HRS § 386-85 - Presumptions

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: (1) That the claim is for a covered work injury; (2) That sufficient notice of such injury has been given; (3) That the injury was not caused by the intoxication of the injured employee; and (4) That the injury was not caused by the wilful intention of the injured employee to injure oneself or another. [L 1963, c 116, pt of §1; Supp, §97-94; HRS ; gen ch 1985] Law Journals and Reviews Japanese Corporate Warriors in Pursuit of a Legal Remedy: The Story of Karoshi, or "Death from Overwork" in Japan. 21 UH L. Rev. 169 (1999). Case Notes Scope and nature of presumption discussed. 51 H. 312, 459 P.2d 541 (1969); 51 H. 632, 466 P.2d 439 (1970). Substantial evidence defined. 51 H. 312, 459 P.2d 541 (1969); 53 H. 406, 495 P.2d 1164 (1972). Where death might have been caused by preexisting heart condition or by occupational exertions or by both, presumption of paragraph (1) was applicable. 51 H. 312, 459 P.2d 541 (1969). Presumption places on employer the burden of going forward with the evidence as well as that of persuasion. 53 H. 32, 487 P.2d 278 (1971); 53 H. 406, 495 P.2d 1164 (1972). If employer fails to produce substantial evidence to contrary, presumption dictates that claimant must win. 53 H. 161, 489 P.2d 419 (1971). Evidence adduced by employer to show that death by heart attack was not work-connected held not to amount to substantial evidence. 53 H. 406, 495 P.2d 1164 (1972). Presumption may be rebutted only by substantial evidence to the contrary. 53 H. 406, 495 P.2d 1164 (1972). Presumption applies in §386-89(c) proceeding and places burden on employer. 56 H. 552, 545 P.2d 692 (1976). Employer has burden of going forward with evidence and burden of ultimate persuasion, and all reasonable doubt should be resolved in favor of claimant. 57 H. 296, 555 P.2d 855 (1976). Proceeding for review brought by claimant under §386-89(c) is a "proceeding for the enforcement of a claim for compensation under this chapter". 57 H. 535, 560 P.2d 1292 (1977). If employer fails to present substantial evidence to rebut presumption, employee must prevail. 59 H. 551, 584 P.2d 119 (1978). Paragraph (1) applies from outset. Preliminary showing that injury occurred in course of employment not required. 63 H. 642, 636 P.2d 721 (1981). Where labor and industrial relations appeals board failed expressly to acknowledge statutory presumption of compensability in its decision, issue deemed not to be whether board had explicitly referred to the presumption, but whether the presumption had been rebutted by substantial evidence; board’s conclusion that claimant was not engaged in employment-related activity when claimant sustained injury was supported by substantial evidence. 77 H. 100, 881 P.2d 1246 (1994). Statutory presumption of paragraph (1) not triggered where claimant conceded that accident was not work-related. 77 H. 152, 883 P.2d 73 (1994). Employee's disability was compensable under this chapter where labor appeals board failed to apply statutory presumption in favor of compensability of employee's claim under this section, and employers failed to demonstrate by substantial evidence that employee's disease (1) was not caused by conditions that are characteristic of or peculiar to employee's employment as a dental hygienist, (2) did not result from employee's actual exposure to such conditions, and (3) was not due to causes in excess of the ordinary hazards of employment in general. 94 H. 70, 9 P.3d 382 (2000). In any proceeding on a claim for compensation due to an alleged compensable consequence of a work-related injury, this section creates a presumption in favor of the claimant that the subsequent injury is causally related to the primary injury. 94 H. 297, 12 P.3d 1238 (2000). Where the paragraph (1) presumption of work-connectedness was neither applicable nor relevant to any issue on appeal, as a matter of law, the appellate court erred in applying the presumption to the issue in the case. 97 H. 86, 34 P.3d 16 (2001). Appellate court did not err in applying paragraph (1) presumptions where whether the cause of claimant's permanent disability was work-related or caused by prior injury and other personal and/or psychological stresses was clearly at issue in the proceedings. 97 H. 402, 38 P.3d 570 (2001). In order to overcome the paragraph (1) presumption of work-relatedness, the employer must introduce substantial evidence to the contrary; once the trier of fact determines that the employer has adduced substantial evidence to overcome the presumption, it must weigh the evidence elicited by the employer against the evidence elicited by the claimant. 97 H. 402, 38 P.3d 570 (2001). Appeals board's decision denying employee's claim not clearly erroneous where employer adduced substantial evidence rebutting the presumption of compensability for employee's alleged stress-related workplace injury through psychiatrist's report that employee suffered from preexisting paranoid schizophrenia that was triggered by wage garnishment, which was not an incident of employment. 98 H. 263, 47 P.3d 730 (2002). Injury or death arises in course of employment when it takes place within the period of employment, at place where the employee may reasonably be, and while fulfilling duties or engaged in something incidental thereto. 1 H. App. 77, 613 P.2d 927 (1980). Pursuant to requirements of §91-12, appeals board should generally state whether or not it has applied presumption of paragraph (1). But failure to do so in instant case did not prejudice appellant's substantial rights. 1 H. App. 77, 613 P.2d 927 (1980). Substantial evidence defined. 1 H. App. 77, 613 P.2d 927 (1980). Scope and nature of presumption discussed. 3 H. App. 39, 640 P.2d 1175 (1982). Board failed to correctly apply presumption of compensability; decision that claimant's low back condition was not a compensable consequence of a work injury was clearly erroneous in light of the reliable, probative, and substantial evidence in the whole record. 94 H. 257 (App.), 12 P.3d 357 (2000). In light of the strong presumption of work-relatedness under Hawaii workers' compensation law, as well as the lack of any non-speculative evidence to explain the cause of claimant's injuries from non-witnessed fall while claimant was performing employment duties at claimant's place of employment during working hours, employer failed to satisfy its heavy burden of adducing a "high quantum" of "relevant and credible evidence of a quality and quantity sufficient to justify a conclusion by a reasonable person" that claimant's fall and consequent injuries were not work-related. 101 H. 293 (App.), 67 P.3d 792 (2003). Employer presented substantial evidence to rebut the presumption that employee's injuries were work-related where the undisputed evidence showed employee was injured while on unpaid leave, was injured while bowling, an activity that was not part of employee's work duties, at an off work site that was not operated or controlled by employer; employee's attendance there was strictly voluntary; employer did not finance the tournament; employer did not require employees to participate; and employer derived no substantial direct benefit from the bowling tournament beyond the intangible value of improvement in employee morale. 118 H. 239 (App.), 188 P.3d 753 (2008). Department of education failed to present substantial evidence to overcome the statutory presumption of compensability, where evidence overwhelmingly demonstrated that employee's exposure to vog at work, combined with the surrounding circumstances of employee's employment and employee's preexisting condition, resulted in the exacerbation of employee's asthma. 131 H. 545, 319 P.3d 464 (2014). Mentioned: 52 H. 242, 473 P.2d 561 (1970); 4 H. App. 26, 659 P.2d 77 (1983).