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Safeway Stores9/26/2002
causal relationship" between the right knee injury and the work injury to the left knee. He did acknowledge that the patellofemoral syndrome "could be" caused by transfer of weight, but clearly stated that it was "in no way related to" the work injury and found the syndrome "much more related" to Watson's "longstanding osteoarthritis." As for the "questionable" meniscal tear, Dr. Danzinger expressed scepticism concerning Dr. Dorn's claim that it could have resulted from a transfer of weight and without an antecedent injury.
Based on Dr. Danzinger's extensive diagnosis, which provided a detailed explanation supporting his conclusions, we cannot agree with the Director's decision that it was insufficient to rebut the presumption of compensability. Although we defer to the Director's characterization of Dr. Danzinger's opinion as "inconsistent" in that Dr. Danzinger observed that the patellofemoral syndrome in Watson's right knee had the potential to be caused by transfer of weight, we note that the inconsistency, if any, was minor, as the doctor unequivocally stated his opinion that the work injury was not the precipitating cause in this case, pointing to "long-standing osteoarthritis" and the "original injury of 1990" to the left knee. Similarly, Dr. Danzinger's opinion regarding the cause of the possible meniscal tear in Watson's right knee cast doubt on Dr. Dorn's explanation for that injury. In dismissing Dr. Danzinger's opinion as insufficient, the Director effectively required Safeway to "disprove causality with an absolute certainty" which we have said is too heavy a burden to place upon the employer to rebut the presumption of compensability. See Washington Hosp. Ctr., 744 A.2d at 1000; see also Washington Hosp. Ctr. (Callier) v. (Anderson) District of Columbia Dep't of Employment Servs., 746 A.2d 278, 281-82 (D.C. 2000) (reversing Director's decision where examiner failed to account for "significant parts" of testimony by employer's physician which was evidence sufficient to rebut the presumption); cf. Parodi v. District of Columbia Dep't of Employment Servs., 560 A.2d 524, 526 (D.C. 1989) (affirming Director's decision where employer's medical evidence not only failed to rebut the presumption but was consistent with the employee's medical evidence). It is sufficient for the employer to present substantial medical evidence - as opposed to unequivocal medical evidence - to rebut the statutory presumption. We therefore reverse and remand so that the examiner can proceed to the second step in the consideration of all evidence, giving due weight to the opinion of the treating physician.
III.
We briefly address Safeway's other claims, which we summarily reject. Safeway argues that the Director's decision affirming the examiner's findings on the percentage of permanent partial impairment to Watson's left knee is not supported by substantial evidence because: (1) Watson has not reached maximum medical improvement, (2) Dr. Dorn's conclusions were "based on a faulty understanding of Watson's medical history," and substantial evidence did not support the examiner's apportionment in light of the medical opinions of Dr. Fechter and Dr. Danzinger, and (3) the hearing examiner failed to "credit" Safeway for any permanent impairment to Watson's left knee caused by the previous injuries not related to his employment at Safeway.
Dr. Dorn's reports support the examiner's finding that Watson has reached maximum medical improvement, as he consistently opined that the condition of the left knee was permanent and stationary. His suggestion that total knee replacement surgery would be required in the future does not affect this determination as that reasoning was largely based on Watson'
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