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Korsak v. Hawaii Permanente Medical Group11/28/2000
any workers' compensation claim. HRS § 386-85 does just that. Moreover, any argument that the breadth of the statute is overly harsh on employers should be addressed to the legislature and not to the courts.
Accordingly, notwithstanding the ICA's failure to reference the "direct and natural" test articulated in Diaz or to explain and clarify its application of the presumption to compensable consequences of primary injuries, we hold that the ICA correctly applied the presumption to the compensable consequence alleged in this case.
C. Substantial Evidence
Kaiser next contends that the ICA misapprehended the nature of the substantial evidence necessary to overcome a claim of compensability. We disagree. "The statute is not a mere procedural device that disappears upon the introduction of contrary evidence." Akamine, 53 Haw. at 408, 495 at 1166. As previously discussed:
HRS § 386-85(1) creates a presumption in favor of the claimant that the subject injury is causally related to the employment activity. . . . his presumption imposes upon the employer both the heavy burden of persuasion and the burden of going forward with the evidence. [Akamine,] 53 Haw. at 408, 495 P.2d at 1166. The claimant must prevail if the employer fails to adduce substantial evidence that the injury is unrelated to employment. The term "substantial evidence" signifies a high quantum of evidence which, at the minimum, must be "relevant and credible evidence of a quality and quantity sufficient to justify a conclusion by a reasonable man that an injury or death is not work connected." Id. at 408-09, 495 P.2d at 1166; Survivors of Timothy Freitas v. Pacific Contractors, Co., 1 Haw. App. 77, 85, 613 P.2d 927, 933 (1980). Chung, 63 Haw. at 650, 636 P.2d at 726.
Regarding the evidence in this case, the ICA stated that the doctors' reports that were relied upon gave only generalized medical opinions regarding the cause of Korsak's low back pain and concluded that the evidence was, therefore, not substantial. We agree that, pursuant to Akamine, generalized medical opinions do not constitute substantial evidence. See Akamine, 53 Haw. at 410, 495 P.2d at 1167-68 (noting the distinction between medical causation -- e.g., the etiology of a disease -- and legal causation). Moreover, we stress the ICA's conclusion that the focus of the medical reports, if they were to be considered adequate in rebuttal, "should have been whether the March 1993 physical therapy session in any way exacerbated Korsak's existing low back condition." Korsak, slip op. at 4. Notwithstanding that conclusion, the ICA also stated:
The doctor's reports did not expressly, directly and specifically address the presumption, as required by Akamine. The doctors' opinions did not even impliedly address the presumption. Korsak, slip op. at 5 (emphasis added).
Akamine, however, does not stand for, and we do not uphold, the proposition that medical opinions must address or rebut the legal presumption imposed by statute. Although a medical expert is competent to give an opinion as to the medical causation of an injury, a medical expert is not competent to opine as to the legal causation of an injury. See Akamine, 53 Haw. at 410-11, 495 P.2d at 1167-68. The ICA's aforementioned statement, therefore, is an inaccurate statement of law. Nevertheless, the statement, read in context, as well as the opinion as a whole, clearly demonstrates that the ICA viewed the doctors' reports as failing expressly, directly, and specifically to rebut the presumption because the reports did not address whether Korsak's existing low back condition could have, in any way, been exacerbated in the March 1993 PT session. Thus, by impl
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