Case Name: NASHVILLE LIVESTOCK COMMISSION and U.S. Insurance Group v. John Paul COX
Court: Arkansas Supreme Court
Jurisdiction: Arkansas
Decision Date: 1990-04-16
Citations: 302 Ark. 69
Docket Number: 89-178
Parties: NASHVILLE LIVESTOCK COMMISSION and U.S. Insurance Group v. John Paul COX
Judges: Hays and Turner, JJ., dissent.
Reporter: Arkansas Reports
Volume: 302
Pages: 69–77

Head Matter:
NASHVILLE LIVESTOCK COMMISSION and U.S. Insurance Group v. John Paul COX
89-178
787 S.W.2d 664
Supreme Court of Arkansas
Opinion delivered April 16, 1990
Barber, McCaskill, Amsler, Jones & Hale, P.A., for appellants.
Wright, Chaney & Berry, P.A., for appellee.

Opinion:
David Newbern, Justice.
The Arkansas Workers' Compensation Commission refused compensation to the respondent, John Paul Cox. Due to unusual circumstances, Cox was required by his employer, Nashville Livestock Commission (NLC), to work extra hours over a three-day period. He suffered chest pain and was disabled and hospitalized. The workers' compensation commission's decision was based upon language found in Black v. Riverside Furniture Co., 6 Ark. App. 370, 642 S.W.2d 338 (1982) and Kempner's & Dodson Ins. Co. v. Hall, 1 Ark. App. 181, 646 S.W.2d 31 (1983). We granted review of the court of appeals plurality decision which remanded the case to the commission. The court of appeals held that the statements in those two cases which the commission considered to be governing, were obiter dicta, and thus the workers' compensation commission should not have regarded them as controlling of this case. While we agree with that conclusion, we also conclude that the court of appeals should have decided the fundamental question whether a disabling symptom of an underlying disease may be the basis of compensation if it is brought on by exertion in the course of employment. We hold that the work-related occurrence of a disabling symptom of underlying heart disease is compensable. The court of appeals decision is thus reversed and remanded.
The references in the Black and Kempner's opinions to symptomology aggravation being noncompensable were clearly unnecessary to the decisions of those cases. In the Black case, the issue was solely whether there was sufficient evidence to support the workers' compensation commission's conclusion that a claim for death benefits should be denied. The claimant had an underlying heart condition which had not been shown to have been aggravated by employment. Nor had it been shown that the claimant's employment was the reason for surgery resulting in death. The claim was a death claim and not one for benefits for disability resulting from an angina attack. In the Kempner's case, the holding was simply that the testimony of a physician was sufficient to support the commission's decision that an infarction which had occurred was work related. There was discussion of the language in the Black case, and even a statement that the Black case "holding" was that a disability resulting from a symptom such as angina was not compensable. That discussion, however, clearly was not necessary to the decision and thus was an obiter dictum. W.S. Kirkpatrick & Co., Inc. v. Environmental Tectonics Corp., International, No. 87-2066, slip op. (U.S., January 17, 1990).
The workers' compensation commission's opinion in the case before us now contained the following:
The claimant testified that he previously had heart problems in 1977. During a six month time period the claimant experienced weakness, shortness of breath and tightness in his chest. The claimant was hospitalized three or four times and was diagnosed as having minor heart blockage. Claimant attempted to refute that diagnosis by testifying that he later was rediagnosed as having a nervous condition from being around groups of people.
At the time of his alleged injury, the claimant was the manager of the Nashville Livestock Commission. As manager he participated in soliciting business, gathering cattle, and getting cattle ready for weekly sales. On November 19, 1986, cattle sales were scheduled for 1:00 p.m. and 7:00 p.m. Claimant testified that he began getting ready for the Wednesday sales on Sunday and that he had been working from 5:00 or 6:00 a.m. until 12:00 to 2:00 each night from Sunday through Wednesday. Shortly after the beginning of the 7:00 sale, claimant experienced pain in this chest and left arm and felt sick at his stomach. The claimant took some medicine and continued working until 2:30 or 3:00 a.m. Later that night, claimant awoke with severe chest pains and was taken to Nashville Hospital.
Claimant was examined by Dr. Pye, a general practitioner in Nashville, and was later referred to Dr. Hutchins, a cardiologist at the U of A Medical Center in Little Rock. Dr. Hutchins diagnosed claimant as having a pre-existing heart condition; namely single vessel coronary artery disease, and stated that claimant's working conditions aggravated angina, a symptom of this pre-existing condition. Claimant then filed a workers' compensation claim alleging that the chest pains arose out of and during the course and scope of his employment causing him to incur hospital and medical bills.
The commission concluded that "claimant's working conditions merely aggravated angina, a symptom of claimant's preexisting condition, and is not compensable."
Under our workers' compensation law, an employer pays compensation to an employee for "disability or death from injury arising out of and in the course of employment without regard to fault as a cause of the injury." Ark. Code Ann. § 11 -9-401(a)(1) (1987). The employer must also promptly provide such medical services to any injured employee as are reasonably necessary. Arkansas Code Ann. § 11-9-508(a) (1987)." 'Injury' means only accidental injury arising out of and in the course of employment, including occupational diseases . . . and occupational infections arising out of and in the course of employment." Ark. Code Ann. § 11-9-102(4). " 'Disability' means incapacity because of injury to earn, in the same or other employment, the wages which the employee was receiving at the time of the injury." Ark. Code Ann. § 11-9-102(5) (1987).
There is no question that Cox's condition was disabling. The argument here centers on whether Cox suffered an "injury." Cox argues an incident of angina which arises out of and in the course of employment is an "injury." NLC argues such an incident cannot constitute an injury unless there is a change, such as an infarction which damages heart tissue, in the physical condition of the claimant. Other than the obiter dicta in the Black and Kempner's cases, the only authority cited for that statement by NLC is Sowders v. Mason & Dixon Lines, Inc., 579 S.W.2d 380 (Ky. App. 1979), which, as Cox points out, was based upon a Kentucky statute which specifically defined "injury" as "work related harmful change in the human organism."
Cox cites a number of cases from other jurisdictions which have allowed recovery for angina pectoris attacks resulting in disability absent a showing of an aggravation, in the sense of making an underlying arteriosclerosis or septal effect worse, of the underlying heart condition which caused the pain. Jones v. Alaska Workers' Compensation Board, 600 P.2d 738 (Alaska 1979); Canning v. State Department of Transportation, 347 A.2d 605 (Me. 1975); Bertrand v. Cole Operator's Casualty Company, 253 La. 1115, 221 So. 2d 816 (1968); and H.V. & T.G. Thompson Lumber Co. v. Bates, 148 Ga. App. 810, 253 S.E.2d 213 (1979).
In addition to those cases, we have studied Crum v. General Adjustment Bureau, 738 F.2d 474 (D.C. Cir. 1984), which arose under the Longshoreman's and Harbor Workers Compensation Act which, at 33 U.S.C. § 902(2), defines "injury" much the same as our statute quoted above. The employer made exactly the same argument as that made by NLC here. The employer argued that no compensable injury had been suffered because angina is not a disease but merely a symptom, and as the employment did not cause the underlying disease, there could be no recovery under the act. The court held that the disabling onset of angina was an "injury" within the meaning of the act and cited other cases where compensation had been allowed despite the fact that the underlying disease or condition had not been caused by the employment, such as back pain in a person suffering spina bifida, pain resulting from varicose veins which prevented the claimant from standing for long periods, and aggravation of underlying psoriasis. 738 F.2d at 478. See also Perrin v. Baldwinsville VF Co., 494 N.Y.S.2d 169 (1985).
In workers' compensation law the employer "takes the employee as he finds him" and employment circumstances which aggravate pre-existing conditions are compensable. See McGregor & Pickett v. Arrington, 206 Ark. 921, 175 S.W.2d 210 (1943); Green v. Lion Oil Co., 215 Ark. 305, 220 S.W.2d 409 (1949). 1 A. Larson, The Law of Workmens' Compensation, § 12.20 (1985). We see no reason to hold that a person who is disabled from pain causally related to his or her employment and resulting from an underlying physical condition should be any less entitled to workers' compensation benefits just because there is no change in that underlying condition. For years this court has labeled myocardial infarctions, "heart attacks," as "injuries" in the parlance of the workers' compensation act. R. B Leflar, Compensation for Work-Related Illness in Arkansas, 41 Ark. L. Rev. 89 (1988), citing as examples, Hoerner Waldorf Corp. v. Alford, 255 Ark. 431, 500 S.W.2d 758 (1973); Reynolds Metals Co. v. Cain, 243 Ark. 483, 420 S.W.2d 872 (1967); and McGregor & Pickett v. Arrington, supra. When there is a work-related disabling angina attack, the disability, although temporary as in this case, is no less a disability. The expense of hospitalization and related medical treatment may be less in the case of an angina attack resulting purely from underlying heart disease than with respect to an angina attack which symptomizes an accompanying infarction or other tissue change, but we can think of no reason why there should be compensation for one but not the other if both are brought on by employment. Our holding here is that an attack of angina pectoris which results in disability as defined in the workers' compensation act may constitute an injury giving rise to compensation under the act if it arises out of and occurs in the course of employment.
Cox's reply brief suggests .that the commission has not decided whether the angina was caused by his employment. Our reading of the commission's opinion quoted in part above is that a finding of a relationship between the angina and the employment was made and is clearly shown in the commission's statement that the angina was aggravated by the employment. The case will nonetheless have to be remanded to the commission to determine the amount of compensation to which Cox is entitled.
Reversed and remanded.
Hays and Turner, JJ., dissent.
Glaze, J., concurs.