No. 88-301
LN THE SUPREME COURT OF THE STATE OF MONTANA
1989

LINDA J. WINCHELL 

### , (RichardM. Winchell, fatal),
Claimant ad Respondent,-vsFALTJS SHEET METAL, Employer, and STATE COMPENSATION INSURANCE FUND,
Defendant and Appellant.

APPEAL FROM: The Workers' Compensation Court, The Honorable Timothv Reardon, Zudge presiding.
COUNSEL OF RECORD:
For Appellant:
Charles R. Johnson; Marra, Wenz, Johnson & Hopkins, Great Falls, Montana
For Respondent:
J. David Slovak; Ugrin, Alexander, Zadick & Slovak, Great Falls, Montana

CSubmitted on Briefs: Nov. 17, 1988
Decided: January 5, 1989
Fired: 

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<A -J !I "-- C3 G e3 C; 

# - ED SMITH

LI - ClerkMr. Justice Fred J. Weber delivered the Opinion of the Court.

Linda Winchell filed a claim for compensation following the death of her husband, Richard Winchell. The Workers' Compensation Court determined that Richard's death due to a ruptured congenital aneurysm was the result of a compensable injurywithin themeaning of theWorkers' Compensation Act of 1985. The State Insurance Fund (State Fund) appeals from thatdetermination. We affirm. We consolidate the issues set forth by the State Fund intoa single inquiry for purposes of our review: Did the Workers' Compensation Court err in determininq thatRichardWinchell's deathwas the resultofa compensahle injury? On December 6, 1985, Richard Winchell suffered a ruptured congenital brain aneurysm while performing his duties at Falls Sheet Metal, a familyowned business inGreat Falls, Montana. Richard was the president of Falls Sheet Metal, which was engaged in the sale, installation, and repair of heating and air-conditioning systems. He had been involved in thebusiness for 31years and hisprimary responsibilities
were to perform warranty and service work on systems which Falls SheetMetal installed. The morning of December 6, 1985,Richard was preparing to convert a naturalgas furnace to propanewhen he collapsed to the floor of the shop soonafter arriving atwork. Hewas discoveredby his brother,GaryWinchell, andwas transported to a local hospital where he died 5 days later without regaining consciousness. He was 

### 44 years old and was survived by hiswife Linda and their two minor children. The cause of Richard's death isundisputed. He died of
a "subarachnoid hemorrhage resulting from a ruptured

### congenital saccular aneurysm of the intracranial arteries at the base of the brain." Through deposition testimony, a neurosurgeon described an aneurysm as "an out-pouching or bulging in the wall of a blood vessel due to a weakness in the wall. This outpouching is a thin inelastic wall,which may either turn to fibrous tissue, or it may become thinner and thinner and then eventually burst." The neurosurgeon testified that while Richard's aneurysmwas not present from birth, as might be implied from the term "congenital," the predisposition or weakness was, and the aneurysm developed over the ensuing years. All four of the medical experts deposed, including the neurosurgeon, agreed that hypertension is amajor contributing factor to the growth of an aneurysm. One of themedical experts stressed the importance of treating high blood pressure in persons with a predisposition for an aneurysm, in order to deter the aggravation of a preexisting aneurysm. There was no evidence that Richard Winchell or his doctors
were aware of any high blood pressure in the decedent prior to his death. A 

### physician who examined Richard on two occa-- sions during the year preceding his death testified that his blood pressurewasnormal onboth dates. However, the autopsy revealed thatRichard had sufferedhypertension for severalmonths prior to his death. The pathologistwho performed the autopsy testified that the left ventricle of Richard's heart was enlarged, which is consistent with high blood pressure,and that the thicknessof the left ventricularwallindicated hypertensionhad been present for at leastmonths. The medical experts agreed that hypertension can be sustained over a longperiod of time or itcanbe a temporary increase in blood pressure. The experts varied in their opinions about the causes of hypertension or what degree of hypertension would cause an aneurysm to rupture. Three ofthe experts testified that mental stress orperceived mental stress could sufficiently raise a person's blood pressure. The fourth physician stated thatmental stresswas not known to play an active role in the rupture of an aneurysm, but he testified that mental stress can cause the release of adrenal hormones whichhasbeen linked to hypertension. Vigorous physical activity and extreme emotional reactions were identified as other factors leading to a temporarv increase in blood pressure. Finally,therewas testimony to the effect that, regardless of conjecture, it is impossible formedical science todeterminewhat actually caused Richard Winchell's aneurysm to rupture. On appeal, the State Fund contends that the claimanthas failed to show,either through medical testimony or by other evidence, that the decedent's work had anything todowith his ruptured aneurysm.

Did the Workers' Compensation Court err in determining that Richard Winchell's deathwas the result of a compensahle injury? The standard of review tobe applied iswhether substantial credible evidencewas presented to support theWorkers' Compensation Court's determination thatRichard Winchell died

as a result of a compensable injury. Snyderv. San Francisco Feed and Grain (Mont. 1987), 748 P.2d 924, 929, 44 St.Rep. 2216, 2224. For Linda Winchell to be successful in her claim, she was required to prove that her husband's death resulted from an injury which arose out of and was in the
course ofhis employment. Section 39-71-407,MCA (1985). 

### In Snyder, this Court found a compensable injury under the 1985 Workers' Compensation Act where the claimant suffered a ruptured aneurysm which was shown to be aggravated to the point of rupture by mental strain due to the claimant's stressfulwork environment. Snyder, 748 P.2d at 930. Underthat theory it was necessary for Linda Winchell to bring forth evidence of a stressfulwork environmentand to establish causation. We note that the legislaturehas amended the definition of "injury" under the 1987 Workers

### ' Compensation Act to preclude recovery for injuries caused by physical or mental conditions which arise from emotional or mental stress, which is not applicable here. Section 39-71-119, MCA

# .The Workers' Compensation Court correctly noted that because medical science is presently unable to determine exactly what caused Richard's aneurysm to rupture, it is necessary to look to indirect evidence to establish causation. Conway v. Blackfeet Indian Developers, Inc. (1983)

### , 205P4ont. 459, 468, 669 P.2d 225, 229. The court referred to the testimony of the four medical experts and Richard's wife and brothers to determinewhether his rupture could have been caused by hypertension due to a stressful work environment. We will review the court's findings of fact in this regard to see if they are supported by the evidence in the record. TheWorkers' Compensation Court found that theperiod of September through the end of November is generally the most hectic time of year at Falls SheetPletal. Customerswho have problems with their heating systems usually wait until the cold sets in to have an!7 repairs done. Recently installed systems, of which there were many during that period, often require warranty service towork outminor problems. It was Richard's responsibility to respond to those service and warranty calls. According to business records, Falls Sheet Metal performed I?service callsduring themonth ofNovember and 20 service calls during December of 1985. There was no documentation on how many warranty calls were made during that time. The court also found that November and December of 1985 were unusually cold months even for Montana, whichresulted in Richard's service calls often being of an emergency nature and requiring immediate attention. These findings are substantiated by the testimony of Gary Winchell, Richards' brother and co-owner of the family business, who handled many of the incoming service request calls during thatperiod. Detailed findings were made by the court regarding Richard Winchell's easygoing nature and uncomplaining attitude, which began to change during the weeks prior to his death. The court found Richard to be a taciturn man who liked towork at his own pace,was not accustomed to doing a lot of emergency type work, and would not express himself regarding any stresses or emotional or physical problems he might be experiencing. Although GaryWinchell testified that his brother did not appear any more hurried or busy during November,he did notice thatRichard looked "kind ofpeaked." The court made similar findings based on the testimony of Richard's wife Linda. During the weeks prior to his death,Richard appeared to be very fatigued and he complained of the terrible cold. He had become "crabbier and he barked at the children." He complained of chest pains and intermittent headaches,and told Linda thathewas tired because they
were "running theirbutts off"at the shop. One Friday night approximately 2weeks prior to his collapse,Richard responded to two night-time service calls. That evening he came home from work complaining of fatigue and chills,and went to bed early. At 10:30 p.m. he was awakened by a telephone service call to which he responded and returned home an hour later. At 2:30 a.m. Richard was required to respond to another service call. He returned very tired and chilled, as it was 30 degrees below zero that night. Four daysprior to his collapse, the court found that Richard suffered adebilitating headache which he described as feeling "likehe had atumor inhishead," andwhich caused him difficulty in sleeping for several days. Having reviewed the record,we conclude that the court

### 's explicit findingsregarding Richard'

### s characteristic temperamentand his apparent change indemeanor closely parallel the testimony of the brother and the wife, and that this is substantial evidence to support the court's findings. Based on those findings, the court concluded that Richard's sudden change in demeanor was inconsistent with his easygoing nature, illustrating that he was undergoing a period of unusual stress. Given his tendency to keep his feelings and emotions to himself, we do not consider it unusual that Richard did not relate any stresses he might have felt to his family, much less discuss the source or implicationsof that stress. The medical experts agreed that hypertension is amajor contributory factor to the rupture of an aneurysm, and the pathologist's findings conclusively establish that Richard suffered hypertension for at least several months prior to his death. We note that there was no evidence indicating that any other facet of Richard's life outside of his work produced any stress or emotional strain. We conclude that the medical evidence together with the other evidence is sufficient to support the court's conclusion that Richard's death was the result of a compensable injury within the meaning of the Workers' CompensationAct of 1985. Affirmed.