Court Opinion

ID: 9664548
Source: CourtListenerOpinion
Date Created: 2023-08-24 00:21:09.27347+00
Date Added: 2024-06-11T18:15:07.157567
License: Public Domain

Shanahan, J.,
concurring.
On rereading the Nebraska test for legal causation in a workers’ compensation case based on a “heart attack,” one immediately recognizes that the present test is not only impractical but unrealistic and an invitation for conjecture and speculation otherwise judicially condemned in prosecution of a workers’ compensation claim. As expressed today,
[a]n exertion- or stress-caused heart injury to which the claimant’s preexisting heart disease or condition contributes is compensable only if the claimant shows that the exertion or stress encountered during employment is greater than that experienced during the ordinary nonemployment life of the employee or any other person.
The majority has declined to explain or illustrate application of the preceding standard. The reason for such absence of an explanation or illustration will become quite evident.
*246Under current Nebraska law, compensability for an employee’s heart attack, including an employee’s death from that cardiovascular condition, is a process of comparing or weighing the employee’s actual work exertion and ordinary nonemployment exertion. If employment involves exertion greater than exertion in nonemployment life, a claimant has established a legal cause necessary for compensability under the Nebraska Workers’ Compensation Act. Thus, under Nebraska’s current rule for compensability of a heart attack, comparison of relative exertions is crucial, i.e., employment exertion versus exertion in an employee’s ordinary nonemployment life, as well as employment exertion versus exertion in the ordinary nonemployment life of any person other than the employee who has suffered a heart attack.
Consider the following illustration: A is an enthusiast for physical fitness and runs several miles each week, which requires an average 80 units of heart strain every time A embarks on running. B leads a rather sedentary lifestyle and in any ordinary activity outside B’s employment never incurs more than 30 units of heart strain. Assume that “any other person” in ordinary nonemployment life experiences exertion at 45 units of heart strain. Both A and B have a preexisting deleterious heart condition and work for the same employer. One day, while A and B are simultaneously doing the same work which requires 50 units of heart strain, each collapses from a heart attack and dies. B’s death did “arise out of employment” because the fatal work exertion of 50 units exceeds the 30-unit exertion in B’s nonemployment life. Therefore, under the present Nebraska rule, B’s death from a heart attack is compensable. Although it appears that A’s death did not “arise out of employment,” since the 50 units of heart strain from employment exertion is less than the 80 units ordinarily experienced in A’s nonemployment life, nevertheless, under the Nebraska alternative standard, “this or any other person,” A can also establish legal cause necessary for compensability because A experienced employment exertion, 50 units, which is greater than exertion experienced by “any other person” in ordinary nonemployment life, 45 units. Legal cause for A’s death is established, notwithstanding the reality that A’s heart *247attack resulted from employment exertion no greater than, and actually less than, the exertion experienced in A’s ordinary nonemployment activity. The preceding illustration, however, may be suspect on account of the assumption concerning the level of heart strain from exertion in the ordinary nonemployment life of “any other person.”
Commentators have observed:
[I]n an effort to create a universal standard, Larson uses a comparison between the particular employment exertion at issue with “the exertions present in the normal nonemploymentXde of this or any other person.” ...
Larson seeks to examine particular job stress, but does not examine that stress as it relates to a particular individual. Individuals are able to accommodate themselves over a period of time to physical stresses. In addition, individuals react differently to emotional stresses. Therefore, it is necessary to place the numerators (e.g., stress) with their denominators (reactivity of the individual). To consider only if the exertion is the type that is present in the “normal nonemployment life of this or any other person” is to ignore medical realities,
(Emphasis in original.) D. Juge & J. Phillips, A New Standard for Cardiovascular Claims in Workers’ Compensation, 43 La. L. Rev. 17,39-40(1982).
Regarding the “any other person” alternative test for compensability of a heart attack, that is, exertion of the “normal nonemployment life of this [employee] or any other person,” the court in Duvall v. Charles Connell Roofing, 564 A.2d 1132, 1136 (Del. 1989), stated:
Adoption of this rule . . . raises several immediate problems which may defy reasonable solution. First is the matter of definition. Who is the average person in “normal” non-employment life? Second, how is the comparable level of activity in “normal” non-employment life to be determined, and by whom? How does one compare the level of exertion in moving or lifting heavy objects on the job versus strenuous, but “normal” non-employment activities? To what extent is *248one’s personal life to be dissected to fit the equation? While undoubtedly well-intended, this proposal seems unworkable----
See, also, Southern Bell Tel. & Tel. Co. v. McCook, 355 So. 2d 1166 (Fla. 1978) (event on which workers’ compensation claim was based did not “arise out of” employment, when the employee suffered from an idiopathic condition manifested for the first time during the course of employment, since the employee simply bent over to pick up tissue paper, a movement which, due to the idiopathic condition, produced disability).
Under the Workers’ Compensation Act, causation necessary for compensability is determined in reference to a particular employee who has sustained a specific disability from distinctive employment. The question is, Did this particular work-related incident cause this particular person this particular injury? Generally, in a workers’ compensation case, causation does not inquire whether this particular work-related incident actually caused injury to an employee in the same manner as the injury would have been suffered by any other person. For that reason, exertion experienced in the ordinary nonemployment life of any person other than the employee becomes irrelevant to the issue of legal causation necessary for compensability under the Nebraska Workers’ Compensation Act. Also, by injecting nonemployment exertion of “any other person” into the workers’ compensation equation, an employer’s liability turns on the relationship between a fictional individual’s undefined efforts and a real person’s — the worker’s — known activities. If “any other person” meant “a person reasonably identifiable with or similar to” the worker who has sustained a heart attack, perhaps some semblance of particularity might be infused into Nebraska’s alternative test, but that meaning does not exist in the Nebraska workers’ compensation law. Consequently, the test remains and involves the ordinary nonemployment life of “any other person” — female, male, adult, or child. Additionally, the compensability standard involving the ordinary nonemployment life of “any other person” imposes an apparently impossible burden of proof consisting of conjecture or speculation inherent in the “any other person” hypothesis.
*249In a worker’s “heart attack” case, the question is “whether the injury was the result of a personal rather than employment risk. . . . ‘ “The reason is that the employment risk must offset the causal contribution of the personal risk. . . .” ’ ” Sellens v. Allen Products Co., Inc., 206 Neb. 506, 509-10, 293 N.W.2d 415, 417-18 (1980). See, also, Hyatt v. Kay Windsor, Inc., 198 Neb. 580, 254 N.W.2d 92 (1977). “[W]hen the employee contributes some personal element of risk ... the employment must contribute something substantial to increase the risk. The reason is that it must offset the causal contribution of the personal risk.” IB A. Larson, The Law of Workmen’s Compensation § 38.83(b) at 7-278 (1987). Therefore, when legal causation has been established in a workers’ compensation case based on a “heart attack,” there still remains the necessity of establishing medical causation for compensability, that is, “exertion or stress in [the worker’s] employment contributed in some material and substantial degree to cause the heart injury.” Spangler v. State, 233 Neb. 790, 796, 448 N.W.2d 145, 150 (1989). Accord, Mann v. City of Omaha, 211 Neb. 583, 319 N.W.2d 454 (1982); Sellens v. Allen Products Co., Inc., supra; Newbanks v. Foursome Package & Bar, Inc., 201 Neb. 818, 272 N.W.2d 372 (1978).
Consequently, there appears to be a more practical and realistic rule: If an employee has a preexisting coronary condition conducive to a heart attack and suffers a heart attack which is the basis for a workers’ compensation claim, the claimant must prove, by a preponderance of evidence, that, when considered apart from the antecedent condition, the worker’s employment exertion is greater than the employee’s usual nonemployment exertion and that such employment exertion substantially contributed to the employee’s heart attack. The preceding test for compensability of disability or death from an employee’s heart attack meets the requirement that an employee’s personal injury must arise out of employment and avoids hypothetical humans as pseudofactors for an employer’s liability in a very real and particularized employment situation. Moreover, the requirement that employment substantially contributes to an employee’s heart attack forestalls evolution of the Workers’ Compensation Act *250into health or life insurance.
Under the preceding rule proposed, with the exception of eliminating the “any other person” element from the comparison between a worker’s employment exertion and nonemployment exertion, the Nebraska rules for compensability of a heart attack would remain unchanged.
Notwithstanding my objection to the current legal causation test in heart attack cases, appellees supplied a reasonable factual basis for a comparison between the exertion experienced by Kenneth Leitz in his employment and the exertion which he usually experienced in his nonemployment life, evidence which provided a basis for the conclusion that Leitz’ employment exertion was greater than his usual nonemployment exertion. Thus, the proof established that Leitz’ myocardial infarction arose out of his employment with Roberts Dairy. Hence, the award in the Nebraska Workers’ Compensation Court must be affirmed.