In Wyatt v. Baptist Health Sys., Inc., No. 2160280, 2017 WL 3096691, at *1 (Ala. Civ. App. July 21, 2017), the Alabama Court of Civil Appeals clarified that the Plaintiff bore the burden of establishing medical causation and that the fact finder did not have to resolve all reasonable doubts in conflicting medical evidence in her favor.

On November 28, 2015, while lifting and twisting a bag of soiled linens, the Plaintiff Laura Wyatt (the “employee”) felt a sharp pain in her back followed by a burning sensation and pain down her legs into her toes. The incident occurred while the employee was on the job working as a patient-care technician at Shelby Baptist Medical Center (the “employer”). Shortly after the incident, the employee was admitted to the hospital followed by a stint at a rehabilitation center. The employee was ultimately diagnosed with transverse myelitis and still suffers from weakness in her legs, trouble with walking and with balance, and issues with her bladder and bowels.

Prior to her release from the rehabilitation center, the employee filed suit against her employer seeking benefits under the Alabama Workers’ Compensation Act (the “Act”). The trial court entered a judgment in favor of the employer, concluding that the employee had failed to prove her condition had resulted from a work-related accident. In its judgment, the trial court explained that it had found the testimony of two reviewing physicians “more well-reasoned, medically sound, and persuasive than the testimony offered by” the employee’s treating physician. The employee timely appealed.

The employee argued that the trial court “incorrectly assigned greater weight to the testimony of physicians retained by the employer who conducted a medical review over her treating physician in reaching its conclusion” and that the trial court “abused its discretion in failing to resolve all reasonable doubts in conflicting medical evidence in favor of the employee.” In support of her argument, the employee cited to National Rest. Corp. v. Blevins, 611 So.2d 1096, 1098 (Ala. Civ. App. 1992) and Conley v. SCI Sys., Inc., 495 So.2d 698, 700 (Ala. Civ. App. 1986).

In rejecting both of these claims, the Court of Civil Appeals held that the opinions and language relied upon by the employee from Blevins and Conley were clearly distinguishable. The passages relied upon by the employee in both Blevins and Conley simply stood for the proposition that the Act is to be liberally construed in favor of the employee, not that a trial court must give more weight to the employee’s causation witness when presented with conflicting opinions of from other providers. 

Supporting this position is further passages quoted in Blevins, which states that it has long been the law in Alabama that, “[w]hen testimony is conflicting, the weight given to that evidence is a question for the trial court.” The court went on to quote the 1924 Alabama Supreme Court case of Ex parte Coleman, which succinctly stated that although it is a settled rule that the Act is to be construed liberally and in favor of the employee, it “does not mean, as counsel seem to argue, that the rule as to the measure of proof, of the sufficiency of evidence, is different from the rule in ordinary cases.”

Therefore, although the evidence at trial was conflicting, the Court of Civil Appeals determined that just as in any other case, the trial court did not abuse its discretion here by placing higher significance on testimony provided by two physicians even in light of conflicting testimony presented by the employee’s treating physician.

This case is good reminder that a plaintiff may not simply present evidence of a temporal relationship between the onset of injury as supported by one physician to definitively establish medical causation. Rather, a plaintiff must present sufficient evidence, which the fact finder determines to be more persuasive than any conflicting testimony offered in rebuttal, to properly establish medical causation to claim benefits under the Act. An employer and its workers’ compensation carrier should therefore carefully consider the importance of having an independent physician review the medical opinions of a treating physician prior to trial.