Opinion
No. WD 60298
August 13, 2002
Appeal from the Labor and Industrial Relations Commission.
Aldo P. Caller, Kansas City, KS, Attorney for Employee-Respondent.
Michael L. Wilson, Kansas City, MO, Attorney for Employer/Insurer-Appellant.
Before Howard, P.J., and Smith and Newton, JJ.
Mar-Kay Plastics, Inc., appeals from the decision of the Labor and Industrial Relations Commission (Commission) awarding workers' compensation benefits to the respondent, Juan Reyes, for a heart attack he suffered while at work, which the Commission found arose out of and in the course of his employment with the appellant.
The appellant raises three points on appeal. In Point I, it claims that the Commission erred in awarding workers' compensation benefits to the respondent because the evidence was insufficient for the Commission to find, under the "mutual benefit doctrine," that the respondent's alleged compensable injury arose out of and in the course of his employment with the appellant in that the cause of the respondent's heart attack, respondent's heated argument with his wife's supervisors over disciplinary action taken against her, did not confer a substantial benefit upon the appellant. In Point II, it claims that the Commission erred in awarding workers' compensation benefits to the respondent because the evidence was insufficient for the Commission to find, under the "mutual benefit doctrine," that the respondent's heart attack arose out of and in the course of his employment with the appellant in that the respondent's advising his supervisors that he was terminating his employment to allow his employer to assign another employee to his position to prevent clogging of the machines at the appellant's workstation did not confer a substantial benefit on the appellant. In Point III, it claims that the Commission erred in awarding workers' compensation benefits to the respondent because the Commission's finding that the respondent's heart attack arose out of and in the course of his employment with the appellant was against the weight of the evidence in that in finding as it did the Commission found that the testimony of the respondent and the respondent's wife that Reyes had notified the appellant that he was terminating his employment so that the appellant could assign another worker to his position to avoid clogging the machine at the appellant's workstation was credible, which "callously ignores, arbitrarily disregards or capriciously rejects the ALJ's (Administrative Law Judge) disbelief of their testimony and resultant conclusion that Reyes failed to carry his burden of proof."
We affirm.
Facts
On the afternoon of January 9, 1997, the respondent, while working for the appellant, suffered a heart attack. Earlier in the day, the respondent had become upset over a supervisor's treatment of Barbara Cedeno, his common-law wife, who was also employed by the appellant. During the lunch hour, the respondent and his wife met and informed their supervisors that they were quitting and that they needed to get someone else to work at the respondent's workstation. During this meeting, which lasted approximately forty minutes to an hour, an argument ensued, and one of the supervisors stated that, if the respondent and Cedeno did not return to work, they would not be paid for that day's work. During the argument, the respondent became pale, started to perspire, experienced shortness of breath, and felt a pain in the middle of his chest. However, because the supervisor had threatened not to pay him for the time he had already worked, the respondent returned to his workstation.
The respondent's job was to drag containers filled with plastic waste, which weighed 50 to 100 pounds, to a grinding machine. The respondent had to climb three or four steps to the grinder, remove some of the plastic waste by hand, lift the container over his head to the edge of the grinder, and empty the remaining plastic waste into the grinder. The respondent would then return the empty container to the machine, exchange it for a filled container, and repeat the process.
After the respondent had returned to his job, he began to perspire more profusely, continued to experience shortness of breath, and then collapsed. An ambulance was called, and while the paramedics were evaluating the respondent, he went into cardiac arrest. The paramedics inserted an endotracheal tube and defibrillated the respondent seven to eight times. He was then transported by ambulance to the emergency room at North Kansas City Hospital where he was reintubated with a larger tube and defibrillated again.
Immediately after the respondent regained consciousness, he could not see, speak, or walk. He was diagnosed with cortical blindness, mild ataxia, and cognitive deficits and behavioral changes due to hypoxic brain injury from myocardial infarction. Although the respondent eventually regained his eyesight, ability to speak, and ability to walk, he continued to experience problems including shortness of breath, loss of strength, memory loss, loss of peripheral vision, difficulty with speaking, lack of hand-eye coordination, personality changes, depression, and leg tremors.
On March 20, 1997, the respondent filed a claim for compensation with the Workers' Compensation Division of the Missouri Department of Labor and Industrial Relations. His claim was heard by an administrative law judge (ALJ) over three days, October 21, 1999, November 5, 1999, and February 25, 2000.
Dr. James E. Davia, a specialist in cardiology, testified via deposition as an expert witness on behalf of the appellant. Dr. Davia described the basic mechanism of a heart attack, in which a person has a narrowing in an artery due to a buildup of cholesterol plaque. According to Dr. Davia, the surface of the plaque becomes so thin that a fissure or rupture occurs, and the inside contents of the plaque are exposed to the blood flowing by, which causes a blood clot to form. The blood clot, or thrombus, increases in size until it occludes the artery, resulting in a heart attack. According to Dr. Davia, it was most likely that the respondent's coronary artery became totally occluded during his argument with company supervisors, which he said was most likely the triggering factor of the respondent's heart attack. In Dr. Davia's opinion, the respondent's work activities after the argument did not make "any difference because I think the infarction was already in progress."
Dr. Gerald B. Lee, a specialist in cardiology, internal medicine, and forensic pathology, testified via deposition as an expert witness on behalf of the respondent. According to Dr. Lee, it was most likely that, while the respondent had some occlusion of his artery at the time of the argument, the respondent's artery did not become totally occluded until after he had resumed his work activities that afternoon. It was Dr. Lee's opinion that the physical exertion from the respondent's afternoon work activities was a substantial factor in the heart attack. Dr. Lee opined that both the argument with company supervisors and the respondent's work activities in the afternoon were substantial factors contributing to the respondent's heart attack.
On May 23, 2000, the ALJ denied the respondent's claim for benefits, finding that the respondent had failed to prove that his heart attack was an injury resulting from an accident arising out of and in the course of his employment. On June 12, 2000, the respondent applied to the Commission for review of the ALJ's decision. On June 29, 2001, the Commission, having reviewed the record, reversed the decision of the ALJ, finding that the respondent's injury did arise out of and in the course of his employment. In so holding, the Commission made the following conclusions of law:
Claimant could have simply left employer's workplace after signing out on January 9, 1997. Instead, claimant conferred a benefit on employer by informing the supervisors that he was quitting and that they would need to get another worker to empty the containers of plastic waste. The evidence is undisputed that if claimant did not empty the containers of plastic waste in a timely manner, employer's machines would clog. In the course of the noon meeting, employer, by threatening to withhold claimant's pay, convinced claimant not to quit and to return to his job. Although claimant had intended to quit his job with employer, the argument involving claimant and the supervisors resolved that dispute between claimant and employer. The evidence demonstrates that the argument involving claimant and the supervisors was a natural and reasonable incident of the work.
It is undisputed that when claimant returned to work following the argument, he was working at his assigned work site, performing the regular duties of his job, as well as the work of two others. Claimant satisfied his burden of proving that he sustained an accident and injury arising out of and in the course of his employment.
. . .
Dr. Lee credibly testified that both the noontime argument and claimant's afternoon work activities were substantial factors in causing his myocardial infarction. Dr. Lee's credible opinions persuade us that claimant's myocardial infarction and resulting brain injury, were caused by his employment while working for employer on January 9, 1997. Claimant established medical causation.
The Commission awarded the respondent permanent total disability benefits of $175 per week from the date of the accident, and ordered the appellant to pay past medical expenses and provide future medical treatment for the respondent.
This appeal follows.
Standard of Review
Our review is governed by § 287.495.1, which provides, in relevant part:
All statutory references are to RSMo 2000, unless otherwise indicated.
Upon appeal no additional evidence shall be heard and, in the absence of fraud, the findings of fact made by the commission within its powers shall be conclusive and binding. The court, on appeal, shall review only questions of law and may modify, reverse, remand for rehearing, or set aside the award upon any of the following grounds and no other:
(1) That the commission acted without or in excess of its powers;
(2) That the award was procured by fraud;
(3) That the facts found by the commission do not support the award;
(4) That there was not sufficient competent evidence in the record to warrant the making of the award.
"We review decisions of the Commission which are clearly interpretations or applications of law for correctness without deference to the Commission's judgment." Wiele v. Nat'l Super Mkts., Inc. , 948 S.W.2d 142, 145 (Mo.App. 1997) (citations omitted) . Findings of ultimate facts which are reached through the application of rules of law, rather than by natural reasoning based on facts alone, are conclusions of law. Id . Where the evidentiary facts are not in dispute, the Commission's award becomes a question of law. Id .
I.
All three of the appellant's claims on appeal assume that the sole cause found by the Commission for the respondent's heart attack, justifying its award of benefits, was the respondent's argument with company supervisors over the disciplining of his wife and the attendant circumstances. With this as a given, the appellant proceeds to attack the Commission's finding that the respondent's injury arose out of and in the course of his employment by contending that the mutual benefit doctrine did not apply to justify an award of benefits. This strategy, of course, ignores the fact that the Commission found that both the respondent's argument with company supervisors and his work activities, after he acquiesced to a company supervisor's demand that he return to work, were substantial factors in causing the respondent's heart attack. As we discuss, infra, the Commission does not have to find that the respondent's employment was the sole or primary cause of the alleged compensable injury, but only that it was a substantial factor in causing the injury. Thus, even if the appellant's claims in Points I, II, and III are assumed correct such that benefits would not be proper under the mutual benefit doctrine for the circumstances surrounding the respondent's argument with company supervisors, the appellant still would not be entitled to the appellate relief it seeks inasmuch as the respondent's work activities on the afternoon of the heart attack, as found by the Commission, would in and of themselves be sufficient bases to support the Commission's decision that the heart attack arose out of and in the course of the claimant's employment, and thus was a compensable injury.
Section 287.120.1 of the Workers' Compensation Act provides for compensation for an injury to an employee arising out of and in the course of employment. In order to recover under that section, the employee has the burden of proving, by a preponderance of the evidence, that his or her injury arose out of and in the course of his or her employment. Jemison v. Superior Auto Mall , 932 S.W.2d 431, 434 (Mo.App. 1996). "'In the course of employment' refers to the time, place and circumstances of the injury." Id . (citation omitted) . "'Arising out of' means that a causal connection exists between the employee's duties and the injury." Id . (citation omitted) . An injury arises out of employment if it is a natural and reasonable incident of the employment. Id . An injury is only compensable if it is clearly work related, and an injury is clearly work related if work was a substantial factor in the cause of the resulting medical condition. Section 287.020.2.
The statutory test for determining whether an injury has "arisen out of and in the course of employment" in order to justify an award of workers' compensation benefits is contained in § 287.020.3(2), which reads:
An injury shall be deemed to arise out of and in the course of the employment only if:
(a) It is reasonably apparent, upon consideration of all the circumstances, that the employment is a substantial factor in causing the injury; and
(b) It can be seen to have followed as a natural incident of the work; and
(c) It can be fairly traced to the employment as a proximate cause; and
(d) It does not come from a hazard or risk unrelated to the employment to which workers would have been equally exposed outside of and unrelated to the employment in normal nonemployment life[.]
To satisfy the substantial factor element found in § 287.020.3(2)(a), the Commission does not have to find that the employment was the sole or primary cause of the alleged compensable injury, but only that it was a substantial factor in causing the injury. Cahall v. Cahall , 963 S.W.2d 368, 372 (Mo.App. 1998); Cook v. St. Mary's Hosp. , 939 S.W.2d 934, 939 (Mo.App. 1997) .
In our case, the Commission determined, in its conclusions of law, that not only was the respondent's argument with company supervisors a substantial factor in causing his heart attack, but so were his work activities that afternoon. In that regard, the Commission concluded:
It is undisputed that when claimant returned to work following the argument, he was working at his assigned work site, performing the regular duties of his job, as well as the work of two others. Claimant satisfied his burden of proving that he sustained an accident and injury arising out of and in the course of his employment.
. . .
Dr. Lee credibly testified that both the noontime argument and claimant's afternoon work activities were substantial factors in causing his myocardial infarction. Dr. Lee's credible opinions persuade us that claimant's myocardial infarction and resulting brain injury, were caused by his employment while working for employer on January 9, 1997. Claimant established medical causation.
The appellant does not attack on appeal the Commission's conclusion that the respondent's work activities after the argument with company supervisors were a substantial factor in causing his heart attack. As such, the Commission's conclusion in that regard stands, and applying the law that the Commission does not have to find that the employment was the sole or primary cause of the alleged compensable injury, but only that it was a substantial factor in causing the injury, the appellant fails to carry its burden of raising on appeal all the issues necessary for us to determine in its favor entitling it to the relief sought. Landry v. Miller , 998 S.W.2d 837, 840 (Mo.App. 1999), abrogated on other grounds by In re McIntire , 33 S.W.3d 565, 567 (Mo.App. 2000).
Conclusion
The Commission's award of workers' compensation benefits to the respondent is affirmed.
Howard, P.J., and Newton, J., concur.