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Dell\rquote Isola}{\fs20\insrsid7889901\charrsid7889901 , Opinion\tab \tab Page \chpgn of }{\field{\*\fldinst {\fs20\insrsid7889901\charrsid7889901 NUMPAGES \\* ARABIC }}{\fldrslt {\fs20\lang1024\langfe1024\noproof\insrsid9196897 18}}}{\fs20\insrsid7889901\charrsid7889901 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 {\fs20\insrsid7889901\charrsid7889901 \par }{\lang1024\langfe1024\noproof\insrsid2431241 {\shp{\*\shpinst\shpleft0\shptop0\shpright0\shpbottom0\shpfhdr0\shpbxmargin\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz0\shplid2049 {\sp{\sn shapeType}{\sv 20}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn lineColor}{\sv 2}}{\sp{\sn lineWidth}{\sv 9144}}{\sp{\sn fLine}{\sv 1}} {\sp{\sn posrelh}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxmargin\dobypara\dodhgt8192\dpline\dpptx0\dppty0\dpptx0\dppty0\dpx0\dpy0\dpxsize0\dpysize0\dplinew14\dplinecor2\dplinecog0\dplinecob0}}} {\shp{\*\shpinst\shpleft0\shptop7\shpright9360\shpbottom7\shpfhdr0\shpbxmargin\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz1\shplid2050{\sp{\sn shapeType}{\sv 20}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}} {\sp{\sn lineColor}{\sv 2}}{\sp{\sn lineWidth}{\sv 9144}}{\sp{\sn fLine}{\sv 1}}{\sp{\sn posrelh}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxmargin\dobypara\dodhgt8193\dpline\dpptx0\dppty0\dpptx9360\dppty0 \dpx0\dpy7\dpxsize9360\dpysize0\dplinew14\dplinecor2\dplinecog0\dplinecob0}}}}{\fs20\insrsid7889901\charrsid7889901 \par }}{\*\pnseclvl1\pndec\pnstart1 {\pntxta .}}{\*\pnseclvl2\pnlcltr\pnstart1 {\pntxta .}}{\*\pnseclvl3\pnlcrm\pnstart1 {\pntxta .}}{\*\pnseclvl4\pndec\pnstart1 {\pntxtb (}{\pntxta )}}{\*\pnseclvl5\pnlcltr\pnstart1 {\pntxtb (}{\pntxta )}}{\*\pnseclvl6 \pnlcrm\pnstart1 {\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pndec\pnstart1 {\pntxta .}}{\*\pnseclvl8\pnlcltr\pnstart1 {\pntxta .}}{\*\pnseclvl9\pnlcrm\pnstart1 }\pard\plain \qc \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\b\insrsid15151648\charrsid13828682 IN THE SUPREME COURT OF GUAM}{\b\insrsid15151648\charrsid13828682 \par }{\insrsid15151648\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 BETTY FAGAN,}{\insrsid15151648\charrsid13828682 \par Plaintiff}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 Appellant, \par \par }{\b\insrsid15151648\charrsid13828682 vs.}{\insrsid15151648\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 DAVID G. DELL\rquote ISOLA, in his capacity as the Worker\rquote s Compensation Commissioner, TAIWAN ELECTRICAL & MECHANICAL ENGINEERING SERVICES, INC., Employer and Real Party in Interest and CHUNG KUO INSURANCE COMPANY, LTD. Insurance Carrier and Real Party in Interest,}{\insrsid15151648\charrsid13828682 \par Defendants}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 Appellees. \par \par Supreme Court Case No.:}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 CVA04}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 003 \par Superior Court Case No.:}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 CV1542}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 01 \par \par }{\b\insrsid15151648\charrsid13828682 OPINION}{\insrsid15151648\charrsid13828682 \par }{\b\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 Filed: September 15, 2006}{\insrsid15151648\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 Cite as:}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 2006 Guam}{\b\insrsid15151648\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 11}{\insrsid15151648\charrsid13828682 \par \par Appeal from the Superior Court of Guam \par Argued and submitted on February 15, 2005 \par Hag\'e5t\'f1a, Guam \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid15151648\charrsid13828682 \par }\trowd \irow0\irowband0\lastrow \ts11\trqc\trgaph112\trleft-112\trftsWidth1\trpaddl112\trpaddr112\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4725\clshdrawnil \cellx4613\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4635\clshdrawnil \cellx9248\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid13828682 { \ul\insrsid15151648\charrsid13828682 Appearing for the Plaintiff}{\ul\insrsid13828682\charrsid13828682 -}{\ul\insrsid15151648\charrsid13828682 Appellant}{\insrsid15151648\charrsid13828682 : \par A. Alexander Gorman, }{\i\insrsid15151648\charrsid13828682 Esq}{\insrsid15151648\charrsid13828682 . \par Law Offices of Gorman & Gavras, P.C. \par Second Floor, J & R Bldg. \par 208 Route 4 \par Hag\'e5t\'f1a, Guam 96910 \par \cell }{\ul\insrsid15151648\charrsid13828682 Appearing for the Defendants}{\ul\insrsid13828682\charrsid13828682 -}{\ul\insrsid15151648\charrsid13828682 Appellees}{\insrsid15151648\charrsid13828682 : \par Thomas C. Sterling, }{\i\insrsid15151648\charrsid13828682 Esq}{\insrsid15151648\charrsid13828682 . \par Klemm, Blair, Sterling & Johnson, P.C. \par Suite 1008 Pacific News Bldg. \par 238 Archbishop Flores St. \par Hag\'e5t\'f1a, Guam 96910 \par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\insrsid15151648\charrsid13828682 \trowd \irow0\irowband0\lastrow \ts11\trqc\trgaph112\trleft-112\trftsWidth1\trpaddl112\trpaddr112\trpaddfl3\trpaddfr3 \clvertalt \clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4725\clshdrawnil \cellx4613\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4635\clshdrawnil \cellx9248\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid15151648\charrsid13828682 \par BEFORE:}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 FRANCES M. TYDINGCO}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 GATEWOOD,1{\footnote \pard\plain \qj \fi720\li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\super\insrsid15151648 1}{\insrsid15151648 }{\fs20\insrsid15151648 The Chief Justice was unable to participate in this case as scheduled. Justice Tydingco-Gatewood, as senior member of the panel, was appointed Presiding Chief Justice. \tab \tab }} Presiding Justice; ROBERT J. TORRES, JR., Associate Justice;}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 MIGUEL S. DEMAPAN,}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Justice }{\i\insrsid15151648\charrsid13828682 Pro Tempore}{\insrsid15151648\charrsid13828682 . \par \par }\pard \ql \fi-3600\li3600\ri0\nowidctlpar\faauto\rin0\lin3600\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 TYDINGCO}{\b\insrsid13828682\charrsid13828682 -}{\b\insrsid15151648\charrsid13828682 GATEWOOD, J}{\insrsid13828682\charrsid13828682 .:}{\insrsid15151648\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid15151648\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [1]}{\insrsid15151648\charrsid13828682 \tab This matter comes before the court on the issue of whether the trial court properly affirmed the Worker\rquote s Compensation Commissioner\rquote s decision denying death benefits to Fagan\rquote s widow.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 We announce for the first time how our Guam courts should deal with claims for heart attacks brought under our Worker \rquote s Compensation laws.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 We find that the Commissioner\rquote s}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 decision was not in accordance with the law announced today and therefore, the trial court\rquote s affirmation was improper.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Thus, we remand this matter to the lower court with instructions to vacate its order and to then send the claim back to the Worker\rquote s Compensation Commission for a hearing under an appropriate analysis consistent with this opinion.}{ \insrsid13828682\charrsid13828682 \par \par }\pard \qc \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 I.}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [2]}{\insrsid15151648\charrsid13828682 \tab On July 6, 1999, a co}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 worker found Larry Paul Fagan }{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 motionless and unconscious}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 at the Taiwan Electrical and Mechanical Engineering Services, Inc., job site in Piti.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Appellant\rquote s Excerpts of Record (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ER}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ), at 8 (Findings and Order, Aug. 10, 2001).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 He was taken to the U.S. Naval Hospital, where he was pronounced dead.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 The next day, Chief Medical Examiner Dr. Aurelio Espinola issued the Certificate of Death, stating that }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 coronary occlusion}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 was the immediate cause of death.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 ER, at 8 (Findings and Order, Aug. 10, 2001).}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The certificate also indicated that it had been a natural death.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [3]}{\insrsid15151648\charrsid13828682 \tab Mr. Fagan\rquote s widow, Plaintiff}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 Ap}{\insrsid13828682\charrsid13828682 p}{ \insrsid15151648\charrsid13828682 ellant Betty B. Fagan (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 Mrs. Fagan}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ) filed a claim with the Worker\rquote s Compensation Commission on July 25, 2006, seeking death benefits under the worker\rquote s compensation policy of Mr. Fagan\rquote s employer, Taiwan Electrical.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 She alleged that her husband had been }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 harassed and bullied on a daily basis at work by his employer for his refusal to train other workers.}{\insrsid13828682\charrsid13828682 " }{ \insrsid15151648\charrsid13828682 ER, at 9 (Findings and Order, Aug. 10, 2001).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [4]}{\insrsid15151648\charrsid13828682 \tab The Commission forwarded her claim to Chung Kuo Insurance Co., Ltd., the carrier of the Taiwan Electrical\rquote s worker\rquote s compensation policy.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Chung Kuo denied the claim, and issued a Notice of Controversion on September 1, 1999, indicating that the cause of Mr. Fagan\rquote s death was determined to be natural causes. }{ \insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [5]}{\insrsid15151648\charrsid13828682 \tab In a February 4, 2000 report, Dr. Espinola summarized the results of the autopsy conducted on Larry Fagan, and made two key findings.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 First, he acknowledged that }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 tremendous stress is known to trigger heart attack.}{\insrsid13828682\charrsid13828682 " }{ \insrsid15151648\charrsid13828682 ER, at 11 (Espinola Report).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Second, Dr. Espinola found:}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [B]oth coronary arteries showed marked coronary sclerosis with segmental narrowing up to 95%.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The right coronary at one point was completely occluded by a fresh blood clot that caused his death.}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 ER, at 11 (Espinola Report).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 He further concluded that } {\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 with the severity of his coronary arteries, he could have heart attack anytime, even during sleep.}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 ER, at 11 (Espinola Report).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [6]}{\insrsid15151648\charrsid13828682 \tab The Commission denied Mrs. Fagan\rquote s claim for death benefits without holding a hearing.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 She then filed a Complaint for Injunction to Set Aside Compensation Order No. 2001}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 0065 and to Enter an Order Awarding Benefits in the Superior Court.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The complaint, which was later amended, specifically cited 22 GCA \'a7 9122(b)2{\footnote \pard\plain \qj \fi720\li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\super\insrsid15151648 2}{\fs20\insrsid15151648 Title 22 GCA \'a79122(b) (2005) states in relevant part: \'93 If not in accordance with law, a compensation order may be suspended or set aside, in whole or in part, through injunction proceedings, mandatory or otherwise, brought by any party in interest against the Commissioner, and instituted in the Superior Court.\'94}} as the basis for granting injunctive relief.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 After a June 27, 2002 hearing, the trial court denied the injunctive relief, holding:}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 The Court finds substantial evidence to support the order of the Worker\rquote s Compensation Commission denying benefits to Plaintiff [Mrs. Fagan].}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 ER, at 16 (Decision and Order).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The Judgment was filed on January 28, 2004, but was not signed by Mrs. Fagan\rquote s attorney.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Mrs. Fagan timely appealed the trial court\rquote s denial of injunctive relief.}{ \insrsid13828682\charrsid13828682 \par \par }\pard \qc \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 II.}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [7]}{\insrsid15151648\charrsid13828682 \tab We have jurisdiction to hear appeals of a final order of the Superior Court.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 48 U.S.C. \'a7 1424}{ \insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 1(a)(2) (2004); 7 GCA \'a7\'a7 3107(b) and 3108(b) (2005).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 This is a final and appealable order under 7 GCA \'a7 25102(f) (2005). }{\insrsid13828682\charrsid13828682 \par \par }\pard \qc \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 III.}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [8]}{\insrsid15151648\charrsid13828682 \tab We must initially determine the applicable standard of review because it, essentially, instructs us as to the degree of deference to afford the agency and the trial court.}{ \insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 See Farley v. Sullivan}{\insrsid15151648\charrsid13828682 , 983 F.2d 405, 407 (2nd Cir. 1993) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 In assessing action by an administrative agency, the court must temper its standard of review according to the degree of discretion [the legislature] has given to the agency concerned.}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 ).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [9]}{\insrsid15151648\charrsid13828682 \tab Generally, where the standard of judicial review of an agency action is enunciated by regulation or statute, such standard of review will govern.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 However, where, as here, the agency regulation or statute (22 GCA \'a7\'a7 9101}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 9145) only addresses whether the decision is }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 in accordance with law,}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 3{\footnote \pard\plain \qj \fi720\li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\super\insrsid15151648 3}{\fs20\insrsid15151648 We note that 22 GCA \'a7 9122 (2005) provides for judicial review if the decision of the Commission is \'93not in accordance with law.\'94 To the extent that section 9122 dictates a standard of review, it is consistent with the standard of review given to the Commissioner \rquote s decisions under the Administrative Adjudication Law, which requires the reviewing court to determine whether the Commissioner\rquote s decision is in accordance with law and supported by substantial evidence under 5 GCA \'a7 9240.}} we must look further, to the standard provided by the general administrative adjudication law.}{\insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Ninilchik Traditional Council v. United States}{\insrsid15151648\charrsid13828682 , 227 F.3d 1186, 1193 (9th Cir. 2000). (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [A] reviewing court must apply the deferential [Administrative Procedures Act] standard in the absence of a stated exception when reviewing federal agency decisions.}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ); }{\i\insrsid15151648\charrsid13828682 Ka Makani O Kohala Ohana Inc. v. Water Supply}{ \insrsid15151648\charrsid13828682 , 295 F.3d 955, 959 (9th Cir. 2002) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 Because [the governing statute] does not contain a separate provision for judicial review, we review an agency \rquote s compliance with [the statute] under the Administrative Procedure Act.}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 )}{\insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 N.L.R.B. v. Beverly Enter.} {\i\insrsid13828682\charrsid13828682 -}{\i\insrsid15151648\charrsid13828682 Mass., Inc.,}{\insrsid15151648\charrsid13828682 174 F.3d 13, 22 (1st Cir. 1999) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 Because the NLRA is silent as to the standard for reviewing nonfactual matters, the standard of review for such matters is provided by section 10(e) of the Administrative Procedure Act.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 Errors of law are reviewed by the court de novo.}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 )}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [10]}{\insrsid15151648\charrsid13828682 \tab The general law on administrative adjudications on Guam is found in 5 GCA \'a7\'a7 9100}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 9312, entitled the }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 Administrative Adjudication Law}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 (}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 AAL}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Pursuant to section 9240 of the AAL, the standard of review to be applied by the trial court, upon judicial review of the agency\rquote s action, is as follows:}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 If the agency decision is not in accordance with law or not supported by substantial evidence, the court shall order the agency to take action according to law or the evidence.}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 5 GCA \'a7 9240 (2005).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The court always reviews questions of law }{\i\insrsid15151648\charrsid13828682 de novo.}{\i\insrsid13828682\charrsid13828682 }{ \i\insrsid15151648\charrsid13828682 Nissan Motor Corp. in Guam v. Sea Star Group Inc.}{\insrsid15151648\charrsid13828682 , 2002 Guam 5 \'b6 10.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [11]}{\insrsid15151648\charrsid13828682 \tab The trial court was required to review }{\i\insrsid15151648\charrsid13828682 de novo }{\insrsid15151648\charrsid13828682 the Commission\rquote s conclusions of law.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The trial court was also required to affirm the Commission\rquote s findings of fact, and any conclusions resulting therefrom, if supported by substantial evidence.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 This is because a reviewing body }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 may not substitute its views for those of the [agency], but instead must accept the [agency\rquote s] findings unless they are contrary to law, irrational, or unsupported by substantial evidence.}{\insrsid13828682\charrsid13828682 " }{ \i\insrsid15151648\charrsid13828682 Alcala v. Dir., Office of Workers Comp. Programs}{\insrsid15151648\charrsid13828682 , 141 F.3d 942, 944 (9th Cir. 1998) (addressing the standard of administrative review of the Longshore and Harbor Worker\rquote s Compensation Act (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 LHWCA}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 )).4{\footnote \pard\plain \qj \fi720\li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\super\insrsid15151648 4}{\fs20\insrsid15151648 The LHWCA\rquote s standard of review requires that the decision of the agency not be \'93contrary to law, irrational, or unsupported substantial evidence.\'94 }{\i\fs20\insrsid15151648 Port of Portland v. Dir., Office of Workers\rquote Comp. Programs}{ \fs20\insrsid15151648 , 932 F.2d 836, 838 (9th Cir. 1991), citing }{\i\fs20\insrsid15151648 Todd Shipyards Corp. v. Black}{\fs20\insrsid15151648 , 717 F.2d 1280, 1284 (9th Cir. 1983). The LHWCA standard is similar to Guam\rquote s standard of review for agency decisions found at 5 GCA \'a7 9240 (2005), which requires the agency decision to be \'93in accordance with law\'94and supported by substantial evidence.}} }{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [12]}{\insrsid15151648\charrsid13828682 \tab Our inquiry in effect mirrors the review which should be conducted by the trial court.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 First, we determine whether the agency decision }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 was in accordance with law.}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 5 GCA \'a7 9240 (2005); 22 GCA \'a7 9122 (2005).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Second, we determine whether the agency decision was }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 supported by substantial evidence.}{ \insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 5 GCA \'a7 9240.}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [S]ubstantial evidence is defined as \lquote such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.\rquote }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Bondoc v. Worker\rquote s Comp. Comm \rquote n}{\insrsid15151648\charrsid13828682 , 2000 Guam 6 \'b6 65{\footnote \pard\plain \qj \fi720\li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\super\insrsid15151648 5}{ \fs20\insrsid15151648 Bondoc appealed the decision of the Worker\rquote s Compensa tion Commission under Title 7 of the Guam Code Annotated, petitioning the Superior Court for a writ of review under Title 7. In this case, Mrs. Fagan has sought review of the Worker\rquote s Compensation Commission\rquote s decision pursuant to Title 22 of the Guam Code Annotated, specifically, 22 GCA \'a7 9122, \'93Review of Compensation Order,\'94 which provides that \'93 a compensation order may be suspended or set aside, in whole or in part, through injunction proceedings, mandatory or otherwise. . . .\'94 Since Mrs. Fagan sought review under 22 GCA \'a7 9122 rather than Title 7, the standard of review set forth in }{ \i\fs20\insrsid15151648 Bondoc}{\fs20\insrsid15151648 is not applicable here. Moreover, we do not currently address the propriety of the method of appeal or the standard of review of a petition for review of a commiss ion decision under Title 7 of the Guam Code Annotated. }} (citation omitted); }{\i\insrsid15151648\charrsid13828682 see also Am. Grain Trimmers, Inc. v. Office of Workers\rquote Comp. Programs}{\insrsid15151648\charrsid13828682 , 181 F.3d 810, 818 (7th Cir. 1999) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 when evaluating administrative decisions, the courts of appeals review legal conclusions }{\i\insrsid15151648\charrsid13828682 de novo}{ \insrsid15151648\charrsid13828682 but must affirm findings of fact and conclusions drawn therefrom if supported by substantial evidence}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ) (citing }{ \i\insrsid15151648\charrsid13828682 Morehead Marine Services, Inc. v. Washnock}{\insrsid15151648\charrsid13828682 , 135 F.3d 366, 370 (6th Cir. 1998)).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [13]}{\insrsid15151648\charrsid13828682 \tab Applying the above standards to the facts at bar, we examine whether the trial court determined whether the decision was in accordance with the law and supported by substantial evidence.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 In so doing, we will review all conclusions of law }{\i\insrsid15151648\charrsid13828682 de novo}{\insrsid15151648\charrsid13828682 , and will hold unlawful and set aside any agency action, findings and conclusions found to be irrational, or otherwise not in accordance with law or unsupported by substantial evidence in a case.}{\insrsid13828682\charrsid13828682 }{ \i\insrsid15151648\charrsid13828682 Kalama Services, Inc. v. Dir., Office of Workers\rquote Comp. Programs,}{\insrsid15151648\charrsid13828682 354 F.3d 1085, 1090 (9th Cir. 2004).}{\insrsid13828682\charrsid13828682 \par \par }\pard \qc \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 III.}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 A.}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 Whether the Commission\rquote s Decision was }{\b\insrsid13828682\charrsid13828682 "}{\b\insrsid15151648\charrsid13828682 in accordance with law.}{\b\insrsid13828682\charrsid13828682 "}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [14]}{\insrsid15151648\charrsid13828682 \tab In reviewing the trial court\rquote s decision, it is necessary to begin our discussion with whether the court properly determined the Commissioner\rquote s decision was in accordance with the law.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In so doing, we examine whether Mr. Fagan\rquote s injury falls within the provisions of Guam\rquote s Worker\rquote s Compensation law, and further, whether such injury is compensable.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Based on our }{\i\insrsid15151648\charrsid13828682 de novo}{\insrsid15151648\charrsid13828682 review of the questions of law in this case, we conclude that the Commissioner\rquote s action in denying Mrs. Fagan\rquote s claim for death benefits was not in accordance with the law.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 1.}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 Guam Worker\rquote s Compensation Law}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [15]}{\insrsid15151648\charrsid13828682 \tab Generally speaking, Guam\rquote s Worker\rquote s Compensation law, found at 22 GCA \'a7\'a7 9101}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 9145, allows a claimant to seek compensation for injury sustained while in industrial or public employment.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In particular, section 9104(a) (2005) provides: }{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 Compensation shall be payable under this Title in case of disability or death of an employee, but only if the disability or death results from an injury sustained while engaged in industrial employment or public employment or both as defined in \'a7 9103.}{\insrsid13828682\charrsid13828682 " }{ \insrsid15151648\charrsid13828682 22 GCA \'a7 9104 (2005).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [16]}{\insrsid15151648\charrsid13828682 \tab The term }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 injury}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 is defined in 22 GCA \'a7 9103(m) (2005) as }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 accidental injury or death arising out of and in the course of employment, and such occupational disease or infection as arises naturally out of such employment or as naturally or unavoidably results from such accidental injury.}{ \insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 In order to qualify as a compensable injury under the Worker\rquote s Compensation law, the injury must therefore }{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 aris[e] out of and in the course of employment.}{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 See}{\insrsid15151648\charrsid13828682 22 GCA \'a7 9103 (2005).}{ \insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [17]}{\insrsid15151648\charrsid13828682 \tab Moreover, section 9121(a) (2005) provides for a presumption of compensability:}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 In any proceeding for the enforcement of a claim for compensation under this Title, it shall be presumed, in the absence of substantial evidence to the contrary (a) [t]hat the claim comes within the provision of this Title.}{ \insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 Guam\rquote s statutory scheme, however, provides no guidance in determining whether a particular injury arises out of and in the course of employment, as such phrase is used in section 9103.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Similarly, Guam\rquote s statutory scheme provides no guidance with respect to the applicability of the presumption of compensability provided by section 9121(a).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [18]}{\insrsid15151648\charrsid13828682 \tab However, because our Worker\rquote s Compensation law is substantially similar to the federal Longshoremen and Harbor Workers\rquote Compensation Act (}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 LHWCA}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ), we look to case law interpreting the LHWCA for guidance.}{\insrsid13828682\charrsid13828682 }{ \i\insrsid15151648\charrsid13828682 Amerault v. Intelcom Support Services, Inc.}{\insrsid15151648\charrsid13828682 , 2004 Guam 23 \'b6 16 (observing that Guam\rquote s worker\rquote s compensation laws are substantially similar to the LHWCA)6{\footnote \pard\plain \qj \fi720\li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\super\insrsid15151648 6}{\insrsid15151648 }{\fs20\insrsid15151648 In }{\i\fs20\insrsid15151648 Amerault}{ \fs20\insrsid15151648 , 2004 Guam 23 \'b6 16, we recognized that th e LHWCA is modeled after the statutory scheme of New York law. Unfortunately, New York courts, applying statutes with language identical to the LHWCA, do not provide clear guidance. This has been observed by such scholars as Larson, when he said \'93 [W]hen the New York statutory presumption is superimposed upon actual New York practice of accepting almost any evidence of exertion as adequate to satisfy its test,\'94 many cases result in the conclusion \'93 that the decedent at the time of death was engaged in exertions comparable to those which have satisfied the New York courts in the great bulk of those cases.\'94 1 Arthur Larson & Lex K. Larson, Larson\rquote s Workers\rquote Compensation Law, \'a7 7.04[3][a] (2005). This is because in general, New York cases are inconsistent in heart attack cases, so much so that little guidance comes from New York\rquote s cases in this area. }{\i\fs20\insrsid15151648 See}{\fs20\insrsid15151648 discussion }{ \i\fs20\insrsid15151648 infra}{\fs20\insrsid15151648 , subsection 2.d. For these reasons, we do not find the New York cases to be persuasive. }}; }{\i\insrsid15151648\charrsid13828682 Gibbs v. Holmes,}{\insrsid15151648\charrsid13828682 2001 Guam 11 \'b6 15 (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [finding] guidance in the case law of those jurisdictions that have adopted worker\rquote s compensation statutes that are substantially similar to Guam\rquote s statutes.}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [19]}{\insrsid15151648\charrsid13828682 \tab To be sure, the provisions of our Worker\rquote s Compensation law are virtually identical to the provisions found in the LHWCA.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 To begin with, 22 GCA \'a7 9104 and the LHWCA both require that the injury must arise out of and be in the course of the claimant\rquote s employment.}{\insrsid13828682\charrsid13828682 }{ \i\insrsid15151648\charrsid13828682 See }{\insrsid15151648\charrsid13828682 22 GCA \'a7 9104 and 9103; }{\i\insrsid15151648\charrsid13828682 cf.}{\insrsid15151648\charrsid13828682 33 U.S.C. \'a7 903 (2006) (Westlaw through Pub. L. 109}{ \insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 279 (2006) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [C]ompensation shall be payable under this chapter in respect of disability or death of an employee, but only if the disability or death results from an injury occurring upon the navigable waters of the United States}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 )); 33 U.S.C. \'a7 902 (Westlaw through Pub. L. 109}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 279)(2006) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 \lquote [I]njury\rquote means accidental injury or death arising out of and in the course of employment, and such occupational disease or infection as arises naturally out of such employment or as naturally or unavoidably results from such accidental injury.}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 )).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [20]}{\insrsid15151648\charrsid13828682 \tab In addition, our Worker\rquote s Compensation law and the LHWCA have virtually identical language with respect to the presumption of compensability.}{ \insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 See}{\insrsid15151648\charrsid13828682 22 GCA \'a7 9121(a); }{\i\insrsid15151648\charrsid13828682 cf.}{\insrsid15151648\charrsid13828682 33 U.S.C. \'a7 920(a) (Westlaw through Pub. L. 109}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 279) (2006) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 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 . . .}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 that the claim comes within the provisions of this chapter}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 )).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [21]}{\insrsid15151648\charrsid13828682 \tab The provisions of the LHWCA, like Guam law, provide no statutory guidance in determining whether an injury arises out of and in the course of employment, nor do the provisions of the LHWCA provide guidance as to the applicability of the presumption of compensability.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Nonetheless, numerous courts interpreting the LHWCA provisions, under factually similar circumstances, have formulated various tests to be applied in determining, first, whether an injury has arisen out of and in the course of employment, and second, the effect of the presumption of compensability.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 We discuss such cases below.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 2.}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 The LHWCA cases}{\insrsid13828682\charrsid13828682 \par \par }\pard \ql \li720\ri0\nowidctlpar\faauto\rin0\lin720\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 a.}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 Claimant\rquote s prima facie case and the presumption of compensability }{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [22]}{\insrsid15151648\charrsid13828682 \tab As previously discussed, a claimant under the Worker\rquote s Compensation law enjoys a presumption of compensability under 22 GCA \'a7 9121.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 We must first consider }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 what initial demonstration of employment}{\insrsid13828682\charrsid13828682 -}{ \insrsid15151648\charrsid13828682 connection will give the presumption a foothold.}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 1 Arthur Larson & Lex K. Larson, Larson\rquote s Workers\rquote Compensation Law, \'a7 7.04[3][a] (2005) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 Larson 1}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In other words, does the allegation of an injury occurring at the workplace in itself operate to trigger the presumption, thus shifting the burden immediately to the employer, or must the claimant establish the elements of the }{ \i\insrsid15151648\charrsid13828682 prima facie}{\insrsid15151648\charrsid13828682 case before the presumption is triggered and the burden is shifted to the employer?}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 A survey of this issue has yielded varying results:}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 The sweeping inclusiveness of the language might seem at fir st glance to mean that the mere making of a claim is also the making of a prima facie case.}{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Id.}{\i\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 However, } {\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 courts have not so interpreted the statutes.}{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Id.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [23]}{\insrsid15151648\charrsid13828682 \tab Cases interpreting the operation of the presumption under the LHWCA have required more than an allegation of an injury in the workplace.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In }{\i\insrsid15151648\charrsid13828682 Meehan Seaway Service Company v. Director, Office of Worker\rquote s Compensation Programs}{\insrsid15151648\charrsid13828682 , 125 F.3d 1163, 1168 (8th Cir. 1997), the court required that the claimant set forth a }{\i\insrsid15151648\charrsid13828682 prima facie}{\insrsid15151648\charrsid13828682 claim for compensation before the presumption will attach.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 That is, the claim }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 must allege an injury that arose in the course of employment as well as out of employment.}{ \insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Id.}{\i\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In turn, to establish that the injury arose in the course of and out of employment, it is also suffic ient that the claimant }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 establish[] both that he suffered harm, and that workplace conditions or a workplace accident }{\i\insrsid15151648\charrsid13828682 could have}{ \insrsid15151648\charrsid13828682 caused, aggravated, or accelerated the harm.}{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 American Stevedoring Ltd., v. Marinelli}{\insrsid15151648\charrsid13828682 , 248 F.3d 54, 64}{ \insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 65 (2d Cir. 2001) (emphasis added).}{\insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Accord Bell Helicopter Int\rquote l, Inc. v. Jacobs}{ \insrsid15151648\charrsid13828682 , 746 F.2d 1342 (8th Cir. 1984).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Stated another way, a claimant seeking compensation pursuant to the LHWCA }{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 bears the initial burden of establishing that (1) he suffered an injury and (2) the accident occurred in the course of employment or conditions existed at work that could have caused the harm.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Once the claimant has established his }{\i\insrsid15151648\charrsid13828682 prima facie}{\insrsid15151648\charrsid13828682 case, a presumption is created . . . .}{ \insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Gooden v. Dir., Office of Worker\rquote s Comp. Programs,}{\insrsid15151648\charrsid13828682 135 F.3d 1066, 1068 (5th Cir. 1998) (citation omitted).}{ \insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [24]}{\insrsid15151648\charrsid13828682 \tab We hold, in line with the above federal cases, that the mere showing of an injury at the workplace does not invoke the presumption of compensability found in 22 GCA \'a7 9121.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Rather, in order to invoke the presumption of compensability, a claimant bears the burden of establishing, first, that he suffered an injury, and second, that the injury occurred in the course of employment, or conditions existed at work that co uld have caused, aggravated, or accelerated the injury.}{\insrsid13828682\charrsid13828682 \par \par }\pard \ql \li720\ri0\nowidctlpar\faauto\rin0\lin720\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 b.}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 Employer\rquote s burden to rebut the presumption by substantial evidence}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [25]}{\insrsid15151648\charrsid13828682 \tab Once the }{\i\insrsid15151648\charrsid13828682 prima facie}{\insrsid15151648\charrsid13828682 case is established by the claimant, and the presumption is invoked,}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 the burden then shifts to the employer, who may present evidence in rebuttal.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 That is, the presumption of compensability }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 can be rebutted by the employer through substantial evidence establishing the absence of a connection between the injury and the employment.}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Gooden}{\insrsid15151648\charrsid13828682 , 135 F.3d at 1068.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [26]}{\insrsid15151648\charrsid13828682 \tab We have defined substantial evidence as }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Bondoc v. Worker\rquote s Comp. Comm\rquote n}{ \insrsid15151648\charrsid13828682 , 2000 Guam 6 \'b6 6.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The employer\rquote s burden to provide substantial evidence ha s been further defined and clarified by courts in applying the LHWCA.}{\insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 See La. Ins. Guar. Ass\rquote n v. Bunol}{\insrsid15151648\charrsid13828682 , 211 F.3d 294, 298 (5th Cir. 2000) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 defining \lquote substantial evidence\rquote as evidence that provides a substantial basis of fact from which can be reasonably inferred}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ) (citation omitted);}{\insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Am. Grain Trimmers, Inc. v. Office of Workers\rquote Comp. Programs}{ \insrsid15151648\charrsid13828682 , 181 F.3d 810, 818 (7th Cir. 1999).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 This same definition of substantial evidence has been applied in other LHWCA cases, such as }{ \i\insrsid15151648\charrsid13828682 Louisiana Insurance Guaranty Ass\rquote n}{\insrsid15151648\charrsid13828682 , 211 F.3d at 298, defining }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 substantial evidence}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 as evidence that provides a substantial basis of fact from which the fact in issue can be reasonably inferred.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In a comprehensive discussion of what an employer must produce to rebut the presumption, the court in }{\i\insrsid15151648\charrsid13828682 American Grain Trimmers, Inc.}{\insrsid15151648\charrsid13828682 , 181 F.3d 810, 818 (7th Cir.1999), agreed with the administrative law judge\rquote s characterization of the }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 substantial evidence}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 burden of the employer as a requirement of introducing }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 specific and comprehensible evidence, not speculation,}{\insrsid13828682\charrsid13828682 "} {\insrsid15151648\charrsid13828682 before the presumption would be defeated.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [27]}{\insrsid15151648\charrsid13828682 \tab Where a worker\rquote s compensation claimant sets forth a }{\i\insrsid15151648\charrsid13828682 prima facie}{\insrsid15151648\charrsid13828682 case and successfully invokes the presumption of compensability, the burden then shifts to the employer to rebut the presumption.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Moreover, we hold that in order to defeat such presumption, the employer must provide substantial evidence, defined as specific and comprehensible evidence, and not speculation.}{\b\insrsid13828682\charrsid13828682 \par }{\insrsid13828682\charrsid13828682 \par }\pard \ql \li720\ri0\nowidctlpar\faauto\rin0\lin720\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 c.}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 Claimant\rquote s burden\endash injury arising out of and in the course of employment}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [28]}{\insrsid15151648\charrsid13828682 \tab Courts applying the LHWCA have held that once the employer successfully rebuts the presumption of compensability, the burden of persuasion then shifts back to the claimant. }{\insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Parsons Corp. v. Dir., Office of Workers\rquote Comp. Programs}{\insrsid15151648\charrsid13828682 ,}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 619 F. 2d 38, 41 (9th Cir. 1980) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [O]nce substantial evidence is produced to rebut the statutory presumption, the burden of persuasion shifts to the claimant.}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [29]}{\insrsid15151648\charrsid13828682 \tab The inquiry then becomes whether, viewing all the evidence of record, the injury arose out of and in the course of employment.}{\insrsid13828682\charrsid13828682 }{ \i\insrsid15151648\charrsid13828682 Gooden}{\insrsid15151648\charrsid13828682 , 135 F.3d at 1068. (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 If the employer rebuts the presumption, then the issue of causation must be decided by looking at all the evidence of record}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ); 22 GCA \'a7 9103(m) (defining a compensable injury as } {\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 accidental injury or death arising out of and in the course of employment}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ).}{ \insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [30]}{\insrsid15151648\charrsid13828682 \tab The phrase }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [a]rising out of and in the course of}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 employment is essentially a test for causation, particularly in the case of heart attacks.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 2 Arthur Larson & Lex K. Larson, Larson\rquote s Worker \rquote s Compensation Law, \'a7 43.03 (2005) (}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 Larson 2}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 ); }{\i\insrsid15151648\charrsid13828682 but see Meehan}{\insrsid15151648\charrsid13828682 , 125 F.3d at 1137 (stating that }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 arising out of}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 refers to injury causation and }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 in the course of employment}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 refers to the time, place, and circumstances of the injury).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [31]}{\insrsid15151648\charrsid13828682 \tab However, the terms }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 arising out of}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 and }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 and in the course of employment,}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 found in most state worker\rquote s compensation laws, have come to mean the same thing:}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [T]he two tests, in practice, have not been kept in air}{\insrsid13828682\charrsid13828682 -}{ \insrsid15151648\charrsid13828682 tight compartments, but have to some extent merged into a single concept of work}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 connection.}{\insrsid13828682\charrsid13828682 " }{ \insrsid15151648\charrsid13828682 Larson 2 \'a7 29.01.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Suggesting that the injury arise out of and in the course of employment be treated as a continuum test, Larson states:}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 One is almost tempted to formulate a sort of quantum theory of work}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 connection.}{ \insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 Larson 2 \'a7 29.01.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 We agree and find that the }{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 arising out of and in the course of}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 employment is essentially a test for causation, particularly in the case of heart attacks.}{ \insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 See}{\insrsid15151648\charrsid13828682 Larson 2 \'a7 43.03.}{\insrsid13828682\charrsid13828682 \par \par }\pard \ql \li720\ri0\nowidctlpar\faauto\rin0\lin720\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 d.}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 Causation }{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [32]}{\insrsid15151648\charrsid13828682 \tab In worker\rquote s compensation heart attack cases, courts generally choose between either the }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 usual exertion rule}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 or the }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 unusual exertion rule}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 of legal causation.}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [T]he preponderance of those jurisdictions that now accept the usual}{\insrsid13828682\charrsid13828682 -}{ \insrsid15151648\charrsid13828682 exertion rule in heart cases is three to one over those that reject it.}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 Larson 2 \'a7 43.03[1][a](footnote omitted).}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 A sizeable minority, however, have adopted and continue to employ the }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 unusual exertion rule.}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 7{\footnote \pard\plain \qj \fi720\li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\super\insrsid15151648 7}{ \insrsid15151648 }{\fs20\insrsid15151648 See Arthur Larson, }{\i\fs20\insrsid15151648 The \'93Heart Attack\'94 Cases in Workmen\rquote s Compensation: An Analysis and Suggested Solution,}{\fs20\insrsid15151648 65 Mich. L. Rev. 441, 445-446 (1967), nn. 17 and 18. }}}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [33]}{\insrsid15151648\charrsid13828682 \tab Under the usual exertion rule, a heart attack is compensable unless the record shows by substantial evidence that the heart attack was not precipitated or aggravated by claimant\rquote s }{\i\insrsid15151648\charrsid13828682 usual work conditions}{ \insrsid15151648\charrsid13828682 . }{\i\insrsid15151648\charrsid13828682 Wheatley v. Adler}{\insrsid15151648\charrsid13828682 , 407 F.2d 307, 311 (D.C.Cir. 1968).}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 [A]ccidental}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 injury may occur notwithstanding the injured is then engaged in his usual and ordinary work, and}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 likewise [] the injury need not be external.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 It is enough if something unexpectedly goes wrong within the human frame.\rquote }{\insrsid13828682\charrsid13828682 " }{ \i\insrsid15151648\charrsid13828682 Id.}{\insrsid15151648\charrsid13828682 at 311 n.6.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In other words, an }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 employer generally takes his employee as he finds him.}{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Gooden}{\insrsid15151648\charrsid13828682 , 135 F.3d at 1069 (applying the LHWCA).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [34]}{\insrsid15151648\charrsid13828682 \tab The unusual exertion rule, also known as the excessive strain rule, has been adopted in New York as well as other states.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 Under this stricter rule, to prevail in a claim for coverage for a heart attack on the job under this rule, there must be some evidence of }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 unusual or excessive}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 strain}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 on the job, a stress going beyond his }{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 usual}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 job demands, such as is illustrated in the case of }{\i\insrsid15151648\charrsid13828682 Schlange v. Briggs Manufacturing Co.}{ \insrsid15151648\charrsid13828682 , 40 N.W.2d 454 (Mich. 1950), in which compensation was awarded only because the workman was performing his work }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 in an unusual manner and with the exertion of unusual force.}{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Id. }{\insrsid15151648\charrsid13828682 at 455.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 Defendant claims that}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 under this test, Mrs. Fagan cannot prevail because the record is utterly void of any reference to unusual exertion, force or stress on Mr. Fagan at work. }{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [35]}{\insrsid15151648\charrsid13828682 \tab New York\rquote s }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 unusual}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 exertion rule \endash that the claimant must have suffered from an unusual stress or exertion on the job in order to be compensated \endash was illustrated in such cases as }{\i\insrsid15151648\charrsid13828682 Frankel v. National 5, 10 & 25 Cent Stores}{\insrsid15151648\charrsid13828682 , 278 N.Y.S. 450 (App. Div. N.Y. 1935), where the claimant was denied compensation because the exertion that caused the heart attack was usual for his job.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Yet New York cases evolved eventually to expand compensability to those situations where even if there was no unusual exertion, but only if there was }{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 greater than the ordinary wear and tear of life,}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 the heart attack would be compensable.}{ \insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Masse v. James H. Robinson Co.}{\insrsid15151648\charrsid13828682 , 92 N.E.2d 56 (N.Y. 1950). }{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [36]}{\insrsid15151648\charrsid13828682 \tab The New York progression is illustrated in the case of }{\i\insrsid15151648\charrsid13828682 Schechter v. State Insurance Fund}{\insrsid15151648\charrsid13828682 , 190 N.Y.S.2d 656 (Ct. App. 1959).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The }{\i\insrsid15151648\charrsid13828682 Schechter }{\insrsid15151648\charrsid13828682 court broadened the }{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 unusual exertion}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 rule in elucidating that }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 so long as the conditions of performing the work are such that an exceptional strain is imposed on the worker so great that his heart is affected and damaged thereby the requirement of unusual or excessive strain is satisfied.}{ \insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Id. }{\insrsid15151648\charrsid13828682 at 660.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In }{\i\insrsid15151648\charrsid13828682 Schechter}{ \insrsid15151648\charrsid13828682 ,}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 the claimant was subjected to unusual strain by reason of an increase in his workload, and the medical testimony was sufficient to sustain the Workmen\rquote s Compensation Board decision that the increase in workload}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 constituted the unusual strain which in turn caused the heart attack.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [37]}{\insrsid15151648\charrsid13828682 \tab Some New York judges have criticized the approach taken by the }{\i\insrsid15151648\charrsid13828682 Schechter }{\insrsid15151648\charrsid13828682 case.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Appellee Chung Kuo Insurance Co., Ltd., adopts this criticism, arguing from the dissent in }{\i\insrsid15151648\charrsid13828682 Klimas v. Trans Cari}{\i\insrsid13828682 b}{ \i\insrsid15151648\charrsid13828682 bean Airways, Inc., }{\insrsid15151648\charrsid13828682 219 N.Y.S.2d 14 (1961):}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 We have gone far in other heart cases . . . but if we are to go beyond that point and allow compensation to be awarded simply for psychic or nervous strains . . . [w]e will \lquote make workmen\rquote s compensation the equivalent of life and health insurance.\rquote }{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Id.}{\insrsid15151648\charrsid13828682 at 19 (citation omitted).}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 In addition, in New York certain cases evolved eventually to expand compensability to those situations where, even if there was no unusual exertion, but only if there was }{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 greater than the ordinary wear and tear of life.}{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Masse}{\insrsid15151648\charrsid13828682 , 92 N.E.2d 56.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 However,}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 the }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 wear and tear}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 rule came to be applied only when there was no unusual exertion.}{\insrsid13828682\charrsid13828682 }{\i\insrsid15151648\charrsid13828682 Burris v. Lewis}{\insrsid15151648\charrsid13828682 , 160 N.Y.S.2d 853 (1957).}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Therefore, New York expanded to adopt both }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 unusual exertion}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 and }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 greater than ordinary wear and tear}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 as tests for compensability for heart attacks.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [38]}{\insrsid15151648\charrsid13828682 \tab Larson criticizes the arbitrariness of these various approaches in New York.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In one case, }{ \i\insrsid15151648\charrsid13828682 Chiara v. Villa Charlotte Bronte}{\insrsid15151648\charrsid13828682 , 76 N.Y.S.2d 59 (App. Div. 1948), a man who carries 60 pounds down stairs is denied compensation, while in another case, }{ \i\insrsid15151648\charrsid13828682 Serie v. F. & M. Schaefer Brewing Co.}{\insrsid15151648\charrsid13828682 , 76 N.Y.S.2d 50 (App. Div. 1948), a man who lifts a 60}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 pound burden on a slippery surface is compensated for his heart attack.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Likewise, in }{\i\insrsid15151648\charrsid13828682 Coleman v. Guide}{\i\insrsid13828682\charrsid13828682 -}{ \i\insrsid15151648\charrsid13828682 Kalkhoff}{\i\insrsid13828682\charrsid13828682 -}{\i\insrsid15151648\charrsid13828682 Burr, Inc.}{\insrsid15151648\charrsid13828682 , 222 N.Y.S.2d 689 (1961), a claimant who had a heart attack while arguing with his superior was denied compensation, while in }{\i\insrsid15151648\charrsid13828682 Wilson v. Tippets}{\i\insrsid13828682\charrsid13828682 -}{\i\insrsid15151648\charrsid13828682 Abbott}{\i\insrsid13828682\charrsid13828682 -}{ \i\insrsid15151648\charrsid13828682 McCarthy}{\i\insrsid13828682\charrsid13828682 -}{\i\insrsid15151648\charrsid13828682 Stratton}{\insrsid15151648\charrsid13828682 , 253 N.Y.S.2d 149 (App. Div. 1964), a worker who argued with his superior via an intermediary was compensated.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The results were inconsistent, despite a purported test i nvolving unusual exertion or beyond the ordinary wear and tear of ordinary life.}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [39]}{\insrsid15151648\charrsid13828682 \tab We recognize that the LHWCA finds its source in New York law, and in the normal course, such case law should have some persuasive effect in our choice of a standard of legal causation to be applied in cases under our Worker\rquote s Compensation law.8{\footnote \pard\plain \qj \fi720\li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 { \super\insrsid15151648 8}{\insrsid15151648 }{\fs20\insrsid15151648 \'93Guam courts have considered courts of other states interpreting statutes similar to laws of Guam to be {\*\bkmkstart SR_59_3430}{\*\bkmkstart SearchTerm}{\*\bkmkend SR_59_3430} {\*\bkmkend SearchTerm}persuasive authority.\'94 }{\i\fs20\insrsid15151648 Amerault}{\fs20\insrsid15151648 , 2004 Guam 23 \'b6 16. }}}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 In light of the arbitrariness and inconsistency in the application of the unusual exertion rule, we decline to adopt such line of cases. }{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [40]}{\insrsid15151648\charrsid13828682 \tab Rather, we adopt the usual exertion rule as announced by the LHWCA courts.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 We do so cons idering the overall language of the Guam worker\rquote s compensation statutes.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Guam\rquote s Legislature has decreed that a worker\rquote s compensation claimant is to be aided by a presumption.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 The presumption is a claimant}{\insrsid13828682\charrsid13828682 -}{\insrsid15151648\charrsid13828682 friendly device, relieving claimants of the usual rigors of proving causation before the burden of production shifts to the employer to rebut it.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 As the Supreme Court of Hawaii so eloquently stated, in addressing its own presumption of coverage in its worker\rquote s compensation statutes:9{\footnote \pard\plain \qj \fi720\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid7889901 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\super\insrsid15151648 9}{\insrsid15151648 }{\fs20\insrsid15151648 Hawaii\rquote s Worker\rquote s Compensation statutes include the following presumption: \par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\insrsid15151648 \par \tab }{\b\fs20\insrsid15151648 \'a7 386-85 Presumptions.}{\fs20\insrsid15151648 \par }\pard \qj \li720\ri720\nowidctlpar\faauto\rin720\lin720\itap0 {\fs20\insrsid15151648 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: \par }\pard \qj \li1440\ri1440\nowidctlpar\faauto\rin1440\lin1440\itap0 {\fs20\insrsid15151648 (1) That the claim is for a covered work injury; \par (2) That sufficient notice of such injury has been given; \par (3) That the injury was not caused by the intoxication of the injured employee; and \par (4) That the injury was not caused by the wilful intention of the injured employee to injure oneself or another. \par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\insrsid15151648 \par }\pard \qj \li0\ri0\sa240\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\insrsid15151648 Haw. Rev. Stat. \'a7 386-85 (2005).}}}{\insrsid13828682\charrsid13828682 \par \par }\pard \ql \li720\ri0\nowidctlpar\faauto\rin0\lin720\itap0\pararsid13828682 {\insrsid15151648\charrsid13828682 The legislature indeed has cast a heavy burden on the employer in workmen's compensation cases. In its wisdom in formulating public policy in this area of the law, the legislature has decided that work injuries are among the costs of production which industry is required to bear; and if there is reasonable doubt as to whether an injury is work}{\insrsid13828682\charrsid13828682 -}{ \insrsid15151648\charrsid13828682 connected, the humanitarian nature of the statute demands that doubt be resolved in favor of the claimant.}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }\pard \ql \li720\ri0\nowidctlpar\faauto\rin0\lin720\itap0\pararsid13828682 {\insrsid15151648\charrsid13828682 Operation of the statutory presumption is crucial in cardiac cases where the causes of heart disease are not readily identifiable. \lquote The presumption has been of substantial aid to claimants i n obtaining awards in cardiac cases by enabling them to connect up a death involving some from of cardiac disorder with the work. On the other hand, dependents of workmen who have died on the job of an unwitnessed attack have frequently failed to recover compensation where no such presumption was operative.}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 McNiece, Heart Disease and the Law 22 (1961). Because of the relatively higher degree of uncertainty surrounding causation of heart diseases, the strength of the presumption is especially formidable.}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\i\insrsid15151648\charrsid13828682 Akamine v. Hawaiian Packing & Crating Co}{\insrsid15151648\charrsid13828682 ., 495}{\insrsid13828682 P.2d 1164, 1166 (Hawaii 1972).}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [41]}{\insrsid15151648\charrsid13828682 \tab We find that the Legislature\rquote s decision to aid the claimant with this presumption shows a legislative intent favoring claimants in general; Guam\rquote s }{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 legislature indeed has cast a heavy burden on the employer in workmen's compensation cases.}{\insrsid13828682\charrsid13828682 " }{\i\insrsid15151648\charrsid13828682 Id.}{ \i\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 We find that if the claimant is subjected to usual exertions of his workplace and that those usual conditions caused or aggravated an injury such as a heart attack, then the claimant }{\insrsid13828682 has proven causation.}{ \insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 B.}{\b\insrsid13828682\charrsid13828682 }{\b\insrsid15151648\charrsid13828682 Application to Fagan\rquote s Claim}{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [42]}{\insrsid15151648\charrsid13828682 \tab Now that we have determined what law is applicable in worker\rquote s compensation cases dealing with claimants suffering from heart attacks, the next issue we must resolve is whether the Commissioner\rquote s compensation order was in accordance with it. }{\insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [43]}{\insrsid15151648\charrsid13828682 \tab In conducting a }{\i\insrsid15151648\charrsid13828682 de novo}{\insrsid15151648\charrsid13828682 review of the trial court\rquote s review of the legal conclusions in the Commissioner\rquote s decision, we find that the trial court\rquote s Decision and Order is not in accordance with the law we have just pronounced.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 The only record of the worker\rquote s compensation claim dealing with Mrs. Fagan\rquote s request is the Commissioner\rquote s order.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 No hearing was ever conducted by the commission.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 ER at 14 (Decision and Order).}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 No testimony was ever taken.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 A thorough review of the scant record before the Commissioner reveals that there was absolutely no discussion of what law applies.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 There was no discussion in the Commissioner\rquote s findings of facts or conclusion of law of whether Mrs. Fagan was the beneficiary of the statutory presumption dictated in 22 GCA \'a7 9121. }{ \insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [44]}{\insrsid15151648\charrsid13828682 \tab In its order denying compensation, the trial court mentions the statutory presumption found in section 9121, but fails to show if or how t he Commissioner applied the presumption.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 There is no analysis of whether Mrs. Fagan met the burden of showing that the work conditions }{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 could have}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 caused the heart attack, thereby shifting the burden to the employer.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 There is no discussion of whether the employer rebutted the presumption with }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 substantial evidence,}{\insrsid13828682\charrsid13828682 "}{ \insrsid15151648\charrsid13828682 which we hold to be required if the presumption is invoked.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Additionally, there is no analysis whether the Commissioner found that Mrs. Fagan met her burden of establishing that Mr. Fagan\rquote s heart attack }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 arose out of and in the course of his employment,}{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 such as to trigger the }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 usual exertion}{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 test for causation.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 There is nothing in the worker\rquote s compensation record which demonstrated that the Commissioner looked at all the evidence of record and determined the issue of causation.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Specifically, there is nothing in the record to suggest that the Commissioner found by substantial evidence that Mr. Fagan\rquote s attack was not precipitated or aggravated by the alleged harassment and bullying Mr. Fagan was receiving at work in accordance with the }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 usual exertion rule.}{\insrsid13828682\charrsid13828682 " \par \par }{\b\insrsid15151648\charrsid13828682 [45]}{\insrsid15151648\charrsid13828682 \tab The trial court weighed what appeared to be Mrs. Fagan\rquote s statement regarding harassment of her husband, and Dr. Espinola\rquote s autopsy report.}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Despite the fact that Dr. Espinola\rquote s report was internally inconclusive, the trial court affirmed the Commissioner\rquote s finding given the conclusion that Mr. Fagan\rquote s heart arterial condition made him susceptible to a heart attack at anytime, even during sleep.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 However, Dr. Espinola\rquote s report also stated, }{ \insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 tremendous stress is known to trigger heart attack.}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 ER, at 11 (Espinola Report).}{ \insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 Because the Commission did not memorialize whether it took into account the presumption of coverage or whether the employer rebutted it, and did not apply a standar d of any kind for determining whether Mr. Fagan\rquote s heart attack arose out of his job, it is not possible for a reviewing court to determine whether that standard of causation was met by Mrs. Fagan.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 A proper review would have required the record to contain evidence of whether usual exertion was placed upon Mr. Fagan, and whether the exertion medically contributed to his heart attack.}{ \insrsid13828682\charrsid13828682 \par \par }{\b\insrsid15151648\charrsid13828682 [46]}{\insrsid15151648\charrsid13828682 \tab This court is to uphold the trial judge if the decision is in accordance with law and supported by substantial evidence.}{\insrsid13828682\charrsid13828682 }{ \insrsid15151648\charrsid13828682 Since neither the Commissioner nor the trial court applied the law as we have today clarified it, we find that the decision was not }{\insrsid13828682\charrsid13828682 "}{\insrsid15151648\charrsid13828682 in accordance with law.}{\insrsid13828682\charrsid13828682 " }{\insrsid15151648\charrsid13828682 Because neither applied the proper law, we need not reach whether the decision was supported by substantial evidence.}{\insrsid13828682\charrsid13828682 \par \par }\pard \qc \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\b\insrsid15151648\charrsid13828682 IV.}{\insrsid13828682\charrsid13828682 \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid13828682 {\insrsid13828682\charrsid13828682 \par }{\b\insrsid15151648\charrsid13828682 [47]}{\insrsid15151648\charrsid13828682 \tab Therefore, though the trial court correctly identified the standard of review, he failed to review }{\i\insrsid15151648\charrsid13828682 de novo}{ \insrsid15151648\charrsid13828682 whether the agency had applied the proper law.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 For this reason alone, the case must be remanded to the trial court for proceedings consistent with this opinion.}{\insrsid13828682\charrsid13828682 }{\insrsid15151648\charrsid13828682 We therefore }{\b\insrsid15151648\charrsid13828682 VACATE }{\insrsid15151648\charrsid13828682 and }{\b\insrsid15151648\charrsid13828682 REMAND}{\insrsid15151648\charrsid13828682 this matter to the lower court with instructions to vacate its decision and remand the matter to the Worker\rquote s Compensation Commission for a hearing consistent with this opinion.}{ \insrsid13828682\charrsid13828682 \par }}