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Stemming from the case of a firefighter who claimed he developed cancer from on-the-job exposure to carcinogens, the Pennsylvania Supreme Court has clarified the evidentiary standards for alleging an occupational disease in a workers’ compensation case.

The court’s multifaceted and, at times, divided ruling—one that generated three concurring and dissenting opinions—reversed a ruling of the Commonwealth Court holding that plaintiff Scott Sladek did not prove his cancer was the result of his employment as a Philadelphia firefighter.

In doing so the justices held that the workers’ compensation statute allows admissibility of epidemiological evidence, Justice Christine Donohue wrote in the court’s opinion.

“The provision only requires the claimant to establish a general causative link between the claimant’s type of cancer and a Group 1 carcinogen. In other words, the claimant must produce evidence that it is possible that the carcinogen in question caused the type of cancer with which the claimant is afflicted. It does not require the claimant to prove that the identified Group 1 carcinogen actually caused claimant’s cancer,” Donohue said.

In the firefighting arena, Donohue said, “epidemiological evidence is clearly relevant and useful in demonstrating general causation. Epidemiology deals with, inter alia, the identification of potentially causative associations in various populations between possible causative agents and the resulting incidence of particular diseases and seeks to generalize those results. In so doing, epidemiology may provide ‘useful information as to whether there is a relationship between an agent and a disease and, when properly interpreted, can provide insight into whether the agent can cause the disease.’”

In response to Donohue’s opinion, three justices issued their own concurring and dissenting opinions.

Chief Justice Thomas Saylor dissented with the majority’s reasoning in the case but concurred with its decision to remand for further proceedings.

“In all events, on the arguments presently before the court, I would not dilute the Commonwealth Court’s holding requiring some showing, by a firefighter-claimant, that the type of cancer could have been caused by Group 1 carcinogens to which the claimant was exposed at work, while at the same time foreclosing employers from demonstrating that this type of cancer is incapable of having been caused by relevant workplace exposure,” Saylor said.

Justice David Wecht also wrote a concurring and dissenting opinion.

“In sum, I would hold that: (1) occupational disease claimants can satisfy Subsection 108(r) by showing that they suffer from a kind of cancer that is caused by a Group 1 carcinogen; and (2) an expert-epidemiologist’s general causation testimony may constitute substantial competent evidence that a firefighter’s cancer was not caused by the occupation of firefighting,” Wecht said.

And lastly, Justice Sallie Mundy also separately concurred and dissented with the ruling.

“Based on the foregoing, I would hold: 1) Sladek met his burden of establishing an occupational disease under 108(r), and was thus entitled to the presumption of Section 301(e) that his malignant melanoma was caused by his employment as a firefighter; and 2) the general causation evidence in the nature of expert testimony on epidemiology offered by the city was insufficient to rebut the presumption of benefits to Sladek,” Mundy said.

Sladek was represented Michael Dryden of Willig, Williams & Davidson.

“It was a good day for firefighters,” Dryden said of the majority’s decision. “The Supreme Court’s decision provided a fairer standard for firefighters diagnosed with cancer to pursue compensation.”

He added, “Their decision is in line with the intent of the General Assembly.”