§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 §386-85; 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).
Employer failed to present substantial evidence sufficient to overcome the presumption that employee's shoulder injuries were related to a work accident where employer's physicians did not do more than opine generally that employee had injuries predating employee's employment and did not consider how employee's prior injuries might have been affected or aggravated by the work accident. 136 H. 448, 363 P.3d 296 (2015).
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).
Structure Hawaii Revised Statutes
Title 21. Labor and Industrial Relations
386. Workers' Compensation Law
386-2 Definitions relating to family relationships.
386-5 Exclusiveness of right to compensation; exception.
386-6 Territorial applicability.
386-7 Interstate and foreign commerce and maritime employment.
386-8 Liability of third person.
386-8.5 Limits of third party liability.
386-9 Contracting out forbidden.
386-10 Out of state employers.
386-21 Medical care, services, and supplies.
386-21.5 Publication of fees by prepaid health care plan contractors.
386-21.7 Prescription drugs; pharmaceuticals.
386-22 Artificial member and other aids.
386-23.5 Services of attendant, allowance adjustments.
386-23.6 Weekly benefit adjustments for recipients of services of attendants.
386-24 Medical rehabilitation.
386-25 Vocational rehabilitation.
386-26 Guidelines on frequency of treatment and reasonable utilization of health care and services.
386-27 Qualification and duties of health care providers.
386-28 Opioid therapy; qualifying injured employees; informed consent process.
386-29 Qualifying injured employees; initial concurrent prescriptions; opioids and benzodiazepines.
386-33 Subsequent injuries that would increase disability.
386-41 Entitlement to and rate of compensation.
386-43 Duration of dependents' weekly benefits.
386-44 Effect of erroneous payment; insanity of beneficiary.
386-51 Computation of average weekly wages.
386-51.5 Limited liability in concurrent employment.
386-52 Credit for voluntary payments and supplies in kind.
386-53 Nonweekly periodic payments.
386-54 Commutation of periodic payments.
386-55 Trustee in case of lump sum payments.
386-56 Payment from the special compensation fund in case of default.
386-57 Legal status of right to compensation and compensation payments.
386-71 Duties and powers of the director in general.
386-73 Original jurisdiction over controversies.
386-73.5 Proceedings to determine employment and coverage.
386-79 Medical examination by employer's physician.
386-80 Examination by impartial physician.
386-81 Notice of injury; waiver.
386-82 Claim for compensation; limitation of time.
386-83 When claim within specified time is unnecessary or waived.
386-84 Limitation of time with respect to minors and mentally incompetent.
386-86 Proceedings upon claim; hearings.
386-87 Appeals to appellate board.
386-87.1 Standing to intervene in appeals.
386-89 Reopening of cases; continuing jurisdiction of director.
386-90 Conforming prior decisions on appeal.
386-91 Enforcement of decisions awarding compensation; judgment rendered thereon.
386-92 Default in payments of compensation, penalty.
386-94 Attorneys, physicians, other health care providers, and other fees
386-95 Reports of injuries, other reports, penalty.
386-96 Reports of physicians, surgeons, and hospitals.
386-98 Fraud violations and penalties.
386-99 Posting of information.
386-100 Deductible option for medical benefits in insurance policy.
386-121 Security for payment of compensation; misdemeanor.
386-123 Failure to give security for compensation; penalty; injunction.
386-124 The insurance contract.
386-124.5 Insurer's requirements; failure to maintain claims service office; penalty; injunction.
386-125 Knowledge of employer imputed to insurance carrier.
386-126 Insolvency of employer not to release insurance carrier.
386-127 Cancellation of insurance contracts.
386-128 Insurance by the State, counties, and municipalities.
386-129 Employees not to pay for insurance; penalty.
386-142 Employment rights of injured employees.
386-151 Special compensation fund established and maintained.
386-152 Levy and charges to finance special compensation fund.
386-153 Levy on insurers of employers insured under section 386-121(a)(1).
386-154 Charge against employers not insured under section 386-121(a)(1).
386-154.5 Special assessments.
386-161 Who entitled to compensation.
386-171 Volunteer personnel, medical, etc., expenses.
386-172 Administration and procedure.
386-173 Time for giving notice, etc.
386-193 Authority to act as workers' compensation self-insurance group.
386-195 Certificate of approval; termination.
386-197 Board of trustees; membership, powers, duties, and prohibitions.
386-198 Group membership; termination, liability.
386-201 Financial statements and other reports.
386-202 Misrepresentation prohibited.
386-204 Rates and reporting of rates.
386-206 Premium payment; reserves.
386-207 Deficits and insolvencies.
386-210 Cease and desist orders.