Case Name: REDMAN HOMES, INC. and the Insurance Company of the State of Pennsylvania, Appellants, v. DEPENDENTS OF Thomas E. BENNINGTON, Sr., Deceased, Appellees
Court: Mississippi Court of Appeals
Jurisdiction: Mississippi
Decision Date: 1999-09-07
Citations: 749 So. 2d 1201
Docket Number: No. 1998-WC-01207-COA
Parties: REDMAN HOMES, INC. and the Insurance Company of the State of Pennsylvania, Appellants, v. DEPENDENTS OF Thomas E. BENNINGTON, Sr., Deceased, Appellees.
Judges: BEFORE SOUTHWICK, P.J., BRIDGES, AND IRVING, JJ.
Reporter: Southern Reporter, Second Series
Volume: 749
Pages: 1201–1208

Head Matter:
REDMAN HOMES, INC. and the Insurance Company of the State of Pennsylvania, Appellants, v. DEPENDENTS OF Thomas E. BENNINGTON, Sr., Deceased, Appellees.
No. 1998-WC-01207-COA.
Court of Appeals of Mississippi.
Sept. 7, 1999.
Thomas E. Vaughn, Austin R. Nimocks, Gulfport, Attorneys for Appellants.
Donald C. Doman, Jr., Biloxi, Attorney for Appellees.
BEFORE SOUTHWICK, P.J., BRIDGES, AND IRVING, JJ.

Opinion:
SOUTHWICK, P. J., for the Court:
¶ 1. The employer and its insurance carrier appeal from the decision of the Harri son County Circuit Court reversing the decision of the Workers' Compensation Commission. The circuit court awarded benefits to the dependents of Thomas E. Bennington, Sr., who suffered a fatal heart attack shortly after leaving a New Year's Eve party. The employer contends that there was substantial evidence supporting the Commission's determination that Mr. Bennington's heart attack did not result from job-related stress but rather was inevitable due to the severe coronary artery disease from which he suffered. We agree with the employer that this was simply a fact issue, within the discretion of the Commission to resolve. We reverse and reinstate the order of the Commission.
FACTS
¶ 2. Forty-three-year old Thomas Ben-nington was employed as a production worker in the sidewall department of Red-man Homes, Inc, a mobile home manufacturer. Essentially, he worked on an assembly line constructing walls of mobile homes. On September 9,1994, he suffered an injury when a seven-inch wooden stake went through his hand and wrist. The stake was surgically removed and Mr. Bennington returned to work sixteen days later. On December 16, Mr. Bennington suffered another injury, this time a laceration to his thumb. The wound was sutured and he returned to work within three days.
¶ 3. Mr. Bennington continued to experience pain with both wounds. He received additional treatment for his thumb wound which had reopened. Because the wound was healing poorly, he ultimately had the stitches removed and replaced. He was given a splint which was to reduce pain in his thumb while he worked. As for his hand and wrist, he continued to suffer from a "pins and needles" sensation and other discomfort. Belinda Bennington testified that her husband feared he might require additional surgery on his hand and wrist. On December 5, 1994, Mr. Ben-nington was fitted with a wrist brace and advised to return in one month.
¶ 4. Before that occurred, Mr. Benning-ton and his wife attended a New Year's Eve party at a friend's home. Mr. Ben-nington complained that he was not feeling well and the couple returned home. After showering, he sat down on his bed and suffered a fatal heart attack. An autopsy revealed that Mr. Bennington suffered an acute myocardial infarction, or simply stated, a heart attack, due to or as a consequence of arteriosclerotic cardiovascular disease. There was also evidence of a prior, likely unknown, myocardial infarction. At the time of the autopsy, Mr. Bennington's coronary arteries were approximately ninety-percent blocked.
¶ 5. Mr. Bennington's dependents filed their petition to controvert with the Commission on November 27, 1995, contending that the heart attack resulted from the physical pain and emotional stress associated with the two work-related injuries. The employer responded that Mr. Ben-nington's coronary artery disease, not stress, caused the heart attack. On September 15, 1997, the administrative law judge entered an order finding that there was no causal connection between Mr. Bennington's job-related stress and the heart attack. The claimants appealed to the Commission which affirmed the findings of the administrative law judge. The Harrison County Circuit Court reversed. The circuit judge held that the decision of the Commission was not supported by substantial credible evidence and awarded death benefits to Mr. Bennington's wife and son.
DISCUSSION
¶ 6. The sole issue raised by the employer on this appeal is whether there was substantial credible evidence to support the Workers' Compensation Commission's decision. The Commission is the trier and finder of facts in a compensation claim. Inman v. Coca-Cola/Dr.Pepper Bottling Co., 678 So.2d 992, 993 (Miss. 1996). Judicial review is to focus on whether the findings of fact are supported by substantial evidence and whether the proper legal standard was applied. R.C. Petroleum, Inc. v. Hernandez, 555 So.2d 1017, 1021-22 (Miss.1990). Regardless of what the circuit court concluded, if the case is further appealed here our task is again to review the Commission's decision for its validity.
¶ 7. In reversing the Commission's order, the circuit court noted that there was expert medical testimony that claimed a causal connection between the stress associated with Mr. Bennington's work-related injuries and the heart attack. The circuit court relied upon two cases in which benefits were awarded under similar circumstances. In one case, the claimant sustained burns on his left leg at work. Harper Foundry and Machine Co. v. Harper, 232 Miss. 873, 875-76, 100 So.2d 779 (1958). Several days later, while waiting to undergo a skin graft, he suffered a heart attack. One expert attributed the heart attack to the nervous stress occasioned by the anticipated skin graft and future treatment of the burn. Another physician testified that although the burn was not the direct cause of the heart attack, it could have contributed to its onset. Id. at 780. The supreme court found that the claimant did establish a causal relationship between the burn and the heart attack. In affirming the Commission, the court explained that "no decided conflict in the medical opinions existed," but had there been such a conflict it was for the Commission to resolve. Id. at 781.
¶ 8. In the second case, the claimant suffered a heart attack that she claimed resulted from the stress and strain of her job. Insurance Dept. of Miss. v. Dinsmore, 233 Miss. 569, 574-75,102 So.2d 691, 692 (1958). The claimant suffered from hypertension and cardiovascular disease, prompting the employer to argue that "the relentless and inexorable march of a disease or condition of life is not a compensa-ble injury arising out of and in the course of employment simply because the disability manifested itself during a period of employment." Id. at 693. One expert expressed the opinion that there was no causal connection between the heart attack and the claimant's employment. However, he did admit that hypertension could possibly be a contributing factor in the end result of the attack. The claimant's experts testified that tension and job-related strain contributed to the hypertension, which was one factor in the production of the heart attack. In affirming the Commission's award of benefits, the court held that "it is sufficient as a basis for compensation that the work is a contributing cause. It need not be the sole or even the primary cause of resulting disability or death, but if a substantial contributing causal connection is found, the claim is fully compensable_" Id. at 694.
¶ 9. In both precedents, the supreme court affirmed an order of the Commission finding that there was substantial evidence of a causal connection between the stress and the heart attacks. In the present case, the circuit court was to determine whether there was substantial evidence that there was no causal connection. As one commentator has explained:
Since the conflict in medical viewpoint is often related to generally conflicting theories or "schools" of medical thought on the subject of causal connection, rather than to the peculiar facts of the particular case, the rule has plagued the court with contradictions. Thus, it will be noted that the issue of causal connection may arise in two cases which present substantially the same facts and the same typical conflict in medical opinion, and the commission may reach opposite results by adopting one school of medical thought in one case and the opposite school in the other. Under the prevailing rule, the decision in both cases, although contradictory, must be affirmed.
Dunn, Mississippi Workmen's Compensation, § 97 (3d ed.1990).
¶ 10. The evidence in the present case consisted of the testimony of the deceased's wife, Belinda Bennington, Dr. Edward S. Hyman, and Dr. Paul Mullen. Neither physician treated Mr. Bennington. Mrs. Bennington testified that her husband was under considerable strain resulting from the work-related injuries. She stated that Mr. Bennington suffered pain from both injuries up until his death. The thumb injury was particularly stressful because the stitches had to be removed, the wound scraped and restitched. Mrs. Ben-nington testified that her husband described the process as "extremely painful." Mr. Bennington also worried about losing his job because the injuries made it difficult to perform his duties. Mrs. Benning-ton testified that following her husband's second injury, she and Mr. Bennington overheard a conversation in which a supervisor expressed his desire to fire Mr. Ben-nington because of poor job performance. According to Mrs. Bennington, a second supervisor stated that he would not let that happen. Mrs. Bennington stated that her husband was worried about losing his job due in large part to his inability to "keep up the pace" because of his injuries.
¶ 11. Dr. Edward S. Hyman, a specialist in internal medicine, testified on behalf of the claimants. He stated that although he is not a cardiologist, he has treated many patients who suffer from cardiovascular disease. Dr. Hyman testified that in his opinion, there was a cause and effect relationship between the stress and the fact that Mr. Bennington developed a clot in his diseased artery which led to the heart attack. Dr. Hyman explained that he believes that stress accelerates the clotting mechanism in the blood. He went on to state that the myocardial infarction was aggravated and precipitated by the stress related to Mr. Bennington's employment. Dr. Hyman admitted that it is more likely that a clot will form in a diseased artery than a healthy one. When asked to assign a percentage of the heart attack for which stress was responsible, Dr. Hyman stated that stress contributed about eighty or ninety percent to the formation of the clot which led to the heart attack. Finally, Dr. Hyman testified that Mr. Bennington would eventually have suffered a heart attack; however, it might have been another ten years before it occurred.
¶ 12. Dr. Paul Mullen, a cardiologist, testified as the expert witness for the employer. He stated that given the progression of the cardiovascular disease, it had likely been developing for approximately twenty years. In his opinion, the two work-related injuries did not contribute to Mr. Bennington's myocardial infarction. Dr. Mullen testified to a reasonable degree of medical probability that the natural progression of the coronary artery disease caused the fatal heart attack. Dr. Mullen did recognize that there are two schools of thought regarding the relationship between stress and heart attack. He admitted that catastrophic stress can cause sudden death in patients predisposed to a heart attack because of underlying coronary artery disease. Dr. Mullen further admitted that it is possible that something less than catastrophic stress might have the same effect. When asked to assume that stress was at least in part responsible for the heart attack, Dr. Mullen testified that it would be ten-percent responsible while the cardiovascular disease would be ninety-percent responsible.
¶ 13. The conflict in the testimony made an issue for the Commission as the trier of the facts. In heart attack cases such as this, the factual issue of causal relationship is usually one for the medical experts and the triers of the facts. Mississippi Research and Development Center v. Dependents of Shults, 287 So.2d 273, 276 (Miss.1973). Where the medical evidence in a heart case is conflicting, the court will affirm the Commission whether the award is for or against the claimant. Kersh v. Greenville Sheet Metal Works, 192 So.2d 266, 269 (Miss.1966). The Commission obviously found the testimony of Dr. Mullen, a cardiologist, more credible than that of Dr. Hyman, an internist, who admittedly had never even performed a cardiac catheterization.
¶ 14. Because we are reinstating the order of the Commission denying benefits, we need not address the issue of apportionment. Apportionment may only be considered after the claimant has met its burden of establishing a causal connection between an injury and a resulting disability. Dunn, Mississippi WoRkmen's Compensation § 55 (Bd ed.1990). The Commission found that the claimants failed to do so in the present case. Therefore, there is no need to consider a reduction in benefits.
¶ 15. THE JUDGMENT OF THE HARRISON COUNTY CIRCUIT COURT IS REVERSED AND THE ORDER OF THE WORKERS' COMPENSATION COMMISSION REINSTATED. ALL COSTS OF THIS APPEAL ARE ASSESSED TO THE APPELLEES.
McMILLIN, C.J., KING, P.J., IRVING, AND MOORE, JJ., CONCUR.
PAYNE, J., DISSENTS WITH SEPARATE OPINION, JOINED BY BRIDGES, DIAZ AND LEE, JJ.
THOMAS, J., NOT PARTICIPATING.