Case Title: McANDREWS v SCHWARTZ v GLACIER GE

Citation: 

Docket Number: 

State: montana

Court: Montana Supreme Court

Date: 1974-07-10T00:00:00Z

Document:
No. 12603 I N T H E S U P R E M E C O U R T OF THE STATE OF M O N T A N A 1974 PATRICIA I. M c A N D R E W S , Claimant and Respondent, -vs - JOSEPH, EDGER, SYBILA & C A R O L S C H W A R T Z , Employer and Appellants, GLACIER G E N E R A L A S S U R A N C E C O M P A N Y , Defendant and Appellant. Appeal from: D i s t r i c t Court of the Third J u d i c i a l D i s t r i c t , Honorable Robert Boyd, Judge presiding. Counsel of Record: For Appellants : Norman C. Robb argued, Missoula, Montana For Respondent : Scanlon, Brolin and Connors, Anaconda, Montana Jack M. Scanlon argued, Anaconda, Montana Submitted: April 25, 1974 Decided : JOL 1 0 1 9 7 4 Filed : JUL 1 0 1974 M r . J u s t i c e Wesley Castles delivered the Opinion of the Court. This i s a workmen's compensation action a r i s i n g out of an accident suffered by claimant P a t r i c i a I. McAndrews on June 25, 1970 while employed a s a s a l e s clerk or checker by Schwartz De- partment Store i n Anaconda, Montana. A t closing time on June 25, 1970 she was looking f o r a p a i r of slippers f o r a customer. She had t o go up a ladder t o find the slippers, and was a step o r two up the ladder when she slipped and f e l l , o r the ladder slipped from under her. She struck her r i g h t r i b s on the ladder when she f e l l and her l e f t shoulder h i t the floor. O n the date of the injury claimant was paid $2.02 per hour and she worked 8 hours per day, 5 days a week. She was married but had no dependent children. As the accident occurred a t closing time claimant went home and wrapped a towel around her r i b s . She worked a l l the following day June 26th, but t h a t night her r i b s hurt so she c a l l e d D r . Donald Good. The doctor saw her a t the hospital emergency room on the evening of June 26. Her r i b s were X-rayed and she was given a r i b corset t o wear. A t t h a t time her only complaint of i n j u r y was her r i b s . Claimant McAndrews f i l e d a claim f o r compensation with the workmen's Compensation Division, hereinafter called the Division. Glacier General Assurance Company was the workmen's compensation c a r r i e r f o r Schwartz. Glacier accepted the claim and paid McAndrews temporary t o t a l compensation benefits a t her lawful r a t e s i n the amount of $2,609 f o r the period from June 26, 1970 through October 7, 1971, a period of 67 weeks. Glacier a l s o paid doctor, hospital and medical expenses f o r claimant i n the sum of $4,934.90. In the spring of 1971 McAndrews suffered another accident, which was a nonindustrial accident, when she f e l l i n the parking l o t a t her apartment. On October 27, 1971, claimant was found to have a condition known as arteriosclerosis obliterans of her right common femoral artery. On December 1, 1971, Dr. J.R. Sims performed a surgical procedure known as an endarterctom and sympathectomy to relieve the arteriosclerosis obliterans in the femoral artery. The operation was performed at St. Peter's Hospital in Helena. The medical ex- pense for Dr. Sims' care and the operation amounted to $4,448.55. On April 5, 1972, a hearing was held before a Division hearing officer to determine ( 1 ) the nature and extent of the in- juries sustained by claimant in the June 25, 1970 industrial acci- dent, ( 2 ) the date the healing period ended for the injuries she sustained in that accident, ( 3 ) the nature and extent of the im- pairment or disability, if any, suffered by her in that accident, ( 4 ) whether claimant was entitled to any further compensation and, if so, the mount and extent thereof, and ( 5 ) whether there were any unpaid medical expenses connected with the injuries she sustained on June 25, 1970. McAndrews and Dr. Donald Good, her attending physician for the injures she received in the June 25 accident, testified at the hearing. The ~ivision's hearing officer made and entered his findings of fact and conclusions of law on September 18, 1972. The Division then entered an order dated September 26, 1972 awarding compensation, and adopting the hearing officer's findings and conclusions which in effect found that: ( 1 ) the injuries sustained by PlcAndrews in the June 25, 197Q accident were a fracture to her right ninth rib and some possible low back injury; ( 2 ) the healing period for her industrial accident injuries ended in October 1971; as a result of her low back injury McAndrews had an impairment of 5 % to 10% of the body as a whole; ( 4 ) in addition to the compensation previously paid to her for and during the period from June 26, 13?0 through October 7, 1971, McAndrews was entitled to a further award of 75 weeks of compensation at the rate of $37 per week to be paid as follows: that 50 weeks for the period of October 8, 1971 through September 21, 1972 be paid i n a lump sum of $1,850 and bfcAndrews be retained on compensation f o r the remaining 25 weeks based on a showing of l o s s of earning capacity; (5) the condition of a r t e r i o s c l e r o s i s obliterans was not proximately caused by the June 25, 1970 accident and her r i g h t leg problem r e s u l t i n g therefrom was not a proximate r e s u l t of the accident; and (5) Glacier was not responsible f o r the doctor, hospital and medical expenses incurred by McAndrews f o r treatment of the a r t e r i o s c l e r o s i s obliterans. McAndrews requested a rehearing before the Division and was denied. She then appealed t o the d i s t r i c t court where a hearing o r t r i a l was held on March 16, 1973. McAndrews and Dr. J.R. Sims t e s t i f i e d . O n June 19, 1973, the d i s t r i c t court entered findings of f a c t and conclusions of law which reversed the findings, conclu- sions and order of the Division. It concluded: (1) t h a t the condi- t i o n of a r t e r i o s c l e r o s i s obliterans and claimant's r i g h t leg prob- lems r e s u l t i n g therefrom were proximately caused by the June 25, 1970 accident; (2) t h a t her healing period ended on tiarch 21, 1972, r a t h e r than i n October 1971; (3) awarded her compensation i n the amount of $888 f o r the period of October 7, 1971 through March 21, 1972; (4) t h a t claimant had a 20% impairment r a t h e r than a 5% t o 10% impairment a s found by the Division; (5) awarded McAndrews a further award of 100 weeks of compensation a t $37 per week, payable i n a lump sum of $3,700; and (6) ordered Glacier t o pay the medical b i l l s and expenses incurred by NcAndrews because of the a r t e r i o s c l e r - o s i s obliterans. Judgment was entered accordingly on June 21, 1973. Glacier and Schwartz f i l e d motions requesting the court t o amend i t s findings of f a c t and conclusions o r i n the a l t e r n a t i v e t o grant them a new t r i a l . The court denied both motions by order dated July 11, 1973. Schwartz and Glacier appeal from the judgment and order denying t h e i r motions. Glacier has paid McAndrews the $1,850 lump sum compensation award ordered by the Division i n i t s September 26, 1972 order awarding compensation. Other more detailed f a c t s pertinent t o the case a l s o appear: D r . Good continued t o care f o r and t r e a t McAndrews. I n addition t o the June 26, 1970 examination a t the hospital emergency room, he saw, examined and treated her on June 29, July 3, 7, 27, 29, 30 and 31 of 1970. A t a l l of these v i s i t s and examinations Mc- Andrews' only complaints and symptoms were t h a t she had pain i n the r i g h t r i b cage and the doctor treated her f o r that. D r . Good t e s t i f i e d he took a medical history from >lcAndrews on June 29, 1970 and he took notes and kept records of her complaints and symptoms on each time he subsequently saw her. He t e s t i f i e d t h a t during the period from June 26, 1970 through August 27, 1970 McAndrews did not complain t o him of any injury t o , pain i n , o r d i f f i c u l t y with her r i g h t leg o r low back. He t e s t i f i e d her symptoms and complaints of pain were those which people with a fractured r i b usually have. H e further t e s t i f i e d t h a t a t an o f f i c e v i s i t on August 28, 1970, McAndrews f o r the f i r s t time complained of pain and weakness i n her r i g h t leg and low back. O n t h a t date he examined her r i g h t leg and back and found her complaints symtomatic of a s a c r o i l i a c s t r a i n o r a possible herniated disc. O n August 28, 1970, D r . Good a l s o checked f o r and found a normal pulse i n her r i g h t leg. He thought a t t h a t time t h a t a myelogram should perhaps be performed t o check out the p o s s i b i l i t y of a herniated disc, but he f i r s t wanted t o t r e a t her back and r i g h t leg complaints conservatively with t r a c t i o n , drugs, physical therapy, e t c . H e put her i n the Community Hospital i n Anaconda f o r the period of September 3 t o September 24, 1970 f o r a course of t r a c t i o n on her r i g h t leg. The t r a c t i o n was beneficial but due t o an allergy McAndrews had d i f f i c u l t y with the traction. D r . Good continued t o see her and on September 29, 1970 she was s t i l l complaining of pain i n her r i g h t l e g and back so he put her i n a lumbo-sacral b e l t . O n October 15, 1970 D r . Good put McAndrews back i n the hospital f o r pneumonia and pleurisy which were not re- l a t e d t o o r caused by the June 25, 1970 accident. She remained i n t h e hospital u n t i l October 22, 1970 and while there she had periodic complaints of low back and leg pain so D r . Good treated these com- p l a i n t s by giving her benemide and physiotherapy. McAndrews continued t o complain of low back and r i g h t l e g pain so on Novernber 18, 1970 D r . Good again put her i n the hospital f o r 10 days f o r a course of pelvic t r a c t i o n t o t r e a t the sacroiliac s t r a i n . O n January 29, 1971 D r . Good again examined ~ c ~ n d r e w s ' leg and back and a t t h a t time decided she should have a myelogram t o check out the p o s s i b i l i t y of a herniated disc. D r . Good sent her t o D r . John Davidson, an orthopedic s p e c i a l i s t i n Butte,for the myelogram. D r . Davidson put claimant i n a Butte hospital f o r 8 days from February 2 t o February 10, 1971, during which time a myelogram was performed and she had a course of physical therapy. The myelogram was negative i n t h a t it showed she had an e n t i r e l y normal spinal canal. She improved a great deal with the physical therapy. Although the myelogram was negative, D r . Good made arrangements f o r McAndrews t o be examined by D r . Alexander Johnson, a neurosurgeon i n Great F a l l s , t o double check on the p o s s i b i l i t y of a herniated disc and t o determine whether h i s diagnosis of a s a c r o i l i a c s t r a i n a s the cause of her low back and r i g h t leg complaints was correct. D r . Johnson examined McAndrews on April 15, 1971 and concluded t h a t she had: (1) a s a c r o i l i a c j o i n t disease, possibly of a rheumatoid nature, and (2) atypical radicular symptoms, which he f e l t might possibly be from a herniated disc i n the lumbar spine. D r . Johnson wanted t o know what the cerebrospinal f l u i d protein from the myelograrn per- formed by D r . Davidson disclosed before he made a decision a s t o any surgical exploration. D r . Good then sent NcAndrews t o Butte where a D r . Patterson had a spinal tap performed t o get the cerebro- spinal f l u i d protein requested by D r . Johnson. D r . Johnson re- ceived the r e s u l t s of the spinal tap and again examined McAndrews i n September 1971. Based on the r e s u l t s of the spinal tap and h i s second examination D r . Johnson ruled out a herniated disc and diagnosed the cause of her low back and r i g h t leg problems a s a sacroiliac joint disease, maximal r i g h t , and recommended treatment f o r i t by the use of s t e r o i d s , muscle relaxants and heat. D r . Good t e s t i f i e d h i s diagnosis of the i n j u r i e s sustained by ElcAndrews a s a r e s u l t of the June 25, 1970 accident were (1) a fracture of the ninth r i g h t r i b on the r i g h t side and (2) a sacroiliac s t r a i n . This was confirmed by D r . Johnson and D r . Davidson. D r . Good t e s t i f i e d the healing period f o r the fractured r i b ended s i x weeks a f t e r the accident and t h a t maximum healing of the s a c r o i l i a c s t r a i n was reached i n October 1971. H e a l s o t e s t i f i e d t h a t i n h i s opinion McAndrews had had no impairment from the fractured r i b and t h a t she may have 5% t o 10% impairment from the sacroiliac s t r a i n . Glacier paid McAndrews temporary t o t a l compensation bene7its during the e n t i r e period from June 26, 1970 through October 7 , 1971 while she was undergoing the extensive care and treatment outlined above f o r fractured r i b and the low back and r i g h t leg pain from the sacroiliac s t r a i n . This was a period of 57 weeks. The f i r s t 26 weeks were paid a t $42 per week and the remainder of 41 weeks were paid a t $37 per week a s provided by section 92-701, R.C.M. 1947, a s t h a t s t a t u t e read on the date of the accident. Glacier terminated compensation payments a s of October 7, 1971, because the healing period had ended and she had been evaluated and rated f o r impairment. The Division and Mrs. 14cAndrews were so advised by Glacier. Glacier a l s o paid the doctor, hospital and medical expenses during t h i s period of time which amounted t o $4,934. Xith respect t o the nonindustrial accident sustained by McAndrews i n the spring of 1971, there was conflicting testimony. A t the hearing before the Division, McAndrews twice s t a t e d t h a t she never had any i n j u r i e s nor had she been involved i n any accidents e i t h e r p r i o r or subsequent t o the June 25, 1970 accident. Later she admitted she had suffered an i n d u s t r i a l accident i n 1966 when she f e l l a t Schwartz Department Store and injured her r i g h t hip. Finally, she admitted she had fallen i n the parking l o t i n 1971, but gave several d i f f e r e n t versions of t h i s subsequent accident. McAndrews t o l d D r . Good about t h i s second accident but she did not t e l l D r . Sims about it. On October 27, 1971, Dr. Sims examined XcAndrews and found her to be suffering from arteriosclerosis obliterans of the right common or femoral artery. On December 1, 1971, he performed surgery to relieve that condition. Arteriosclerosis is hardening of the arteries. I t is an aging process and all people have it to some degree. It progresses as people grow older. It is an extremely common disease and some people have it to a greater degree than others. Obliterans is a blockage or clot in a blood vessel. Dr. Sims said that during the surgery he found and removed a fresh blood clot and found evidence of an old clot. He testified that the fresh clot was only of several days duration and much too recent to be in any way related to the accident of June 25, 1970. As to the old clot, he said there perhaps was a relationship between it and the June 25, 1970 accident. Dr. Sims further testified he took a medical history from McAndrews when he first saw her on October 27, 1971, and the only accident or trauma she told him about was the June 25, 1970 accident. She did not tell him about her second accident in Nay or June 1971 when she fell down in the parking lot. Dr. Sims there- fore was unaware of the second accident when he said that the arteriosclerosis obliterans might be attributable to the first. Dr. Sims also testified he did not know other doctors had examined McAndrews for arteriosclerosis obliterans and had found no evidence of an obs~ruction or clot before he saw her on October 27, 1971, because she had not told him about that. In short, Dr. Sims had no way of knowing whether the June 25, 1970 accident or the parking lot accident of 1971 caused the clot, or whether in fact either accident caused anything. In regard to the arteriosclerosis obliterans, Dr.Good testified that he never found any symptoms or complaints that indicated Mc- Andrews had that condition; that such a condition is not caused by trauma; and that the June 25, 1970 fall from the ladder neither caused nor aggravated any condition of arteriosclerosis obliterans. The main issue presented for review is whether the accident McAndrews suffered on June 25, 1970 while employed by Schwartz Department Store, was an industrial accident which proximately caused an injury as defined by section 92-418, R.C.14. 1947, to ~cAndrews' right leg. The Division found, concluded and ordered that the arteriosclerosis obliterans and McAndrewsl right leg problems were not proximately caused by the June 25, 1970 accident. On appeal the district court reversed the Division and held that the arteriosclerosis obliterans was a result of the accident, increased the percentage of permanent impairment, awarded her compensation therefor and ordered Glacier to pay medical expenses she incurred for that condition. Glacier and Schwartz contend the evidence is not sufficient to support the findings, conclusions and judgment of the district court. This Court has the entire record before it and finds that the only injuries suffered by McAndrews in the accident of June 25, 1970, were a fractured rib and a sacroiliac strain. The Division so found and awarded compensation and medical benefits for those injuries. I t also found and ordered that the arteriosclerosis obliterans with its problem in her right leg was not a proximate result of the accident. Appellants Schwartz and Glacier accepted the ~ivision's decision and award. The evidence introduced before the district court consisted of an instant replay of McAndrewsl testimony before the Division, which added nothing new to the case, and Dr. Sims' oral testimony. The evidence before the district court did not preponderate against the ~ivision's findings, conclusions, and decision nor was it sufficient to justify the court's action in finding the arteriosclerosis obliterans was proximately caused by the June 25, 1970 accident. For this reason we have outlined the evidence in such great detail. On June 25, 1970, section 92-418, R.C.M. 1947, defined an industrial injury as: 11 I injuryi or I injured' means a tangible happening of a traumatic nature from an unexpected cause, or unusual strain, resulting in either external or in- ternal physical harm, and such physical condition as a result therefrom and excluding disease not traceable to injury." (Emphasis supplied). Both Dr. Good and Dr. Sims said arteriosclerosis is hardening of the arteries; that it is an aging process; that it is an ex- tremely common disease and most people have it to some degree; and, that it progresses as a person grows older. Both doctors said they were not surprised to find it in McAndrews, who was 63 at the time of the June 25, 1970 accident and that her arteriosclerosis predated that accident. Regarding the obliterans, Dr. Sims testified the old blood clot also predated that accident and the new clot was much too recent to be connected with it. To make the arteriosclerosis obliterans a compensable injury, claimant has the burden of proving by a preponderance of the evidence that the condition was proximately caused by a tangible happening of a traumatic nature from an unexpected cause resulting in internal physical harm and that such physical condition was a result there- from. IicAndrews simply failed to prove such an injury. This Court has previously held that where a claimant's dis- ability is the result of a "disease not traceable to injury" it is not a compensable "injury" within the meaning of section 92-418, R.C.M. 1947. LaForest v . Safeway Stores, Inc., 147 Mont. 431, 437, 414 P.2d 200. Clearly ~cAndrews' arteriosclerosis obliterans is a result of a disease not traceable to the June 25, 1970 accident and therefore is not a compensable injury. The distirct court erred in finding and concluding that the arteriosclerosis obliterans related to the June 25, 1970 accident and in awarding her compensation and medical benefits for it. Since we have so found, it is unnecessary to consider the issue of probable cause. This case came to the district court with every presumption that the Division had decided it correctly. The district court was not justified in reversing the findings of the Division unless the evidence clearly preponderated against such findings. Stordahl v. Rush Implement Co., 148 Mont. 13, 417 P.2d 95. I f there i s s u f f i c i e n t evidence t o sustain the ~ i v i s i o n ' s findings, the d i s t r i c t court on appeal must affirm those findings. Miller v. Townsend Lumber Co., 152 Mont. 210, 448 P.2d 148; Jones v. air's Cafes, 152 Mont. 13, 445 P.2d 923. When the d i s t r i c t court permits additional evidence t o be introduced on appeal from the Division's decision and the additional evidence i s not important o r adds nothing new t o the case, then the court i s bound by the same r u l e of appeal which applies where the appeal i s heard only on the ~ i v i s i o n ' s record. Kelly v. West Coast Const. Co., 106 Mont. 463, 78 P.2d 1078. The additional evidence permitted by the d i s t r i c t court was neither important nor added anything new t o the case. Appellants were e n t i t l e d t o the presump- t i o n the Division decided the case correctly. The d i s t r i c t court erred i n f a i l i n g t o affirm the Division's findings and decision. W e a r e aware of the r u l e t h a t i f the d i s t r i c t court permits additional evidence t o be introduced which was not presented t o the Division, the case goes t o t h i s Court with the presumption the d i s t r i c t court decided it correctly. 3lurphy v. I n d u s t r i a l Accident Board, 93 >iont. 1, 16 P.2d 795. This presumption i s not applicable i n the i n s t a n t case because of the insufficiency of the additional evidence. It i s the duty of t h i s Court t o determine whether the d i s t r i c t court's decision i s supported by substantial credible evidence. I f , a f t e r esanining - a l l of the evidence before the Division and the additional evidence introduced before the d i s t r i c t court, it does not appear the evidence c l e a r l y preponderates against the findings of the Division, the judgment of the d i s t r i c t court i n reversing the order of the Division must i n turn be reversed by t h i s Court. Stordahl v. Rush Implement Co., supra. The d i s t r i c t court erroneously ordered Glacier t o pay the medical expenses McAndrews incurred i n the sum of $4,949.72 f o r treatment of the a r t e r i o s c l e r o s i s obliterans. Glacier i s not obligated t o pay these medical b i l l s f o r two reasons: (1) t h e condi- t i o n was not the r e s u l t of an i n d u s t r i a l accident, and (2) the acci- dent occurred i n 1970 and medical expenses under section 92-706, R.C.M. 1947, a t t h a t time, were limited t o $5,000 and Glacier had already paid $4,934.90 i n medical b i l l s f o r the fractured r i b and s a c r o i l i a c s t r a i n a s shown by the Division's f i l e s . The Division had not ordered payment of b i l l s i n excess of $5,000 and the dis- t r i c t court had no authority t o do so i n any event. The findings, conclusions and judgment of the d i s t r i c t court a r e s e t aside and reversed. The ~ i v i s i o n ' s order of September 26, 1972 is affirmed. Costs t o appellants before t h i s Court and the d i s t r i c t court. W e Concur: ............................... Chief J u s t i c e ............................... Justices. Nr. Justice Haswell and Mr. Justice Daly specially concurring: We concur in the result reached by the majority for a different reason. In our view the arteriosclerosis obliterans was not proven by a preponderance of the evidence to have been proximately caused by claimant's June 25, 1970 industrial accident.