Case Name: SYLVIA JENSEN v. CITY OF DULUTH AND ANOTHER
Court: Minnesota Supreme Court
Jurisdiction: Minnesota
Decision Date: 1964-09-04
Citations: 269 Minn. 241
Docket Number: No. 39,119
Parties: SYLVIA JENSEN v. CITY OF DULUTH AND ANOTHER.
Judges: 
Reporter: Minnesota Reports
Volume: 269
Pages: 241–253

Head Matter:
SYLVIA JENSEN v. CITY OF DULUTH AND ANOTHER.
130 N. W. (2d) 515.
September 4, 1964
No. 39,119.
M. J. McKeon and McGuire & McGuire, for relator.
John J. Killen, Jr., and Reavill, Neimeyer, Johnson & Killen; for respondents.

Opinion:
Nelson, Justice.
Certiorari to review a decision of the Industrial Commission denying compensation to dependents of a deceased employee.
The petition was filed by Sylvia Jensen, widow of George F. Jensen, for herself and a dependent child. Mr. Jensen had been employed in the fire department of the city- of Duluth, Minnesota, since 1917. He had been a firefighter during all of those years, working 24 hours on and 24 hours off. It is claimed by petitioner that the mere going to work made him tense'- and- that he was always under a great deal of apprehension, stress, and strain. The fire bell would ring in Mr. Jensen's station regardless of where the fire might be, and the firemen were always moving fast and were in the midst of a great deal of excitement. The decedent, in the course of his employment, would have to enter the buildings first, do rescue work, ventilate the braiding, and help in general firefighting. This work caused him to be under strain and exposed him to smoke. He did all of these things during his employment until August 1955,- a period of service of nearly 40 years.
An autopsy was performed following Mr. Jensen's death on November 17, 1955, which, as far as relevant, gave as a final diagnosis:
"II. Generalized arteriosclerosis
"(A) Arteriosclerosis of the basal arteries of the brain .
"(B) Coronary sclerosis .
"(C) Arteriosclerosis of the aorta .
"(D) Arteriosclerosis of both kidneys."
It would appear that the main question presented here is whether the claim for compensation is barred by Minn. St. 176.66, subd. 3, which reads:
"Neither the employee nor his dependents are entitled to compensa tion for disability or death resulting from occupational disease, unless such disease is due to the nature of his employment as defined in section 176.011, subdivision 15, and was contracted therein within 12 months previous to the date of disablement; except in the case of silicosis or asbestosis, in which cases disablement of the employee must occur within three years from the date of such employee's last exposure with an employer in an employment to the nature of which the disease may have been a hazard, and except if immediately preceding the date of his disablement or death, an employee was employed on active duty with an organized fire department of any municipality, and his disease is that of myocarditis, coronary sclerosis, pneumonia or its sequel, .the disease shall be presumed to have been contracted therein within 12 months previous to the date of disablement." (Italics supplied.)
We are required in the instant case to read the foregoing statute with Minn. St. 176.011, subd. 15, which reads:
" 'Occupational disease' means a disease arising out of and in the course of employment peculiar to the occupation in which the employee is engaged and due to causes in excess of the hazards ordinary of employment and shall include undulant fever. Ordinary diseases of life to which the general public is equally exposed outside of employment are not compensable, except where such diseases follow as an incident of an occupational disease, or where the exposure peculiar to the occupation makes such disease an occupational disease hazard. A disease arises out of the employment only if there be a direct causal connection between the conditions under which the work is performed and if the occupational disease follows as a natural incident of the work as a result of the exposure occasioned by the nature of the employment. An employer is not liable for compensation for any occupational disease which cannot be traced to the employment as a direct and proximate cause and is not recognized as a hazard characteristic of and peculiar to the trade, occupation, process, or employment or which results from a hazard to which the workman would have been equally exposed outside of the employment. If immediately preceding the date of his disablement or death, an employee was employed on active duty with an organized fire department of any municipality, and his disease is that of myocarditis, coronary sclerosis, pneumonia or its sequel, and at the time of his employment such employee was given a thorough physical examination by a licensed doctor of medicine, and a written report thereof has been made and filed with such organized fire department, which examination and report negatived any evidence of myocarditis, coronary sclerosis, pneumonia, or its sequel, the disease is presumptively an occupational disease and shall be presumed to have been due to the nature of his employment." (Italics supplied.)
The relator contends that the Industrial Commission erred in determining that cerebral arteriosclerosis, one of the causes of her husband's death, was not an occupational disease of firemen, because the Industrial Commission committed error in awarding evidentiary status to § 176.011, subd. 15, (the statute that gives a presumption that coronary sclerosis is an occupational disease of firemen) and in using that as a basis for saying that relator's evidence was not the same as in the coronary sclerosis cases. Relator cites as controlling: Kellerman v. City of St. Paul, 211 Minn. 351, 1 N. W. (2d) 378; Ogren v. City of Duluth, 219 Minn. 555, 18 N. W. (2d) 535; Anderson v. City of Minneapolis, 258 Minn. 221, 103 N. W. (2d) 397; and Schwartz v. City of Duluth, 264 Minn. 514, 119 N. W. (2d) 822.
It thus becomes clear that the legal issue involved is whether the presumption of §176.011, subd. 15, applies to cerebral arteriosclerosis in firemen.
The presumption of § 176.011, subd. 15, is specifically limited to "myocarditis, coronary sclerosis, pneumonia or its sequel." The statute limits it in its application to firemen and other specific occupations. It is therefore clear that as to all other claims, both relating to disease and occupation, no such presumption applies. There must then be shown "a direct causal connection" between the occupation and the disease, and such direct causal connection must be shown by a fair preponderance of the evidence as was held in Hogan v. Twin City Amusement Trust Estate, 155 Minn. 199, 193 N. W. 122.
The respondents contend that it is clear from the record that the Industrial Commission found that the presumption did not apply in the instant case by the use of the following language:
"There is no such legislative presumption in favor of cerebral arteriosclerosis or generalized arteriosclerosis being an occupational disease of firemen."
The record also indicates that the referee during the hearing ruled that while § 176.011, subd. 15, as it relates to firemen, was in effect on August 5, 1955, no evidence was introduced that would raise the presumption, and no statutory authority was submitted that would include cerebral arteriosclerosis under the presumptive rule.
This court discussed the proper use of a presumption in Ogren v. City of Duluth, 219 Minn. 555, 563, 18 N. W. (2d) 535, 539, where it said:
"The presumption in question was a mere rule of evidence; it created a rebuttable presumption of causation under the circumstances mentioned that a particular occupational disease resulted from the corresponding industrial process.
‡ ‡ ‡
" It is well settled that a presumption is not evidence, but is rather a rule of law dictating decision on unopposed facts and shifting the burden of going forward with the evidence. Ryan v. Metropolitan L. Ins. Co. 206 Minn. 562, 289 N. W. 557. The presumption obtains until substantial proof to the contrary is introduced. Then it ceases and vanishes from the case. The case is then to be decided by the trier of fact the same as if the presumption had never existed."
We made it clear in Anderson v. City of Minneapolis, supra, that to permit an inference to be drawn from a presumption is to give the presumption evidentiary status, and that a presumption is not evidence but a rule which controls decision on unopposed facts in the absence of evidence to rebut it. It was held in the Anderson case that the evidence there clearly permitted an inference that the coronary sclerosis involved in that case was an occupational disease since the disease in evidence was myocarditis combined with coronary sclerosis, definitely named in the statute as presumptively an occupational disease.
In Kellerman v. City of St. Paul, supra, this court held that it is for the legislature to fix the limits of class and disease, saying (211 Minn. 355, 1 N. W. [2d] 380):
" The apparent high percentage of occurrence of coronary sclerosis among firemen demonstrates that the legislature was not arbitrary in providing for them as a class. Relator asserts that other occupations were shown to be susceptible to coronary sclerosis. The legislature 'is free to recognize degrees of harm, and it may confine its restrictions to those classes of cases where the need is deemed to be clearest. As has been said, it may "proceed cautiously, step by step," and "if an evil is specially experienced in a particular branch of business" it is not necessary that the prohibition "should be couched in all-embracing terms." ' "
The record indicates that on August 4, 1955, employee was on fire duty and retired for the evening. There was no alarm that evening. However, in the early morning of August 5, one of the other firemen heard a thud in the vicinity of decedent's bed. Apparently decedent had fallen out of bed. He returned to bed for a while and later was driven home. When he arrived there he was unsteady and rather helpless so he was sent to the hospital. On August 7, 1955, he appeared to have suffered a further physical ailment, possibly something of a cerebro-vascular nature. From this time on his course continued downhill, terminating in his death on November 17, 1955.
The attending physician on November 25, 1955, filed a death certificate stating that the immediate cause of death was—
" cerebral thrombosis, encephalomalacia, due to hypertensive cardiovas disease "
and listed as other significant conditions contributing to death but not related to the immediate cause,
" terminal perforation of chronic duodenal ulcer — pulmonary embolism — bronchopneumonia."
The petitioner had a leading internist testify in her behalf. He testi fied that the employee was admitted to the hospital with a cerebral thrombosis which was the result of extensive arteriosclerosis. He also stated that this was all related to the nature of the employee's occupation. He said that he felt the type of work done by firemen is such that it helps to explain why arteriosclerosis is so free in those cases and why it is felt that it is an occupational disease. He further testified that arteriosclerosis often manifested itself in a variety of ways; in different people it will be found in the brain, heart, legs, kidneys, or it could be the arteries of the stomach or perhaps even the duodenum.
Another expert medical witness, appearing as a witness for the respondents, testified that he could see no relationship between the employee's arteriosclerosis and his occupation as a fireman. He stated:
"I would make such an opinion, form such an opinion on the basis of the fact that arteriosclerosis is generalized throughout the population, particularly in the 60-year-old men, that arteriosclerosis in my opinion does not appear selectively particularly to any given occupation. We see young people in our population dying of arteriosclerosis, not uncommonly but certainly not commonly but certainly not frequently either in their early 20's or 30's. The sort of things that you predicate here in your supposition indicate to me that one would not blame the occupation for the presence of arteriosclerosis that this is a basic process of aging. It is a degenerative process that exists to some extent in all human beings starting shortly after birth and continuing in all individuals up to the time of death."
A reading of all the testimony clearly indicates that there was a decided conflict in the expert medical opinion.
The commission has indicated in the instant case that it cannot find from the medical evidence that the relator has furnished sufficient proof that coronary sclerosis and cerebral arteriosclerosis are all a part of the same pathological picture. Petitioner's own medical expert said that "arteriosclerosis is a general progression and we assume that it acts practically the same wherever it goes, but for some unknown reason it localizes in one place more than in another."
In Anderson v. City of Minneapolis, supra, this court considered the applicable statutes and the cases that have been concerned with cor- onaiy sclerosis of firemen and not arteriosclerosis generally. As we have already indicated, those cases commenced with the Kellerman case, followed by the Anderson and Schwartz cases. It will be noted in those cases that both the commission and this court were aided by the provisions of the Workmen's Compensation Act providing that where coronary sclerosis of firemen is involved, it may be presumed to have been due to the occupation of being a fireman. There is yet no legislative presumption provided in favor of cerebral arteriosclerosis or generalized arteriosclerosis being an occupational disease of firemen.
The commission made the following statement in its opinion:
"We do not find that medical or legal status present here [having made reference to the Kellerman, Schwartz, and Anderson cases]. And we cannot conclude that the evidence adduced in the case at bar establishes by a fair preponderance of the evidence, that cerebral arteriosclerosis is an occupational disease of firemen."
As we pointed out in the Kellerman case, under these circumstances a fact issue was presented, and the determination of that fact issue will not be disturbed on appeal where there is competent evidence to sustain it. Where medical experts disagree as to causal relationship between progress and development of an occupational disease and employment, as they do in the instant case, we must apply the foregoing rule.
In the final analysis the question here is whether the evidence, which turns largely on conflicting medical testimony, is such that it permits an inference to be drawn from the accepted facts to warrant the findings of the commission. We think it does.
Affirmed.