To be eligible for occupational disability benefits, an employee must prove only that her employment was a substantial factor—not the substantial factor—in causing her disability, the Alaska Supreme Court has ruled.
The claimant, Shirley Shea, had a medical procedure in 1984 that resulted in intermittent soreness in her legs, back, and pelvic region. She began working for the state of Alaska in 1993 in a job that required her to sit at a desk for prolonged periods of time. Her pain began to worsen around 1998, and in 2001 she was forced to leave her job because of pain.
She filed a claim for occupational disability benefits, claiming that the periods of prolonged sitting at work aggravated her condition. The Division of Retirement and Benefits denied her claim. The administrative law judge (ALJ) concluded that because Shea’s prolonged sitting at work was simply one among many contributing factors to her chronic pain, it was not of particular causal significance to her condition. He affirmed the denial of benefits. Shea appealed, and the superior court upheld the ALJ’s decision. The Supreme Court reversed.
Substantial Factor Causation Standard
The primary issue the case presented was whether the definition of substantial factor required Shea’s employment to have been the substantial cause of her injury—that is, the sole or predominant cause—or whether it must only have been merely a substantial cause of her injury. The Supreme Court noted that it had not yet had occasion to define the substantial factor causation standard for occupation disability benefit cases.
The court explained that, under the statutory requirements for occupational disability benefits, the employee had the burden of proving by a preponderance of the evidence that the disability was proximately caused by an injury that occurred in the course of employment. If one or more possible causes of a disability were occupational, the employee was entitled to benefits when the record established that the occupational injury was a substantial factor in the employee’s disability—regardless of whether a nonoccupational injury could independently have caused disability. “The underlying injury need not be caused by the employment to receive occupational disability benefits,” it said.
Guided by other contexts such as negligence claims and workers’ compensation cases, the court held that the substantial factor test required both actual and proximate cause. “To satisfy the substantial factor requirement, a claimant must prove that her employment was so important in bringing about the injury that reasonable [persons] would regard it as a cause and attach responsibility to it. We have described this requirement as asking whether the conduct has been so significant and important a cause that the defendant should be legally responsible,” the court wrote.
Accordingly, Shea was required to prove only that her employment was a substantial factor—not the substantial factor—in causing her disability. The court remanded the case for the ALJ to reconsider the decision in light of the causation standard and to clarify whether Shea’s prolonged sitting at work was a substantial factor in causing her disability.
Shea v. State, Alaska, No. 6629 (Dec. 23, 2011).
Susan R. Heylman, Esq., is a freelance legal writer and editor based in the Washington, D.C., area. Click here to read the original article.