Court Opinion

ID: 9669766
Source: CourtListenerOpinion
Date Created: 2023-08-24 03:09:09.847231+00
Date Added: 2024-06-11T18:16:00.192365
License: Public Domain

*574Lee, J.
Mrs. Alice Dinsmore, in her claim for workmen’s compensation benefits against the Insurance Department of Mississippi and its carrier, was granted an award by the attorney-referee. On successive appeals by the defendants, the award was affirmed both by the commission and the circuit court. and they have brought' this appeal here.
In the meantime Mrs. Dinsmore died on November 1, 1957, and the action has been revived in the name of R. R. Dinsmore, the lawfully appointed administrator of her estate.
The claimant was sixty years old, and her weekly wage was in excess of $37.50. For many years she had been an employee of the Insurance Department, and had risen to the position of deputy commissioner. Her duties were both clerical and executive. It was shown that she was a perfectionist, loyal and very conscientious, but at the same time irritable, high tempered, high-strung, and not disposed to delegate these duties to others. In fact, she resented any effort to decrease her work. While her work load had been substantially reduced, still she kept just as busy as before. She was very exacting of her subordinates. The first four months of the year was *575the period of greatest activity in the office, with the consequent increased stress and strain.
The claimant had been afflicted with hypertension or high blood pressure for sometime. In fact, she suffered a mild stroke on February 27, 1951, and another on April 8, 1953. In spite of these attacks, she continued to work with little, if any, interruption. In the afternoon of May 4, 1955, she had been signing her mail. Either because she was going to be off the next day, or because Commissioner Davis would be working, she was seated at her desk trying to line-up the work, that is, making notes. While doing this, she became unconscious and suffered the disability for which claim was made.
Drs. L. T. Carl, Charles L. Neill, and John G-allogly were offered as witnesses by the claimant. Dr. Carl, who had treated Mrs. Dinsmore for several years, and who was present when she regained consciousness; made an elaborate report in which he included her history. The examination, following the April 1953 attack, showed her blood pressure was 225/115. His diagnosis as to the May 4, 1955 attack was as f ollows: “ (1) Hemiplegia, left, due to (2) Thrombosis, right middle cerebral artery and (3) Hypretensive cardiovascular disease.” His opinion as to the relationship between her work and the attack was as follows: “It is my impression that her job was a rather responsible one, and in a busy office surely carried with it a certain degree of tension and nervous strain. This probably contributed to the hypertension, which indirectly was one factor in the production of her attack of 4 May 1955. In this manner, it was, in my opinion, contributory. However, I would not state that it was responsible for the vascular changes which usually precede thrombosis.”
Dr. Neill, who also attended Mrs. Dinsmore, said that intense activity can aggravate hypertension, and that he did not know of any practitioner who, in view of her hypertension in 1953, would not have advised her to re*576duce her activity. He was submitted a hypothetical question, embracing the claimant’s traits, the nature of her employment, and the manner in which she performed her duties, and was asked whether her attitude toward her work and her activity in the department contributed to the attack of May 4, 1955. His reply was, “Yes, as long as you remember this could have happened anyway. ’ ’
Dr. G allogly, who had been a consultant to her on August 1, 1955 and June 23, 1956, was of the opinion that the work load which Mrs. Dinsmore carried, coupled with her type of person, aggravated her hypertension.
Dr. S. H. McDonnieal, an internal medicine man, and Dr. William H. Rosenblatt, a specialist in the cardiovascular diseases, as witnesses for the defendants, discussed the difference between a cerebral thrombus and a cerebral hemorrhage. They attributed the thrombus to a disease known as arteriosclerosis, which, because of deposits of cholesterol, causes a decrease in the size of the arteries and diminshes the blood supply, thus increasing the chance of the formation in the blood of a clot, or thrombus. On the contrary, the elevated blood pressure speeds the flow of blood, thus reducing the chance of a clot, but increasing the chance of a cerebral hemorrhage. Dr. McDonnieal conceded that stress and strain in a pre-existing hypertensive can aggravate the patient’s condition. He was of the opinion that, with a blood pressure of 225/115 in April 1953, Mrs. Dinsmore’s activity should have been decreased; and that, to some extent, it was dangerous for her to continue her work. He admitted that loss of consciousness may occur either from a thrombus or hemorrhage, and that, although it was not done in her case, a spinal puncture is useful to determine which of these is the cause. While expressing the opinion that there was no connection between her work and the formation of a thrombus, he conceded that hypertension could possibly be a contributing factor in the end result of a thrombus, although unlikely.
*577Dr. Rosenblatt was of the opinion that in the absence of other impairment a curtailment of activities is unnecessary, and that there was no connection between what Mrs. Dinsmore was doing and the attack.
Neither Dr. McDonnieal nor Dr. Rosenblatt had seen or examined claimant. Their opinions were based on hypothetical questions. Dr. McDonnieal conceded that the attending physician is in better position to know what has happened to the individual patient, but Dr. Rosenblatt, because of his experience, thought that his opinion should not be discounted to any extent merely because he had not attended Mrs. Dinsmore.
The appellants contend that the relentless and inexorable march of a disease or condition of life is not a compensable injury arising out of and in the course of employment simply because the disability manifested itself during a period of employment. They say that the disability must result either from traumatic injury, or precipitation of a dormant condition by specific exertion, or from the special hazard of the work not experienced by the public generally. They contend that appellee’s proof is insufficient to show a causal relation between her employment activity and her subsequent disability. They cite a large number of cases, which, they contend, sustain their views.
But Dr. Carl attributed the paralysis to thrombus and hypertension. He said that Mrs. Dinsmore’s duties probably produced a certain degree of stress and strain which contributed to her hypertension; and that hypertension was one factor in producing the attack. Corroboration for that conclusion is found in the testimony of Dr. Neill; and Mr. McDonnieal conceded it as a possibility.
Dunn’s Mississippi Workmen’s Compensation Section 94, pp. 75-6, contains a good statement of the holding of our cases with reference to the relationship of work to disability, to-wit: “While disability or death from the physical or medical standpoint must arise out of employ*578ment as a proximate result, 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 substantial contributing causal connection is found, the claim is fully compensable without apportionment or deduction. Moreover, causal connection is viewed from the standpoint of the injured employee, and pre-existing disease or infirmity does not disqualify the claim if it be found that the employment aggravated, accelerated or combined with the disease or infirmity to produce the disability or death for which claim is made.” The above text lists many decided cases, beginning with Ingalls Shipbuilding Corporation v. Byrd, 215 Miss. 234, 60 So. 2d 645, and continuing up to and including Prentiss Truck and Tractor Co. v. Spencer, (Miss.) 87 So. 2d 272. Compare Nicholas Co. v. Dodson (Miss.) 99 So. 2d 666, and Harper Foundry and Machine Co. v. Harper, (Miss.) 100 So. 2d 779.
In Cowart v. Pearl River Tung Co., 218 Miss. 472, 67 So. 2d 356, the woman suffered a “massive cerebral vascular accident,” while stooping over, as she had been doing previously, to pick up the tung nuts. This caused the blood to rush to the head, and at least contributed to the accident. That was physical exertion.
In W. G. Avery Body Company v. Hall, 224 Miss. 51, 79 So. 453, one of the contributing factors was that the claimant “was doing work which he was not qualified to do and which he did not usually do.” This would indicate that there was both physical and emotional exertion.
 It seems to be implicit in the medical evidence that hypertension can be aggravated by either physical or mental and emotional exertion. In other words, a victim of this malady might suffer disastrous effects from running up a flight of steps. On the other hand, the shock, occasioned by the receipt of a death message, might produce a like result. Mrs. Dinsmore, in order to serve all persons desiring to transact business with *579the Department during a given day, often ate lunch, in the office. When she was successful in this aim to see all callers, undoubtedly she experienced elation, with practically the same effect as excitement. On the contrary, if she did not attain this objective, no doubt she had a feeling of disappointment and frustration. In either event, there was the stimulus for an accelerated blood pressure, stemming from her zealous effort, although misguided perhaps, to discharge her duties and perform her work efficiently. Immediately before the stroke, either because she was to be out of the office the next day, on account of which the affairs might not run smoothly, or because she was expecting her employer, and for that reason desired to have the records ready for his consideration, she doubtless exceeded her employer’s expectations and perhaps worked above and beyond the call of duty. It seems unthinkable that, if hypertension may be aggravated either by physical or mental and emotional exertion, courts should be willing to accept the physical as causative, but reject, as not accidental, a disability, proximately resulting from mental and emotional exertion. Unless the provisions of the Workmen’s Compensation Act apply in such a case as this, its value is lessened insofar as office workers are concerned.
Of course an employer takes his employees as they are. Some may be indolent. Others may be exceptionally energetic. Some may have little appreciation of potential danger. Others may be unduly alarmed over possible perils. The disposition to give a full day’s work for a full day’s pay is certainly not to be frowned upon. It is commendable when an employee strives to perform her duties efficiently and merit the confidence reposed by her superior. While her effort may be more than demanded, such devotion can hardly justify a demerit against her deportment. If Mrs. Dinsmore, in her then state of health, had been motivated by self-interest, undoubtedly she wrould have greatly curtailed her activities. *580No doubt most people, in like circumstances, would have done so. Thus it may be said that, under all of the circumstances, she was guilty of negligence in failing to do what a reasonable person would have done. But even so, such negligence can play no part in this case, because under the provisions of the Workmen’s Compensation Act, negligence does not bar a recovery.
 On such a highly technical issue arising by reason of the divergent viewpoints of learned doctors, it should not be expected that this Court can, or will, undertake to adjudicate that the attack in question resulted solely from a thrombus or clot, and that the increased blood pressure, owing to the stress and strain of the claimant’s work activities, could have had nothing whatever to do with her disability. Especially is this true when it is borne in mind that there was ample evidence from which the triers of fact were warranted in finding that the aggravation of the claimant’s pre-existing* hypertension was one of the factors which contributed to the attack.
 Cases too numerous to mention have announced the rule that this Court will not vacate or set aside an award where the finding of the Commission, on a disputed question of fact, is supported by substantial evidence.
From which it follows that the judgment of the circuit court must be, and is, affirmed.
Affirmed.
All Justices concur except Roberds and Gillespie, JJ., who dissent.