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[T] Chung v. GTE Hawaiian Telephone Co.9/9/2004
oregoing, including the opinions of Dr. Cupo and Dr. Hector, and due to the lack of medical evidence to support Claimant's claim for either the left or right wrist/hand, we find that Employer has presented substantial evidence to overcome the presumption that Claimant's left de Quervain's tenosynovitis arose out of and in the course of her employment.
CONCLUSIONS OF LAW
Based on the foregoing, we conclude that Claimant did not sustain a personal injury to the left or right wrist/hand on November 6, 1999, arising out of and in the course of employment.
ORDER
The decision of the Director, dated September 28, 2000, is affirmed, in accordance with the foregoing.
(Footnote supplied; original footnote omitted).
II. Discussion
"We review challenges to ultimate decisions of compensability under the 'clearly erroneous' standard. Thus, the appellate court considers whether such a finding is clearly erroneous in view of the reliable, probative, and substantial evidence in the whole record." Korsak v. Hawaii Permanente Med. Group, Inc., 94 Hawaii 257, 259, 12 P.3d 357, 359 (App. 1999) (brackets, citations and internal quotation marks omitted).
"In any proceeding for the enforcement of a claim for compensation under this chapter it shall be presumed, in the absence of substantial evidence to the contrary: That the claim is for a covered work injury [.]" Hawaii Revised Statutes (HRS) ยง 386-85(1) (1993) (enumeration omitted; format modified). This presumption "imposes upon the employer the burden of going forward with the evidence and the burden of persuasion. The employer may overcome the presumption only with substantial evidence that the injury is unrelated to the employment. Evidence, to be substantial, must be credible and relevant." Korsak, 94 Hawaii at 260, 12 P.3d at 360 (citation and block quote format omitted; emphasis in the original).
This court has mapped the analytical framework applicable to this case:
The Hawaii Supreme Court, in a case analogous to this one, addressed the issue of what type of evidence constitutes "substantial evidence" to rebut the presumption of compensability. Akamine v. Hawaiian Packing & Crating Co., 53 Haw. 406, 495 P.2d 1164, (1972).
Edward Akamine died after collapsing while pushing a loaded handtruck at work. His dependents filed a claim for worker's compensation. His employer presented evidence in the form of medical testimony that his pre-existing pathological condition was the sole cause of death. The Board denied compensation based on this evidence, reasoning that his death was due to pre-existing cardiovascular disease and not attributable to employment.
The supreme court reversed, however, holding that generalized medical opinion concerning the cause of an injury does not constitute "substantial evidence" to rebut the presumption of compensability.
For a medical man may give a generalized opinion that there was no connection between an incident at work and a heart attack, and in his own mind, may mean thereby that a pre-existing pathological condition was the overwhelming factor in bringing about the attack and that the part played by the work was insignificant. But, while it may be sound medically to say that the work did not 'cause' the attack, it may be bad law, because, in general, existing law treats the slightest factor of aggravation as an adequate 'cause.'
Id. at 410, 495 P.2d at 1167 (internal quotation marks and citations omitted).
Accordingly, " he primary focus of the medical testimony should have been a discussion on whether the employment effort, whether great
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