U.S. Ind./Fed. Sheet Metal, Inc. v. Director, Owcp, 455 U.S. 608 (1982)

U.S. Industries/Federal Sheet Metal, Inc. v. Director,

Office of Workers’ Compensation Programs
No. 80-518

Argued October 6, 1981
Decided March 23, 1982
455 U.S. 608

CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR

THE DISTRICT OF COLUMBIA CIRCUIT

Syllabus

Respondent Riley (hereafter respondent) awoke on the morning of November 20, 1975, with severe pains in his neck, shoulders, and arms. Subsequently, he filed a claim for disability benefits under the Longshoremen’s and Harbor Workers’ Compensation Act (Act), alleging that he suffered an accidental injury in the course of his employment on November 19, 1975, when he was lifting duct work and felt a sharp pain in his neck. The Administrative Law Judge found that the accident never occurred, and denied the claim, and the Benefits Review Board affirmed. The Court of Appeals vacated the Board’s decision, holding that respondent suffered an "injury" when he awakened in pain on November 20, and that, under § 20(a) of the Act -- which provides that, in any proceeding for the enforcement of a claim for compensation under the Act, "it shall be presumed, in the absence of substantial evidence to the contrary . . . [t]hat the claim comes within the provisions of [the Act]" -- respondent was entitled to a presumption that the injury was "employment-bred."

Held:

1. The Court of Appeals erred in invoking the § 20(a) presumption in support of a claim that respondent did not make, he having claimed that he was injured at work, and not that the "injury" occurred at home and that it was somehow "employment-bred." In this case, there is no reason to depart from the specific statutory direction that a claim be made, and that the presumption, however construed, attach to the claim. Pp. 612-615.

2. The Court of Appeals also erred in its use of the term "injury" as including respondent’s attack of pain occurring on the morning of November 20. The Act defines "injury" as an "accidental injury . . . arising out of and in the course of employment," so that a prima facie "claim for compensation," to which the § 20(a) presumption refers, must at least allege an injury that arose in the course of employment, as well as out of employment. Here, however, the "injury" noticed by the Court of Appeals arose in bed, not in the course of employment. The statutory presumption is no substitute for the allegations necessary to state a prima facie case. Pp. 615-616.

200 U.S.App D.C. 402, 627 F.2d 455, reversed.

STEVENS, J., delivered the opinion of the Court, in which BURGER, C.J., and WHITE, BLACKMUN, POWELL, and REHNQUIST, JJ., joined. BRENNAN, J., filed a dissenting opinion, in which MARSHALL, J., joined, post, p. 617. O’CONNOR, J., took no part in the consideration or decision of the case.