363 P.3d 296
Haw.2015Background
- Panoke injured back in June 17, 2004 work incident while employed by Reef Development of Hawaii, Inc.; Reef/Seabright accepted back injury but denied shoulder injuries claim.
- Shoulder MRIs revealed labral tears and rotator cuff tears in both shoulders; employer denied shoulder liability.
- DCD Director ultimately held shoulders related to June 17, 2004 accident and ordered benefits; Reef/Seabright appealed to LIRAB.
- LIRAB found substantial evidence rebutting compensability and limited TTD benefits due to deficient physician certifications; ICA affirmed.
- Petitioner appealed to ICA; ICA affirmed LIRAB, then Hawaii Supreme Court vacated and remanded for reconsideration in light of substantial evidence standards and certification issues.
- Surgery: left shoulder surgery occurred on October 20, 2007; February 3, 2006, right shoulder surgery followed the physicians’ determinations.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether shoulder injuries were work-related despite presumption. | Panoke contends presumption of compensability applies; doctors McCaffrey/Okamura supported work-relatedness. | Reef/Seabright argue Diamond/Agles/Lau show non-work-related origin. | LIRAB erred; presumption not rebutted by employer evidence. |
| Whether TTD benefits were properly limited by physician certifications. | Work Star reports sufficed to certify TTD despite deficiencies. | Certifications required by HRS 386-96/ HAR 12-15-80; deficiencies justify denial. | Certification deficiencies cannot bar TTD entitlement; remand on TTD merits. |
| Whether penalties for late TTD payments were proper. | Late payments incurred penalties. | Payments disputed; Director's orders not final judgments; penalties not due. | No penalties; remand; penalties affirmed as to timing moot on remand. |
| What is the correct scope of evidence weighing after rebutting the presumption. | Igawa/Akamine standards require weighing credibility of evidence. | Board erred in weighing evidence; Diamond's opinion favored. | Court must defer to LIRAB on weighing evidence; remand for merits. |
| Whether the ICA/LIRAB misapplied statutory interpretation regarding presumption and evidence weighing. | Presumption remains until substantial evidence supports contrary finding. | Substantial evidence supported rebuttal; proper standard applied. | Remand; correct standard of review applied; vacate ICA/LIRAB judgments. |
Key Cases Cited
- Acoustic, Insulation & Drywall, Inc. v. Labor and Industrial Relations Appeal Board, 51 Haw. 312 (Haw. 1969) (presumption and burden of production in workers’ comp cases)
- Akamine v. Hawaiian Packing & Crating Co., 53 Haw. 406 (Haw. 1972) (substantial evidence requires specific causal link avoiding generalized testimony)
- Nakamura v. State, 98 Hawai'i 263 (Haw. 2002) (substantial evidence supports rebutting presumption when expert explains aggravation)
- Igawa v. Koa House Restaurant, 97 Hawai'i 402 (Haw. 2001) (clarifies weighing burden after rebuttal of presumption and deference to agency findings)
- Van Ness v. State, Dep’t of Educ., 131 Hawai'i 545 (Haw. 2014) (substantial evidence standard; humanitarian policy favors claimant in doubt)