Runstrom v. Alaska Native Medical Center, 280 P.3d 567

Esther Runstrom, a healthcare worker, was exposed to fluids from an HIV-positive patient in August 2007 at the Alaska Native Medical Center and received preventive antiretroviral treatment.
The employer initially paid workers’ compensation benefits but later controverted on the employer’s doctor’s view that Runstrom could return to work.
Runstrom entered temporary total disability (TTD) status beginning September 2007 and later sought additional benefits.
Treating providers (Lentz and Tranel) addressed stress and counseling; HIV tests remained negative after initial treatment.
The employer obtained two independent medical evaluations (EIMEs) by Dr. Goranson (Oct. 2007 and Feb. 2008) which shifted views on work-related causation and recommended treatment with return-to-work restrictions.
The Board denied, and the Commission affirmed, Runstrom’s appeal; the Alaska Supreme Court affirmed the Commission, noting evolving presumption analysis and raising a caveat regarding 2005 amendments.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the injury is a physical-mental claim subject to presumption.	Runstrom treated as physical-mental, invoking presumption.	Employer contends proper classification under physical-mental analysis.	Yes; evidence supports physical-mental classification (physical injury with subsequent mental effects).
Whether the employer rebutted the presumption with substantial evidence.	Employer failed to provide substantial evidence to rebut the presumption.	Dr. Goranson (and Lentz) evidence constitutes substantial rebuttal.	Substantial evidence supported rebuttal of the presumption; Runstrom not entitled to additional TTD.
Whether the controversions were made in good faith.	Employer’s controversion were improper based on Dr. Goranson’s opinions.	Controversies were made in good faith based on medical opinions.	Controversies were in good faith; not unfair or frivolous.
Did the 2005 amendments modify the presumption analysis at the second stage?	Ambiguous impact of amendments on presumption stages.	Amendments clarified or changed the burden at the second stage.	Court notes open question; does not decide; encourages further briefing.

McGahuey v. Whitestone Logging, Inc., 262 P.3d 613 (Alaska 2011) (presumption analysis framework cited)
Smith v. Univ. of Alaska, Fairbanks, 172 P.3d 782 (Alaska 2007) (foundational three-step presumption framework)
Smith v. CSK Auto, Inc., 204 P.3d 1001 (Alaska 2009) (relevance to rebuttal standard under presumption)
Shehata v. Salvation Army, 225 P.3d 1106 (Alaska 2010) (discussion of due process and evidentiary standards)