did not trigger symptoms of his preexisting condition. Parsons is not seeking benefits for the preexisting condition; rather he is seeking benefits for the work injury. Based on the entire record, we conclude a reasoning mind could not reasonably determine the ALJ’s findings that Parsons’ injuries are attributable to his preexisting condition and that his employment triggered symptoms of his preexisting condition were proven by the weight of the evidence in the record. The medical evidence supported by objective medical findings establishes a causal relationship between the work injury and Parsons’ condition for which he is seeking medical treatment.”

Majority opinion at ¶ 21.

[¶ 34] The majority notes, but I believe does not abide by, our very limited review of an executive branch agency’s factual determinations. Majority opinion at ¶ 12; Meier v. N.D. Dept, of Human Servs., 2012 ND 134, ¶ 4, 818 N.W.2d 774 (“We are mindful that an appeal from an administrative agency to the district court invokes that court’s appellate jurisdiction, Lewis v. North Dakota Workers Comp. Bureau, 2000 ND 77, ¶ 8, 609 N.W.2d 445, and that appeals from an administrative agency involve issues of separation of powers of the three branches of government. See Power Fuels, Inc. v. Elkin, 283 N.W.2d 214, 220-21 (N.D.1979); N.D. Const, art. XI, § 26.”). Applying our highly deferential standard of review, we must affirm the agency’s decision unless we conclude legal error exists or the findings of fact are not supported by a preponderance of the evidence. N.D.C.C. §§ 28-32-49 and 28-32-46.

[¶ 35] When a court reviews the ALJ’s findings of fact, the question is not whether evidence exists that would allow a fact-finder to make a contrary ruling. The question instead is whether the findings of fact made by the agency are supported by a preponderance of the evidence. N.D.C.C. § 28-32-46(5); Bishop v. N.D. Workforce Safety and Ins., 2012 ND 217, ¶ 5, 823 N.W.2d 257. When making this determination, it is not for this Court to determine whether it would have similarly decided the case; rather the test is whether competent evidence supports the ALJ’s and WSI’s findings of fact. Power Fuels, 283 N.W.2d at 220 (“In construing the ‘preponderance of the evidence’ standard to permit us to apply the weight-of-the-evidence test to the factual findings of an administrative agency, we do not make independent findings of fact or substitute our judgment for that of the agency.”).

[¶36] Here, the ALJ considered and weighed the evidence. He made two sets of findings, conclusions and orders — one after the hearing and the other after remand from the district court — to consider the impact of a legal ruling made by this Court in another case. In both sets, the ALJ found Parsons did not satisfy his burden of proving he suffered a compensa-ble injury. In both sets of findings, the ALJ determined Parsons’ medical evidence *416was inferior to that offered by WSI. On this basis, the ALJ concluded, “The greater weight of the evidence, however, does not show that the work injury substantially accelerated or substantially worsened his preexisting condition. Parsons has not met his burden to show by a preponderance of the evidence that his preexisting cervical DDD would likely not have progressed similarly in the absence of the work injury.”

[¶ 37] I would hold the ALJ’s findings are supported by competent evidence. On that basis, I would affirm the ALJ’s decision under our limited legal authority to review factual findings.

[¶38] DALE V. SANDSTROM, J„ concurs.