Court Opinion

ID: 9645499
Source: CourtListenerOpinion
Date Created: 2023-08-22 21:26:58.204616+00
Date Added: 2024-06-11T13:13:30.366413
License: Public Domain

NEBEKER, Associate Judge,
concurring:
I agree with my colleagues that Washington Metropolitan Area Transit Authority v. District of Columbia Department of Employment Services, 506 A.2d 1127 (D.C.1986) (WMATA), compels us to remand this case to the Department for a determination whether the decedent’s heart failure was a compensable “accidental ... death arising out of and in the course of employment.” D.C. Code § 36-301(12) (1981). In WMATA, this court deferred to the Department’s use of the “human frame” test for what constitutes an “accidental injury or death” under the statute and specifically rejected the contention that such language contemplates proof of an unusual occurrence. 506 A.2d at 1129-30. *710Hence, inasmuch as the Department in this case associated accidental injuries or death with those resulting from unusual incidents, I believe this court is bound under the rule of M.A.P. v. Ryan, 285 A.2d 310 (D.C.1971), to follow WMATA and remand for agency reconsideration.
However, while WMATA ties our hands, its holding is not set in concrete because the Department on remand is free to rethink this, or any, case and adopt any reasonable interpretation of the statute it deems warranted. For the reasons stated below, I feel such reconstruction by the agency is particularly called for here. Nevertheless, if on remand the Department is content with the human frame standard of WMA-TA, it should, in my view, award compensation only if it determines as part of this analysis that the decedent’s heart failure was a clinically unexpected occurrence. That is, a finding by the Department that “something unexpectedly went wrong within the human frame” should not be predicated solely on a determination that the decedent himself was surprised. Of course, the analysis I would require might necessitate the taking of additional evidence and, accordingly, a remand to the Department’s hearing examiner.
With regard to the human frame standard itself, I consider it an amorphous test which has no place in this already difficult area of workers’ compensation. To say, in this case alone, that the Department erred as a matter of law because it did not consider whether something unexpectedly went wrong within the decedent’s human frame, attests to the fact that such language is now deemed the dispositive standard. Yet, it is puzzling to me how this language became talismanic. In WMATA, we simply deferred to the Department's use of the “human frame” test as a reasonable interpretation of prevailing law. 506 A.2d at 1130. Citing only Wheatley v. Adler, 132 U.S.App.D.C. 177, 181 n. 6, 407 F.2d 307, 311 n. 6 (1968), and Commercial Casualty Insurance Co. v. Hoage, 64 App. D.C. 158, 159, 75 F.2d 677, 678, cert. denied, 295 U.S. 733, 55 S.Ct. 645, 79 L.Ed. 1682 (1935), we observed in WMATA that “[o]ur courts had repeatedly held that the requirement of ‘accidental injury’ is satisfied ‘if something unexpectedly goes wrong within the human frame.’ ” 506 A.2d at 1129. Such a “holding,” however, is in fact conspicuously absent in . Wheatley and Hoage given that the issue actually presented in each case was whether the injury arose out of and in the course of the employment, not whether the injury could be considered accidental. And although these words appear in Hoage v. Royal Indemnity Co., 67 App.D.C. 142, 145, 90 F.2d 387, 390, cert. denied, 302 U.S. 736, 58 S.Ct. 122, 82 L.Ed. 569 (1937), a decision relied upon heavily by the majority here and one which does address specifically the issue of “accidental injury,” the language is taken from the dicta in the earlier Hoage opinion. It does not purport to be the definitive interpretation. Hence, in light of its dubious development in our law, I am not surprised that the human frame standard was not applied by the Department in this case. See ante at 708, n. 5. Plainly, the Department, the agency charged with administering our workers’ compensation laws, did not view the standard as engrained as the majority now views it.
Nonetheless, I believe the human frame standard as articulated in WMATA and accepted by my colleagues here is unworkable and is likely to indulge employer liability where none should exist. To be sure, the additional requirements that a compen-sable injury arise out of and in the course of employment will preclude recovery in many truly meritless cases. However, I perceive a great many other meritless claims in which the injury alleged will satisfy these causation criteria and be compen-sable under the tolerant standard of something unexpectedly having gone wrong within the human frame. Consider, for example, the case of a 65-year-old obese chain smoker who, against the advice of doctors, returns to his job as a construction foreman following recovery from a mild heart attack. On a particular day, this *711hypothetical person engages in strenuous physical labor to alleviate an unanticipated crew shortage. Shortly after work, the person goes home and suffers a massive coronary from which he dies. Quite conceivably, expert witnesses would testify, and the Department would conclude, that this death arose out of and in the course of the strenuous employment. Death benefits should then be awarded, it seems, provided there is evidence (even if controverted) that what went “wrong” within the decedent’s “human frame” — the massive coronary, presumably — was not to be expected under the circumstances. And, I should think that such an opinion might readily be held by a plaintiffs expert where, to add to my hypothetical, following the decedent’s recovery from his first attack he withstood several weeks of similarly strenuous labor.
I would not countenance an award of compensation under these circumstances. Yet, as I view it, the standard relied upon by the majority today clears the way for recovery in such instances, and countless others where, if relief is to be provided, explicit legislation should provide it. If, however, we are constrained to apply such a test, I would stress that an accidental injury within the context of the statute is one which is truly unexpected. Thus, where the majority concludes that “[a] heart attack clearly can meet [the] test” that “the injury, to be ‘accidental,’ need only be something that unexpectedly goes wrong with the human frame,” ante at 709,1 would add that this will be true only if the heart attack is indeed unexpected in a most objective sense.
Finally, with regard to whether the death here arose out of and in the course of employment, I would require upon remand, and not simply permit, that the Department independently consider this question if it determines first that the decedent’s heart failure constituted an accidental death within the meaning of § 36-301(12), i.e., an objectively unexpected event under all the facts. A careful review of the final compensation order reveals that the issue of causation — “work-connectedness” in agency parlance — was raised but never decided because the Department rejected on legal grounds the claim that there had been an “accidental death” under the statute. Therefore, in my view, if the heart failure is found factually to be an accidental death, the Department must address for the first time the critical question of causation if it is to deem the death compensable. See generally 7 DCMR § 230.1 (1986); D.C. Code § 36-322(b) (1981). Since the issue was properly preserved by exception, it is not enough to say, as the majority does, ante at 707 that “[t]he Director’s final decision did not address, let alone question, the hearing examiner’s rulings on causation and work-relatedness: that Mr. Jones’ death arose out of and in the course of employment.” Nor is it fair to deny the employer complete review because the Department failed explicitly to rule in the alternative. See ante at 707 n. 4.
Finally, there being a justiciable question of causation on remand if decedent’s heart failure is deemed an accidental death, the Department is free to decide whether, as a matter of law, its “unusual exertion” requirement for cases involving a pre-exist-ing heart condition is met by emotional stress attendant to disciplinary proceedings. See WMATA, supra, 506 A.2d at 1130 n. 5; George Hyman Construction Co. v. District of Columbia Department of Employment Services, 497 A.2d 103, 106 n. 2 (D.C.1985).