Court Opinion

ID: 9861732
Source: CourtListenerOpinion
Date Created: 2023-09-25 00:23:40.051106+00
Date Added: 2024-06-11T11:28:52.558764
License: Public Domain

MESCHKE, Judge
dissenting.
This category of workers’ claims is sad, difficult, and distressing. When he needs *612it most, after nearly a lifetime of work, Rogers’ safety net is taken away because he was too ignorant about the medical causes and the legal effects of his illness when it began, before it was really compen-sable. That is not reasonable. Rogers was only fifty-four in 1990, not yet due for retirement.
Agency officials, necessarily calloused by the wearisome procession of wrenching and weaseling claims, are hardened to the harsh effect of a denial of an individual claim. Legislators, attentive.to the problems pressed by groups more organized than a few wornout workers, seem indifferent, as note 6 of the majority opinion unhappily reports. I believe that the judicial branch must seek to more carefully apply a law when faced with such institutional apathy. Therefore, I respectfully dissent.
Despite the recognition that the “sympto-matology and diagnosis” in Rogers’ case is similar to that in Teegarden, the majority opinion concludes that the Bureau’s findings in this case distinguish it from Teegar-den because Dr. Hughes’ professional reports can be read to say that he told Rogers what caused his illness. I disagree. The focus of the question must be on what Rogers “knew”, not on what Dr. Hughes wrote in his notes.
The agency and the majority (at note 3) expect that a “reasonable lay person” will grasp fully and readily what a doctor or lawyer briefly tells that person. That is contradicted by common experience, as this case illustrates. What a trained medical or legal professional might grasp quickly, and what a reasonable lay person may coincidentally understand will vary widely. See Stepanek v. N.D. Workers Compensation Bureau, 476 N.W.2d 1, 3, n. 3 (N.D.1991). I believe that it is unreasonable to conclude that Rogers’ should have understood enough about the medical and legal consequences of his condition in 1988 to promptly file a workers’ compensation claim.
If Rogers’ medical insurance covered the minor immediate expenses in 1988, and if Rogers was able to continue working, it was not then a “compensable” claim. Without direct expenses or loss of time, it is unreasonable to expect a worker to understand that he must file or be forever barred if it worsens.
The evidence establishes that the physician advised only that the claimant was to avoid dust and to quit smoking, but does not otherwise establish any basis that claimant should have known that the work caused the disease.
Teegarden v. N.D. Workmen’s Compensation Bureau, 313 N.W.2d 716, 719 (N.D. 1981) (Emphasis in original). This conclusion for Teegarden should apply equally to Rogers.
A “reasonable person” must know “or should have known” that the “injury was related to employment.” NDCC 65-05-01. When the injury is “[a]ny disease which can be fairly traceable to the employment,” that knowledge must comprehend that “the disease follows as an incident to, and in its inception is caused by a hazard to which an employee is subjected in the course of his employment.” NDCC 65-01-02(8)(a)(l). (My emphasis). Understanding the causes, effects, and implication of an insidious disease is complex enough for professionals, (physicians, lawyers, and judges alike), without attributing equivalent comprehension to an ordinary worker.
Without more compelling evidence of Rogers’ understanding (not that of Dr. Hughes), I believe that it is unreasonable to conclude that Rogers knew, or should have known, that he had to file a workers’ compensation claim in 1988 when his symptoms first showed up. Compare Rogers’ single episode with Teegarden’s extensive history of excused symptoms:
Virgil E. Teegarden, the claimant and the appellant, started work in 1967 with the Hunter Grain Company in Hunter, North Dakota. Hunter Grain Company owns two elevators in Hunter, and Teegarden started work at a feed mill at one of the elevators. In February 1969, he began to have lung problems along with some pleurisy and pneumonia. He was treated as an outpatient for two weeks but was subsequently hospitalized for a period of time. In March of 1969 he had wheezes and rales of the left lower lung for which *613he was treated and which took approximately two weeks to clear. At this time he was advised by his doctor, Dr. R.W. McLean of Hillsboro, North Dakota, to avoid dust and to quit smoking. Teegar-den transferred out of the feed mill to another job at the elevator where he continued to do general elevator work including delivering feed, loading trucks, and dumping grain. In May of 1969 he was again treated for tightness in his chest and bronchitis. The claimant was again treated for pneumonia and pneu-monitis in December of 1970. In October 1973 he fractured three ribs and developed pneumonitis which required lengthy hospitalization. In April 1974, February 1975, and twice in September 1975, he was treated for bronchitis. He was again treated for bronchitis in May of 1976, February 1977, February 1978, January 1979, and June 1979. In October 1979 he was hospitalized with pneumonia. He was treated for bronchitis in November and December of 1979, and again in February and March 1980. In April of 1980 he was hospitalized with bronchitis. At that time Dr. McLean told Teegarden that he could no longer return to his employment at the elevator because of the sensitivity to dust. Dr. McLean informed Teegarden that he had a compensable claim with the Bureau.
On 29 May 1980 Teegarden filed a claim with the Bureau stating that his respiratory problems were due to constant exposure to grain dust during the course of his work at the elevator.
Teegarden, 313 N.W.2d at 717. Teegar-den’s knowledge of symptoms from grain dust spanned a decade before he sought workers’ benefits. Rogers’ single episode contrasts with that.
Compare, as well, what Dr. Hughes says that he told Rogers in 1988:
“A. (Dr. Hughes) I did not tell him that he had to leave the environment at that time. I told him that it was advisable not to be there, but I did not tell him that he had to leave. I was negotiating for a lower level of exposure. My understanding of his job was that he was doing office activities, he wasn’t involved in the off loading or loading of grain, and that it might be possible for him to limit his exposure and still be employed.”
“So I did not — did not come down heavily on him with the idea that I’m going to — as I think about it, I remember being back in that situation asking it — you know, pondering the question as to whether he needed to — he and his wife needed to see the change in lifestyle, you know, necessary to make the switch to not be working anymore. And I remember having an element of flexibility in there, saying that if he was to lower his exposure, he would — he would benefit from that.”
[[Image here]]
“A. So I think it’s a cofactor and a significant cofactor in his illness. And it’s — you know, the progression of symptoms in emphysema are insidious and characterized by shortness of breath on exertion and frequently rationalized on the part of the patient as part of aging or just denying so that they gradually diminish their level of exertion, saying that they really don’t have much of a problem, and they continue with the exposures that put them at risk. So it’s between — you know, once you get below 40 percent of predicted that they start to get coerced into seeking medical attention, recognizing a problem.”
* * * * * *
“Q. (Mr. Haas) And that’s — Doctor, that’s something that you’d been telling him back in July of ’88; namely, that his employment was a substantial factor in his lung problems; right?”
“A. (Dr. Hughes) The initial thing that I was focusing on was his tobacco use, and that I felt that he should”—
“Q. But one of the things, Doctor, that you told him was that his employment was a substantial factor in his diminished lung function; isn’t that right?”
(Witness examines documents.)
“A. The emphasis — my concern at the time was — was that the tobacco was the major problem.”
* # # * * *
*614“A. (Dr. Hughes) And so I can’t be sure how effectively I transmitted my feelings at the time. I may have transmitted them more effectively in print than I did verbally with the patient.”
“Q. (Mr. Little) By print you’re referring to”—
“A. My dictation.”
* * * * * *
“Q. But would he be in a position that if he was exposed to small amounts of grain dust that he might have problems?”
“A. Yeah, he might. But, again, the — I think in trying to reconstruct what was in my mind on July 27th of ’88, I’d have to point out that his spirometry had actually been improving at that point, and rather significantly, suggesting that part of what we’re dealing with was reversible airway obstruction.”
“Now, generally, were this asthma or the severity, as opposed to emphysema, well, I guess, in all honesty, I tend to be fairly blunt in recommendations which I expect to be difficult to follow-up on.”
[[Image here]]
“A. Well, my primary concern was his tobacco use. And I guess it’s so hard for people to quit smoking that I do have a tendency to use levers in terms of the long-term goal. The long-term goal in him necessitated that he quit smoking. That’s the number one priority. It necessitated that he — implied that he probably should leave work, as well, as a secondary goal.”
“Now, I am a bit of an opportunist at times when it comes to tobacco, and I may simply have left him with the impression that if he were to quit smoking he might be able to continue working, because it was— it was urgently important to get him off tobacco.”
& * ⅜ ⅝ >jc
“A. Yeah. We had seen a significant improvement in his breathing test, indicating that he had a reversible component. And I, at that point, was impressed by the fact that he had responded to treatment, and that that probably did play a role in my communication with him at that time. Now, if we had seen a lack of improvement with treatment and a further decline, it would have been — I would have been more likely to be hard-nosed in talking to him about”—
[[Image here]]
“A. Well, you know, I think, as I look through the record and as I remember, his alpha1-antitrypsin level was not — as I said, I inherited him from another physician, but his alpha1-antitrypsin level was not measured until April of 1990. So the implications for him in dust exposure amplified dramatically with that knowledge. April 5th of 1990 is the first alpha^antitrypsin level that I see in the chart.”
“Q. Okay.”
“A. So I’m sure that — that that knowledge, being new at that point, was the reason that the nature of the communication changed.”
# * * jjc * *
“A. 1990 was where — April of 1990 was when we first actually did the test to document that he had alpha1-antitrypsin deficiency. And I believe the reason we did the test was because we, at that point in time, had documented interval decline in lung function, that it was occurring at enough of a rate to begin to suspect that that might be a problem.”
“His emphysema was getting worse and that raised some concern about — the time course of that change raised concern about the possibility of alpha1-antitrypsin deficiency. Really, we should have done the test earlier than we did, but I’m sure that the knowledge that that — I mean, the knowledge of that in 1990 dramatically changed that nature of the communication, because that — and I, I should have brought that up earlier, I didn’t really think about it. But looking at it in prospective now, once we became aware of that, that’s when the heat really went up on the issue of him leaving work. And it was subsequent to that Dr. Mendoza saw him and gave him that blunt assessment that he had to leave.”
Ht * # * * *
*615“Q. And so when you say that the nature of communication changed, you mean you’re stressing more to him that it was imperative to leave it after you knew that he had a genetic predisposition toward emphysema because of that deficiency?”
“A. Yeah. It’s, I suppose, a difference between having an oily rag stored in your garage and seeing smoke come out the window. The degree of urgency was greatly amplified by the knowledge that— that he had alpha^antitrypsin deficiency.”
“I, you know, in trying to think back to the interaction we had in July of ’88, I’m sure that I — that I indicated to him that his job was a problem and that we had to modify the work exposure, and that the urgency then was his smoking and that we needed to get him to quit smoking.”
“The subsequent clinic visits do much more — much much more to address the issue of smoking than they do to address the issue of his working up until he actually quit smoking. And it wasn’t going to do this gentleman any good to quit work only to go home and smoke more.”
Because I believe that this testimony shows that Rogers’ claim is controlled by the Teegarden precedent, I would reverse.
Therefore, I respectfully dissent.