In this week’s Alabama Law Weekly Update, we bring you a case from the Alabama Court of Civil Appeals addressing the evidence required for a trial court to determine medical causation.

Goodyear Tire & Rubber Co. v. Bush, [20140177, June 19, 2015] – So. 3d – (Ala. Ct. Civ. App. 2015) (trial court may not determine medical causation solely on its own observations).

In Goodyear Tire & Rubber Co. v. Bush, Stephen Dale Bush sought permanent-total-disability benefits under Alabama Workers’ Compensation Act (the “Act”) after falling and tearing the medial and lateral meniscus in his right knee while at work. The trial court held that Mr. Bush’s injury impacted his body as a whole and awarded Mr. Bush permanent-total-disability benefits. The Alabama Court of Civil Appeals reversed the trial court’s amended judgment finding that Mr. Bush is only entitled to permanent-partial-disability benefits under the Act.

Under the Act, an employee is entitled to compensation for the percentage of loss of the use of an injured body part according to certain prescribed schedules in the Act, but may recover compensation in addition to the schedules if the injury affects other parts of the body. In determining whether the effects of Mr. Bush’s knee injury extends to additional parts of his body—thereby allowing him to recover beyond the schedules—the court must find that the knee injury served as the medical causation for afflictions in other parts of the body.

The issue for the Alabama Court of Civil Appeals was whether substantial evidence, as required by the Act, existed for the trial court to determine that Mr. Bush’s knee injury was the medical causation for pain or limitations in other parts of Mr. Bush’s body. The court concluded that the trial court erred in finding that Mr. Bush’s knee injury served as the medical causation for afflictions in other parts of his body.

In its analysis, the court noted a trial court may make a finding of medical causation even in the absence of direct expert medical testimony as long as additional evidence exists to support such a finding. Mr. Bush’s orthopedist testified that Mr. Bush’s injury required surgery to repair and he restricted Mr. Bush to light-duty tasks only.  Mr. Bush’s physician initially assigned Mr. Bush an 8% impairment rating to his body as a whole, but clarified in testimony that the injury caused an 8% impairment-rating to Mr. Bush’s knee. Mr. Bush’s physician also did not testify at any point that Mr. Bush’s knee injury affected other parts of his body. Thus, there was not any additional evidence to support a finding of medical causation. In concluding that the trial court had abused its discretion, the Alabama Court of Civil Appeals emphasized that a trial court may not rely solely on its own observations in concluding the existence of medical causation.