Arizona Court of Appeals Division Two Holds That Equivocal Medical Expert Testimony Is Not Competent Evidence to Support the Denial of a Workers’ Compensation Award.

A warehouse employee’s job required him to stand long hours and lift heavy equipment.  He developed a foot injury diagnosed as Morton’s neuroma.  He filed an application for workers’ compensation, claiming his work as a warehouseman had caused or contributed to the injury.  The claim was denied and he requested a hearing.

At the hearing, the two medical experts agreed on the diagnosis of the injury and agreed that repetitive trauma or prolonged pressure on the foot, such as from standing for extended periods of time, could cause such an injury.  One doctor testified there was a “reasonable medical probability” that the employee’s work had contributed to the injury.  The other, Dr. Grimes, testified that such a connection was “possible” but that he could not “state that to a probability” because he did not “find a definite correlation.”  He testified that Morton’s neuroma most often results from an unknown cause.

Medical literature admitted into evidence described Morton’s neuroma as “most likely a mechanically induced degenerative neuropathy” that results from “excessive motion” in parts of the foot and “excessive weightbearing stress on the forefoot, particularly by wearing pointed and high-heeled shoes.”

The administrative law judge found there was a conflict in the medical testimony, credited Dr. Grimes’s testimony as more well-reasoned, and concluded on the basis of that testimony that the employee had not demonstrated that his industrial work likely caused the injury.  The decision was affirmed on administrative review and the employee filed a special action to the Arizona Court of Appeals. 

The Court of Appeals reversed and set aside the award of no compensation. 

To prove compensability, a workers’ compensation claimant must prove in part that his employment caused or contributed to the injury.  When the cause of an injury is not apparent to a layperson, causation must be established by expert testimony and proven to a reasonable degree of medical probability. 

If no conflict exists in the medical testimony, the administrative law judge (“ALJ”) is bound to accept it.  If medical testimony is in conflict, then the ALJ must resolve the conflict.  The Court of Appeals will not disturb an ALJ’s resolution of such a conflict unless it is wholly unreasonable.

Equivocal or speculative medical testimony, however, is insufficient to create a conflict in the evidence.  Here, Dr. Grimes’s testimony was equivocal because he did not take a definitive position regarding whether the employee’s job activities had likely caused or contributed to the injury.  Dr. Grimes’s testimony that some other, unknown cause may have led to the injury was insufficient to form the basis of an award of no compensation.

Presiding Judge Eckerstrom authored the opinion; Chief Judge Howard and Judge Brammer concurred.