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Nakamura v. State9/26/2000
irected profanity towards you by various individuals. Well, particularly one individual.
And you were also upset that despite your efforts to try to change that, those conditions by meeting with management, that you felt this individual's inappropriate behavior and threats were not taken care of.
[NAKAMURA]: As far as your professional observance, do you feel that as far as my sessions with you in psychotherapy, do you feel that I was stressed out, and do you believe that these conditions were caused by my employer or my employment? In the course of my employment?
[DR. SHIMIZU]: Yes, I do.
In response to Nakamura's question as to whether "my environment, my employer, management, and my co-workers caused these stressful matters to trigger off a stress adjustment[,]" Dr. Shimizu answered, "I think you did suffer a work injury at the University."
Dr. Shimizu further testified that she agrees with Dr. Ponce's conclusion that Nakamura has a pre-existing condition, and that the garnishing of Nakamura's wages exacerbated the condition. Dr. Shimizu indicated that the garnishment of Nakamura's wages affected his condition, and that "that was part of the whole injury ." She also agreed that the garnishment triggered part of the injury because he was able to work and did not receive treatment until after the garnishment.
At the time of the hearing, Dr. Shimizu's diagnosis of Nakamura was depression and adjustment disorder, mixed. Dr. Shimizu described Nakamura's primary symptoms of depression, which included "irritability, sleep disorder, eating problems with weight gain. Difficulty concentrating, and following through on tasks. A negative mood, depressed mood."
Relying upon Dr. Ponce's opinion and his review of Dr. Trockman's records, the Board found that Nakamura was suffering from a pre-existing psychotic disorder that did not remit entirely since 1989. The Board further found that "the IRS garnishment . . . triggered [Nakamura's] need for treatment and inability to work[.]" The Board averred that this latter finding was "supported by the record[:]" first, that Nakamura experienced the bulk of his work stress prior to May 1995 while working under Mr. Chung and Mr. Yoshioka; second, that except for the one incident involving Mr. Yoshioka, Nakamura had no trouble while working for Mr. Sakai from May 1995 to September 15, 1995; and third, that despite the ongoing work stress he alleged, Nakamura "did not seek medical treatment and was able to work up through [September 15, 1995,] the date of the garnishment."
The Board finally concluded that the IRS garnishment was not an incident of Nakamura's employment, and that therefore " ny psychiatric injury that occurred as a result of the garnishment, is, therefore, not related to [Nakamura's] employment."
Although Dr. Ponce did not explicitly opine that Nakamura's injury was not work-connected, his diagnosis suggests that Nakamura's psychological stress injury was largely a product of his pre-existing psychotic disorder which, if recently exacerbated at all, was lit up by the IRS garnishment, and not the work stress.
It appears the Board erroneously relied on this diagnosis when it determined that Nakamura's injury was not causally connected to his employment.
In Akamine, 53 Haw. at 406, 495 P.2d at 1164, a case analogous to this one, the Hawaii Supreme Court determined that a generalized medical opinion concerning the cause of an injury does not constitute sufficient "substantial evidence" to rebut the presumption of compensability. Id. at 410, 495 P.2d at 1167. In that case, the claimant died after collapsing while pushing a loaded han
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