Wаyne DANIELS, Appellant v. WORKERS’ COMPENSATION APPEAL BOARD (TRISTATE TRANSPORT), Appellee.
Supreme Court of Pennsylvania.
Decided July 22, 2003.
828 A.2d 1043
Argued Oct. 15, 2001.
Amber Marie Kenger, Mechanicsburg, for W.C.A.B., Appellee.
Jonathan F. Ball, for Tristate Transport, Appellee.
Before: FLAHERTY, C.J., and ZAPPALA, CAPPY, CASTILLE, NIGRO, NEWMAN and SAYLOR, JJ.
OPINION OF THE COURT
JUSTICE CASTILLE.
This Court granted allowance of appeal to determine whether the Workers’ Compensation Judge (“WCJ“) in this case failed to adequately explain on the record why she rejected claimant/appellant‘s conflicting medical evidence pursuant to Section 422(a) of the Workers’ Compensation Act (“the Act“). See
On December 13, 1990 appellant was involved in a motor vehicle accident while in the course and scope of his employment with his employer, Tristate Transport. He filed a claim petition for workers’ compensation benefits alleging injury to his lumbosacral spine and continuing lower back pain with
The medical expert evidence concerning the status of appellant‘s work injury was disputed. Employer submitted the deposition testimony of John T. Williams, M.D., a board-certified orthopedic surgeon, who had examined appellant on November 7, 1991. Dr. Williams opined that appellant had sustained an acute lumbosacral strain and sprain that had since resolved and, thus, appellant was able to return to work without restrictions. In reaching his diagnosis, Dr. Williams did not review the x-rays, CAT scan, and nerve conduction tests which had been previously performed оn appellant sometime between mid-December 1990 and November 7, 1991.
Appellant rebutted this evidence by submitting the deposition testimony of Dr. Steven Fabian, M.D., a family physician and appellant‘s treating physician, who first examined appellant on the date of his work injury. During this examination, Dr. Fabian determined that appellant suffered from spasms in the paraspinal muscles of the cervical and lumbar regions, and that appellant had a 45% limitation of motion in his cervical spine and a 50% limitation of flexion, extension, and rotation in the lumbar region of his back. After nine months of physical therapy, Dr. Fabian found that appellant had hit a plateau of a 20-25% limitation of motion. Dr. Fabian had last examined appellant on October 16, 1992, at which time appellant complained of pain in his lumbar spine and legs. Based upon that examination Dr. Fabian opined that appellant‘s limitation of cervical flexion, extension, and rotation had improved substantially, i.e., it was now at 15%. Dr. Fabian also opined that appellant suffered from post-traumatic cervical and lumbar sprain with a protruding disc at L-4-5 level. Dr. Fabian
Appellant testified before the WCJ on December 10, 1992 and claimed that his lower back and legs had continued to bother him since the work injury. Appellant stated that he still could not stand or sit for more than one hour; he experienced pain in his lower back when he walked; and he could lift only twenty pounds. Due to his continued pain and limited mobility, appellant testified, he did not think he could return to work with Employer in his pre-injury capacity as an ambulance driver, a job which required him to lift patients and equip ambulances with items such as oxygen tanks weighing up to one hundred pounds. Appellant further testified that he was receiving physical therapy three times a week, that he sees Dr. Fabian once a week, and that he takes Tylenol with codeine for pain.
The WCJ filed her decision on March 14, 1997, finding in favor of Employer and ordering the termination of appellant‘s benefits as of November 7, 1991.1 After summarizing the testimony of Dr. Williams, Dr. Fabian, and appellant, the WCJ made the following, determinative findings:
16. Based upon a review of the evidentiary record as a whole, this Judge finds the testimony of the Claimant is not credible or persuasive.
17. Based upon a review of the evidentiary record as a whole, this Judge finds the opinions of Dr. Williams to be more credible and persuasive than the opinions of Dr.
18. This Judge finds Claimant was fully recovered from his December 13, 1990 work injury as of November 7, 1991.
WCJ‘s Decision at 4.
Appellant appealed to the Workers’ Compensation Appeal Board (“WCAB“), which affirmed the WCJ‘s termination decision. Upon further appeal, the Commonwealth Court, sitting en banc, affirmed by a 5-2 vote. Daniels v. Workers’ Compensation Appeal Bd. (Tristate Transport), 753 A.2d 293 (Pa.Cmwlth.2000). On the salient question presented here—i.e., the contours of the “reasoned decision” requirement set forth in Section 422(a) of the Act in a case where the WCJ is presented with conflicting evidence—the majority opinion by Judge Kelley noted that questions of credibility and weight of the evidеnce fall within the exclusive province of the WCJ as fact-finder. Id. at 303. The majority then found that the WCAB had “properly determined that the WCJ provided an adequate explanation for her determination by outlining all of the evidence considered, stating the credible evidence on which she relied, and setting forth the reasons for the ultimate denial of Employer‘s termination petition.” Id. at 305.2
Judge Friedman, joined by Judge Pellegrini, dissented. The dissent noted that the WCJ had “made no attempt to explain, much less to adequately explain, her reasons for rejecting or discrediting competent evidence,” as required by the 1996 amendment to Section 422(a) of the Act. Id. at 307. Although the dissent did not dispute that the WCJ was authorized to make credibility determinations, in the dissent‘s view the WCJ‘s failure to explain the basis for her credibility determination where the evidence was conflicting did not
In workers’ compensation appeals, this Court must affirm the adjudication below unless we find that an error of law was committed, that constitutional rights were violated, that a practice or procedure of a Commonwealth agency was not followed or that any necessary finding of fact is not supported by substantial evidence of record.
Section 422(a) provides, among other things, that the parties in a workers’ compensation case are “entitled to a reasoned decision containing findings of fact and conclusions of law based upon the evidence as a whole which clearly and concisely states and explains the rationale for the decisions so that all can determine why and how a particular result was reached.”
When faced with conflicting evidence, the workers’ compensation judge must adequately explain the reasons for rejecting or discrediting competent evidence. Uncontroverted evidence may not be rejected for no reason or for an irrational reason; the workers’ compensation judge must identify that evidence and explain adequately the reasons for its rejection.
Appellant claims that the WCJ‘s credibility determination here was not accompanied by an adequate explanation to comply with the “reasoned decision” requirement of Section 422(a) since there was conflicting evidence as to whether his work injury had resolved itself. Echoing the Commonwealth Court dissent, appellant argues that the WCJ merely summarized the testimony of the witnesses and announced her conclusion on credibility without attempting to explain the reasons for rejecting appellant‘s competent evidence. Brief of Appellant at 14. Appellant submits that the 1996 amendments
In responding to appellant‘s plain meaning construction of the statute, Employer does not dispute the validity of the reasoned decision requirement set forth in Section 422(a). Employer instead argues, as it did successfully below, that the WCJ‘s decision in this case was a reasoned one because all parties could discern how and why she decided to terminate appellant‘s benefits and because her decision provided for meaningful appellate review. Brief of Appellee at 10. According to Employer, the WCJ need only demonstrate that all pertinent evidence was considered before the decision was rendered. Id. at 15-17. Here, the WCJ accurately summarized the salient portions of the testimony of Dr. Williams, Dr. Fabian, and appellant, thereby demonstrating that she considered the substance of the testimony of each witness and setting forth those elements of the testimony upоn which she ultimately relied in rendering her decision. Id. at 18. Employer further argues that WCJs should not be required to detail factors or considerations leading to determinations of witness credibility and evidentiary weight, for such would be “tantamount to inviting a reviewing body to supplant” the WCJ‘s credibility and weight determinations. Id. at 9. In this regard, Employer argues that the General Assembly “could
This Court has not yet had occasion to examine the contours of the reasoned decision requirement of Section 422(a). But see generally, Wintermyer, Inc. v. Workers’ Compensation Appeal Bd. (Marlowe), 571 Pa.189, 812 A.2d 478, 487 n.13 (2002) (noting that adoption of reasoned decision requirement evidences General Assembly‘s intention that appellate review be conducted in manner “that ensures that the agency has not exceeded its faсt-finding role or the outer limits of its discretion“). The Commonwealth Court, however, has decided a series of cases addressing whether adjudications by a WCJ were “reasoned” within the meaning of Section 422(a). See, e.g., Darrall v. Workers’ Compensation Appeal Bd. (H.J. Heinz Co.), 792 A.2d 706, 715-16 (Pa.Cmwlth.2002) (reasoned decision even though WCJ did not discuss testimony of witness, where WCJ‘s thorough review of controlling case law rendered accounting for witness‘s testimony unnecessary); Montgomery Tank Lines v. Workers’ Compensation Appeal Bd. (Humphries), 792 A.2d 6, 13 n. 10 (Pa.Cmwlth.2002) (reasoned decision even though certain exhibits not addressed, as Section 422(a) does not require WCJ to address all evidence); Supervalu, Inc. v. Workers’ Compensation Appeal Bd. (Bowser), 755 A.2d 715, 721 (Pa.Cmwlth.2000) (reasoned decision where WCJ discredited claimant‘s expert because expert said claimant could not work, but claimant did work for four years and testified he remains able to work); Empire Steel Castings, Inc. v. Workers’ Compensation Appeal Bd. (Cruceta), 749 A.2d 1021, 1022 (Pa.Cmwlth.2000) (reasoned decision where WCJ stated he rejected testimony of employer‘s expert because expert was unable to attribute claimant‘s neck injury to traumatic incident other than work-related ones); Lambie v. Workers’ Compensation Appeal Bd. (Curry Lumber Co.), 736 A.2d 67, 70 (Pa.Cmwlth.1999) (reasoned decision where WCJ stated he rejected testimony of claimant and his witness because they were unclear as to amount of time claimant spent in Pennsylvania); Cooper Power Systems v. Workers’ Com-pensation Appeal Bd. (McFarland), 722 A.2d 746, 749-50 (Pa.Cmwlth.1998) (reasoned decision where WCJ explained she discredited employer‘s medical expert testimony because expert‘s report was internally inconsistent and expert reached conclusions without any basis); PEC Contracting Engineers v. Workers’ Compensation Appeal Bd. (Hutchison), 717 A.2d 1086, 1088 (Pa.Cmwlth.1998) (reasoned decision where WCJ credited claimant‘s medical expert because of his experience and familiarity with treating claimаnt, and rejected testimony of employer‘s medical expert because expert only saw claimant twice for total of forty minutes and because expert testified 90% of time for employers); Roccuzzo v. Workers’ Compensation Appeal Bd. (School District of Philadelphia), 721 A.2d 1171, 1175 (Pa.Cmwlth.1998) (reasoned decision where WCJ credited employers’ expert over claimant‘s expert because employer‘s expert examined claimant much closer in time to date of injury). The Supervalu; Empire Steel; Cooper Power Systems; PEC Contracting, and Roccuzzo cases are most instructive as they present scenarios analogous to the case sub judice, i.e., they involve disputed expert medical evidence.
In Supervalu, the WCJ summarized the relevant deposition testimony of the parties’ medical experts. Supervalu, 755 A.2d at 718-19. The WCJ‘s findings of fact addressed the claimant‘s physical limitations caused by a work-related injury to his left leg and the claimant‘s ability to work in a modified capacity. On the question of whether the claimant was able to perform the modified work, the WCJ explained that he credited the employer‘s expert, and discredited the claimant‘s expert, because the claimant‘s expert had stated that the claimant was “unable to perform” the modified work from its inception, yet the claimant in fact had performed the work for almost four years and testified that he remained able to perform it. Id. at 718-19. In affirming the WCJ‘s credibility finding, the Commonwealth Court held that a WCJ provides an adequate explanation for his determination pursuant to Section 422(a) “by outlining the evidence considered, stating the credible evidence on which he relied, and setting forth the reasons for the ultimate [decision].” Id. at 721.
The claimant in Cooper Power Systems alleged that he suffered a permanent bilateral hearing loss resulting from hazardous occupational noise. The parties’ medical experts agreed that the claimant had suffered bilateral hearing impairment. The dispute involved causation, with the claimant‘s expert attributing the entire loss to occupational noise and the employer‘s expert attributing a portion of the loss to aging. The WCJ accepted the claimant‘s expert evidence and discredited the employer‘s medical evidence, explaining that the employer‘s expert‘s report was internally inconsistent because the expert stated that his examination revealed no abnormalities but later stated that the claimant suffered a low frequency hearing loss. 722 A.2d at 749-50. The WCJ also noted that, while the employer‘s expert had stated that aging and heredity may have contributed to the claimant‘s hearing loss, the record revealed no family history of hearing loss and the claimant maintained that there was no such family history. Id. The Commonwealth Court found the WCJ‘s credibility decision to be a reasoned one.
In PEC Contracting, the WCJ credited the claimant‘s medical expert because of his long experience as a treating physician and his familiarity with the claimant. In contrast, the WCJ noted, the employer‘s medical expert witness had exam-
Finally, in Roccuzzo, the Commonwealth Court found that the WCJ had rendered a reasoned credibility decision. In that case, the WCJ stated that the claimant had fully recovered from his work-related back injury and that his remaining physical problems were related to a pre-existing, long-standing herniated disc. The WCJ found the deposition testimony of the employer‘s medical expert credible and convincing and rejected the contradictory deposition testimony of the claimant‘s medical expert. In so doing, the WCJ had noted that the employer‘s expert had examined the claimant six months after the work injury, and again six months later, while the claimant‘s expert did not see the claimant until four years after the injury. 721 A.2d at 1172-73.
In each of these cases involving conflicting medical testimony, the WCJ provided a case-specific, if brief, explanation for the credibility determination, focusing on such common factors affecting credibility as the relative timeliness of examinations, familiarity with the patient, possible litigation bias, and inconsistencies in proof. The Commonwealth Court correctly held that the WCJs’ explanations, while not always containing a great deal of detail, nevertheless met the requirements of Section 422(a) since they were sufficient to allow for adequate review under the applicable review standards for a matter of this nature.
These cases stand in contrast to Hahnemann Univ. Hosp. v. Workers’ Compensation Appeal Bd. (Wallace), 718 A.2d 391 (Pa.Cmwlth.1998)—a panel decision which the en banc panel below expressly overruled in rendering its decision here. See 753 A.2d at 305 n. 14. In Hahnemann, the panel found that
Section 422(a) is peculiar in that it imposes obligations directly upon administrative officials (the WCJ and the WCAB) for the purpose of facilitating a judicial function, i.e., to “provide the basis for meaningful appellate review.” As such, the provision arguably could be said to raise separation of powers concerns. But, we recognize that workers’ compensation proceedings, while quasi-judicial in nature, originate in the executive branch, over which the General Assembly has traditionally set the standard of review. See
The appropriate standard of articulation in workers’ compensation cases must account for both the unique nature of these sorts of proceedings and the specific question that is at issue. One of the virtues of the proceedings is their relative informality, an informality which helps to facilitate speedier decisions in a field where the volume of cases is heavy. Section 422(a) helps to create that informality, as it directs that neither the WCAB nor WCJs be “bound by the common law or statutory rules of evidence in conducting any hearing or investigation.”
Turning to the specific question at issue, the Act requires that, in rendering a reasoned decision in a case with conflicting evidence, the WCJ “must adequately explain the reasons for rejecting or discrediting competent evidence.” In workers’ compensation cases, the WCJ functions in a manner similar to the trial judge in a bench trial. Thus, it has long been recognized that the WCJ has the exclusive authority to make findings of fact and credibility determinations. “The WCJ is the ultimаte finder of fact and the exclusive arbiter of credibility and evidentiary weight.” Thompson v. Workers’ Compensation Appeal Bd. (USF & G Co. and Craig Welding & Equipment Rental), 566 Pa.420, 781 A.2d 1146, 1150 (2001), citing LTV Steel v. Workers’ Compensation Appeal Bd. (Mozena), 562 Pa.205, 754 A.2d 666, 676 (2000) and Bethenergy Mines v. Workmen‘s Compensation Appeal Bd. (Sebro), 132 Pa.Cmwlth.288, 572 A.2d 843, 844-45 (1990). The deference generally accorded to fact-finders in disputed proceedings is a function of the comparative advantage the fact-finder has over any reviewing body in making assessments that may depend, inter alia, upon the demeanor of the witnesses.
“Many factors may affect the probative value of testimony, such as age ... intelligence, experience, occupation, demeanor or temperament of the witness. A trial court or jury before whom witnesses appear is at least in a position to take note of such factors. An appellate court has no way of doing so. It cannot know whether a witness answered some questions forthrightly but evaded others. It may find an answer convincing and truthful in written form that may have sounded unreliable at the time it was given. A well-phrased sentence in the record may have seemed rehearsed at trial. A clumsy sentence in the record may not convey the ring of truth that attended it when the witness groped
Commonwealth v. Story, 476 Pa. 391, 383 A.2d 155, 168 (1978), quoting R. Traynor, The Riddle of Harmless Error 20-21 (1970). See Armbruster v. Horowitz, 572 Pa. 1, 813 A.2d 698, 703 (2002) (noting “bedrock principle that questions of credibility are exclusively for the fact-finder“) (citations omitted).
One potential difficulty with the statutory directive is that, when the issue involves the credibility of contradictory witnesses who have actually testified before the WCJ, it is appropriate for the judge to base his or her determination upon the demeanor of the witnesses. In such an instance, there often is not much to say, nor is there a need to say much, in order for a reviewing body to determine that the decision was reasoned. Such a credibility determination may involve nothing more than the fact-finder‘s on-the-spot, and oftentimes instinctive, determination that one witness is more credible than another. The basis for the conclusion that certain testimony has the “ring of truth,” while other testimony does not, may be difficult or impossible to articulate—but that does not make such judgments invalid or unworthy of deference. To the contrary, people routinely undertake affairs of consequence based upon their judgment of the credibility and reliability of others, or their assessment of the mettle and character of the persons with whom they are dealing. Accordingly, in a case where the fact-finder has had the advantage of seeing the witnesses testify and assessing their demeanor, a mere conclusion as to which witness was deemed credible, in the absence of some special circumstance, could be sufficient to render the decision adequately “reasoned.” See Story, supra. We do not believe that the statute, as amended, was intendеd to mandate that adjudicative officers explain inherently subjective credibility decisions according to some formulaic rubric or detailed to the “nth degree.”
The complication here—and in many cases like this—is that, although appellant appeared live before the
In the instant matter, the WCJ heard appellant‘s live testimony and thus was in a position to render a demeanor-based assessment of his credibility—albeit, since the WCJ adverted
Former Chief Justice FLAHERTY did nоt participate in the decision of this case.
Former Chief Justice ZAPPALA did not participate in the decision of this case.
Justice NEWMAN files a concurring and dissenting opinion.
JUSTICE NEWMAN, CONCURRING AND DISSENTING.
I concur in the result reached by the Majority. I write separately to express my concern that, permitting the Workers’ Compensation Judge (WCJ) to declare that a particular witness is simply credible or not credible, without setting forth in some detail the basis for the findings of fact, fails to effectuate the purpose of the statute and neither results in a reasoned decision nor does it facilitate appellate review.
The credibility of a witness is a “subjective amorphous quality, often defined as much by the preconceptions of the persons who perceive the witness as by the witness’ personal characteristics.” 81 Am.Jur.2d Witnesses § 1027. Furthermore, the credibility of a witness may be affected by factors such as the credibility of other witnesses in this case, the plausibility of the theory that the witnеss is meant to support, the order in which witnesses are called, and the character and preconceptions of the fact finder. Id. Thus, to justify the use of any witness, the witness must be competent; the witness must be credible; and, finally, the witness must be believed.
The issue of witness credibility is, in actuality, a bifurcated one. There are two components to a finding of credibility—observational credibility and substantive credibility. Observational credibility goes to the demeanor of the witness when testifying and requires that the fact finder actually be present to observe it. “The manner in which a witness tells his [or her] story; the advantages he [or she] appears to have had for gaining accurate information on the subject, the accuracy and
The findings of the WCJ must assure the reviewing court that all of the evidence has been examined by the WCJ and that there is ample support for the resultant findings. A reviewing court requires no more than assurance from the WCJ that he or she has made his or her findings from the entire record, that these findings are supported by substantial evidence, and that he or she has sufficiently articulated the reasons for arriving at these conclusions, including some basis for its credibility determinations. Justice Cappy, now Chief Justice Cappy, in his responsive Opinion in Bowman v. Dept. of Envtl. Res., 549 Pa. 65, 700 A.2d 427, 431 (1997) (Cappy, J. concurring and dissenting), made the following observation, applicable to the instant matter:
An agency opinion needs to contain sufficiently detailed findings of fact, together with a coherent legal discussion, so that the Commonwealth Court can perform a meaningful review. Any less would frustrate the legislative intent, in addition to providing agency panels with a means of nullifying the effect of legislation, because it would enable an agency to shield its decisions from review by drafting opinions in generalized and conclusory terms.
The suggestion that a WCJ may insulate his findings from review by denominating them credibility determinations is a very real concern. While factors other than demeanor and
The WCJ cannot reject evidence for no reason or for the wrong reason. In my view, a WCJ may not make credibility determinations solely on “instinct.” An explanation from the WCJ, at a minimum, to explain those portions of the testimony found to be credible and/or those aspects of demeanor that formed the basis for a credibility finding is required so that a reviewing court can determine whether the reasons for acceptance or rejection were improper. It is beyond cavil that a simple credibility determination does not satisfy the substantive purposes of the fact-finding requirement. A statement that the WCJ finds a witness credible is no more enlightening than a statement that a claimant is not permanently disabled. Specific findings of fact are essential to an effective system of administrative law. “The prаctical reasons for requiring administrative findings are so powerful that the requirement has been imposed with remarkable uniformity by virtually all federal and state courts. The reasons have to do with facilitating judicial review, avoiding judicial usurpation of adminis-
Both a claimant and the employer have a legal right to know the evidentiary bases upon which the ultimate finding rests. That responsibility initially lies with the administrative agency, which must enter specific findings of basic fact to support its findings of ultimate fact and the resulting conclusions of law. The statutory requirement of a reasoned decision serves to protect against careless or arbitrary administrative action. The requirement that findings of basic fact be entered ensures that a careful examination of the evidence, rather than visceral inclinations, will control an agency‘s decision.
There are cogent and strong reasons for having a [reasoned decision] requirement in Pennsylvania. They include these: (i) the Administrative Agency Law requires it; (ii) failure to provide an adequate explanation for a [WCJ‘s] decision leaves the loser with an impression of arbitrariness and unfairness and a legacy of bitterness and alienation; (iii) if such failure becomes routine, it will alienate the Bureau Of Workers’ Compensation from the community of interest which it was created to serve; (iv) a statement of reasons by the [WCJ], who is the fact finder, will aid the appellate reviewer to do his/her job; (v) clear reasons for decisions which deliver required but unjust results can focus disapproval on the law‘s folly and promote its reform; (vi) fully reasoned decisions will enable parties to understand the issues they must confront, to appreciate the kind of evidence that the tribunal will want to hear and, by permitting litigants to make informed judgments as to chances of success, discourage inappropriate applications or appeals; (vii) adequate reasons provide future litigants with the means for invoking the principle of relative fairness[,] which holds that like cases should lead to like results; (viii) decision writing with reasons has an important role in the decision-making process by causing the adjudicator to think more clearly and to analyze more carefully; (ix) full written reasons provide a means of reviewing the decision-making
Stephen I. Richman, Reasoned Decisions in Workers’ Compensation Cases, Pa. Bar Assoc. Quarterly, 63 Pa.B.A.Q. 32, 33 (January 1992).
When the fact finder does not reveal the factual basis for his or her ultimate determination, which is the quintessential purpose of the requirement that administrative agencies enter sрecific findings of fact as part of their orders, the statutory Workers’ Compensation scheme is frustrated and the parties are dealt a disservice. I would hold that, if the factual basis for the decision includes a determination based substantially on the credibility of a witness, the WCJ must identify whether reliance was placed on observational credibility and/or substantive credibility and provide any specific evidence of the observed demeanor, manner, or attitude of the witness, or any perceived inconsistencies or lack thereof. I would also find that a reviewing court should only accord great weight to a determination of credibility that identifies the factors that support it. Accordingly, I dissent from that portion of the Majority Opinion that permits a WCJ to simply set forth credibility determinations without accompanying rationale.