Source: https://supreme.justia.com/cases/federal/us/293/498/
Timestamp: 2019-04-21 06:12:21+00:00

Document:
1. In an action on a lapsed war risk insurance policy insuring only against "total permanent disability," the evidence established that, since a time prior to the lapse, the insured, as the result of chronic and incurable disorders, was partially disabled, and at times and during periods of substantial duration, totally disabled, but that, in the year next following the lapse, he was officially examined and found fit for service as an air pilot, and that, during the larger part of more than eight years between the lapse and the commencement of his suit, he was able to work, and actually did so, and earned substantial compensation.
(1) That, in view of these facts, his testimony that, under stress of need, he worked when not able cannot be given weight, for he is not entitled to recover unless he became totally disabled before the lapse and thereafter remained in that condition. P. 293 U. S. 505.
(2) Since he was not totally disabled when found fit for air service and while performing work admittedly done, total disability occurring while the policy was in force was temporary, and not permanent. P. 293 U. S. 506.
(3) The fact that, notwithstanding his need of money for the support of his family and himself, he failed for nearly nine years to sue for the insurance money now claimed strongly suggests that he had not suffered total permanent disability covered by the policy. Lumbra v. United States, 290 U. S. 551, 290 U. S. 560. And that suggestion is emphasized by the fact that he procured examination for reinstatement of his insurance. Id.
upon the question whether total disability while the policy was in force continued during the subsequent years. As against the facts directly and conclusively established, this opinion evidence furnishes no basis for opposing inferences. P. 293 U. S. 506.
(5) Medical opinions that he became totally and permanently disabled before his policy lapsed are without weight, it being clear that the experts failed to give proper consideration to his fitness for naval air service or to the work he performed, and misinterpreted "total permanent disability" as used in the policy and statute authorizing the insurance. Id.
(6) The Government's motion for a directed verdict on the evidence should have been granted. P. 293 U. S. 505.
2. An expert ought not be allowed to express an opinion upon the ultimate issue of fact to be decided by the jury. P. 293 U. S. 506.
Certiorari to review the affirmance of a judgment against the United States in an action on a war risk insurance policy.
the policy for total permanent disability alleged to have resulted from kidney disease and injuries received in an airplane crash occurring while the policy was in force. At the close of all the evidence, the United States moved for a directed verdict. The motion was denied, the jury found for respondent, and the court gave him judgment which was affirmed by the Circuit Court of Appeals. 68 F.2d 656.
The policy covers total permanent disability, whatever its cause, occurring before the lapse. The evidence was not confined to that period, for respondent's subsequent condition is pertinent to the extent that it tends to show whether he became totally and permanently disabled before the lapse. Lumbra v. United States, 290 U. S. 551, 290 U. S. 560. The United States maintains that the evidence was not sufficient to sustain the verdict. And that is the sole question presented for our consideration.
In the latter part of 1919, respondent first had kidney trouble. According to the naval medical records, he was sick four times from what was finally diagnosed as a kidney stone. These illnesses were in June and September, 1920, and in January and August, 1921; their duration in all was about six weeks; while they lasted, urinalyses sometimes disclosed albumin, casts, and corpuscles in varying quantities. Some time after the last attack, the stone was removed. November 14, 1921, respondent's upper and lower jaws were fractured in the airplane crash. He was in the naval hospital until February, 1922. He testified that he continuously had kidney trouble and severe pains in the head and back. When discharged, the only defect noted was that his teeth did not occlude properly. Due to that, he had gastritis February 28. Urinalysis then disclosed very few blood cells, occasional pus cells, but no albumin or casts. The gastritis disappeared. In May following, his teeth were treated for the malocclusion.
Respondent testified that he was then suffering kidney pains, and that his left antrum was much swollen. A civilian, Dr. Quina, treated the antrum.
"not physically qualified for active duty in the Navy by reason of the following physical defects which are of a more or less temporary nature: infection of left antrum and malocclusion of the teeth."
And, on that day, he certified that he had the following disabilities entitling him to compensation under the War Risk Insurance Act: infection of the left antrum, malocclusion of the teeth, stomach trouble, and heart murmur. He made no claim that he had become totally and permanently disabled or that he was entitled to the amounts that, under the policy, are payable therefor.
a salary of $125 per month for a part of the time, and commissions for the remainder.
Commencing about September 1, 1925, respondent for seven months was employed as superintendent of construction of roads and ditches at a salary of $300 per month. He next worked for an electric company during four years and two months until September, 1930. For the first five or six months, he was a salesman, and earned commissions amounting to about $500. He then became superintendent of electrical work at a salary of $200 per month. Except for six or seven weeks in another year and three months in 1930, he received salary for every month, though not able to work full time. He was discharged because he could not put in full time. Two fellow employees testified that he was ill and at home three or four days a month. That was his last employment.
An official record put in evidence by him shows that, in July, 1924, he was given a special physical examination to test his qualifications for flying. It indicates recovery from the airplane crash, heart and blood pressure normal, no recurrence of kidney trouble. As a result of the examination, he was officially certified to have no defects and to be qualified for flying duty as a pilot.
where he remained about six weeks. The diagnoses were albuminaria, nephritis diffuse mild, moderate hypertension. It was found that no hospitalization was necessary. Dr. Fowler, a consultant in urology, found the right kidney out of position and suggested surgery. June 1, 1931, respondent went to a naval hospital for treatment of the infected antrum, and remained there until July 7. It was found that his blood pressure and heart were normal. He had moderate hydronephrosis of the right kidney and a kink in the upper half of the right ureter. Urinalysis was negative.
"in my opinion at the time I first examined him and since that time, he has not been capable of continuously carrying on a substantially gainful occupation without injury to his health."
"If a man had mild nephritis in 1923 and in 1932 has diagnosis of mild nephritis . . . , his condition is much worse now than it was then because he still has a breaking down of the kidneys."
"if he continuously engages in any kind of work, he is going to limit his days on this earth. . . . If a man has mild nephritis in 1923 and actually works for seven years and quits work in 1930, and then, in 1932, still has a diagnosis of only mild nephritis, I would say that he had injured himself, for a man with that type of disease would injury his health by doing any kind of work. By working, he has made it worse; he might have recovered. I would . . . say he was totally and permanently disabled. I don't know about his disability from an occupational standpoint."
"I would prescribe absolute rest. . . . If plaintiff engaged in work, it . . . would impair his health. From my examination, I would say that the plaintiff is not able to continuously engage in any substantially gainful occupation without impairment to his health. . . . If I had a patient who had an inception or beginning of that disease in 1923 and . . . had actually worked for a period of seven years continuously and then quit work for two years and then, in 1932, still had virtually the same condition he had in the beginning, I would say that the disease is progressive, that the work would make his condition worse."
permanent disability." Periods of total temporary disability, though likely to recur at intervals, do not constitute the disability covered by the policy, for "permanent" means that which is continuing, as contrasted with that which is "temporary." The fact that one has done some work after the lapse of his policy is not, of itself, sufficient to defeat his claim of total permanent disability. He may have worked when really unable, and at the risk of endangering his health or life. It may not be assumed that occasional work for short periods by one generally disabled because of impairment of mind or body does, as a matter of law, negative total permanent disability. But it is plain that work done may be such as conclusively to negative total permanent disability at an earlier time. Lumbra v. United States, supra, 290 U. S. 558 et seq.
After considerate examination of the record, we are of opinion that the evidence and all inferences that justifiably may be drawn from it do not constitute sufficient basis for a verdict for respondent, and that therefore the trial judge should have directed the jury to find for the United States. Gunning v. Cooley, 281 U. S. 90, 281 U. S. 93; Stevens v. The White City, 285 U. S. 195, 285 U. S. 203-204.
before its lapse and thereafter remained in that condition. If not totally disabled when found fit for air service and while performing work admittedly done, total disability occurring while the policy was in force was temporary, and not permanent. The fact that, notwithstanding his need of money for the support of his family and himself, he failed for nearly nine years to sue for the insurance money now claimed strongly suggests that he had not suffered total permanent disability covered by the policy. Lumbra v. United States, supra, 290 U. S. 560. And that suggestion is emphasized by the fact that, in 1928, he procured examination for reinstatement of his insurance. The opinions of respondent's medical witnesses that work impaired his health and tended to shorten his life had no substantial bearing upon the question whether total disability while the policy was in force continued during the subsequent years. As against the facts directly and conclusively established, this opinion evidence furnishes no basis for opposing inferences.
Brown Land & Lumber Co., 255 F. 645, 646; Germantown Trust Co. v. Lederer, 263 F. 672, 676.
* Cf. United States v. Pollock, 68 F.2d 633, 634; United States v. Timmons, 68 F.2d 654, 655; Tracy v. United States, 68 F.2d 834, 837; United States v. Burns, 69 F.2d 636, 638; United States v. Sumner, 69 F.2d 770, 772; United States v. Green, 69 F.2d 921; United States v. Legg, 70 F.2d 106; United States v. Derrick, 70 F.2d 162; Huffman v. United States, 70 F.2d 266; United States v. Johnson, 70 F.2d 399; United States v. Lancaster, 70 F.2d 515; Atkins v. United States, 63 App.D.C. 164, 70 F.2d 768; Harris v. United States, 70 F.2d 889, 891.

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