Doctor Can Express Skepticism About Heart-Lung Presumption

Thomas Swigart worked as a firefighter for the City of Williamsport, Pennsylvania for 22 years. When he developed chronic obstructive pulmonary disease (COPD), he filed a workers’ compensation claim. When the City denied the claim, the matter wound up before Pennsylvania’s Commonwealth Court.

The Court’s decision turned on Pennsylvania’s “heart-lung” statute, which presumes that heart and lung diseases in firefighters are caused by the job and are compensable under the workers’ compensation system. In particular, the case focused on the testimony of a doctor retained by the City, who testified that he rejected the notion that lung conditions were caused by firefighting. As the Doctor put it:

“So if I have a firefighter who has a hundred-pack-a-year history of smoking and has a classic emphysema, and this man does not, I don’t want to confuse this, okay, I will in every single court under oath indicate what that individual’s cause of [his] impairment is. And his four years or more of firefighting will not be number one on the list. And I will have walls full of literature to support my opinion.”

The Court dismissed the challenge to the doctor’s testimony. The Court held that the doctor “did not testify that a causal relationship does not exist between exposure to the hazards of firefighting and lung disease. Rather, he opined that if an individual has other significant causal factors, he will not attribute firefighting as the number one cause. Accordingly, because the doctor indicated his acknowledgment that the presumption exists, but, he believed its use as a risk factor for lung disease is not as medically compelling, this does not render his expert opinion incompetent.”

Swigart v. Workers’ Compensation Appeal Board, 2015 WL 9311688 (Pa. Cmwlth. 2015).