| IN RE: ARVID ANDERSON | ) | DOCKET NO. 65170 |
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| CLAIM NO. S-392837 | ) | DECISION AND ORDER |
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- APPEARANCES
- Claimant, Arvid Anderson, by
- Maxey Law Offices, per
- Dana C. Madsen
- Self-insured Employer, Kaiser Aluminum & Chemical Corporation, by Winston & Cashatt, per
- Stanley D. Moore and Michael J. Cronin
This is an appeal filed by the claimant on June 20, 1983 from an order of the Department of Labor and Industries dated May 26, 1983 which closed this claim with a permanent partial disability award, for an injury to the claimant's neck, equal to 20% as compared to total bodily impairment. Reversed and remanded.
DECISION
Pursuant to RCW 51.52.104 and RCW 51.52.106, this matter is before the Board for review and decision on timely Petitions for Review filed by the claimant and the employer to a Proposed Decision and Order issued on December 16, 1985 in which the order of the Department dated May 26, 1983 was reversed and the claim remanded with instructions to reopen the claim, accept the claimant's cardiomyopathy as causally related to the industrial injury, and take such further action as is appropriate and indicated. [2]
The Board has reviewed the evidentiary rulings in the record of proceedings and finds that no prejudicial error was committed and said rulings are hereby affirmed.
The general nature and background of this appeal are as set forth in the Proposed Decision and Order, and shall not be reiterated in detail herein.
The question before us is whether any condition involving Mr. Anderson's heart is causally related to his industrial neck injury of January 13, 1981. It is initially noted that Mr. Anderson has three distinct conditions relating to his heart, namely, cardiomyopathy, mitral valve prolapse, and cardiac arrythmia. The medical evidence establishes, without dispute, that the first two of these three conditions pre-existed Mr. Anderson's industrial injury of January 13, 1981. A history of excessive alcohol consumption emerges as the most likely cause of Mr. Anderson's cardiomyopathy, whereas his mitral valve prolapse is most likely congenital in origin.
There is, however, a causal link between Mr. Anderson's cardiac arrythmia and his industrial injury. The medical evidence clearly shows that this condition, variously referred to in the record as atrial fibrillation, cardiac palpitations and tachycardia/bradycardia, directly arose as a result of the stress attendant to Mr. Anderson's industrial neck surgery in May, 1981. It is, of course, settled law that the consequences of treatment for an industrial injury are considered to be part and parcel of the injury itself. Anderson v. Allison, 12 Wn. 2d 487 (1942); Ross v. Erickson Construction Co., 89 Wash. 634 (1916). Dr. Albert H. Reisig, Jr., a cardiologist and Mr. Anderson's attending doctor for his cardiac arrythmia, testified that [3] the neck surgery of May, 1981, did not worsen or increase Mr. Anderson's pre-existing conditions of cardiomyopathy and mitral valve prolapse. His testimony further establishes that Mr. Anderson's cardiac arrythmia was still being treated, and in need of further treatment, as of the date of the Department's closing order herein. Accordingly, since at least part of Mr. Anderson's industrially-related condition was not fixed, any question as to the extent of permanent disability attributable to his industrial injury of January 13, 1981, is premature, and not appropriate to be decided in this appeal.
FINDINGS OF FACT
Findings 1 and 2 of the Proposed Decision and Order entered in this matter on December 16, 1985, are hereby adopted by the Board and incorporated herein as the Board's Findings 1 and 2. In addition, the Board finds:
3. The claimant has conditions involving the heart diagnosed as cardiomyopathy and mitral valve prolapse. Both of these conditions pre-existed the claimant's industrial neck injury of January 13, 1981, and are wholly unrelated thereto. Neither condition was aggravated or worsened by the claimant's industrial neck surgery of May, 1981.
4. As a result of the claimant's industrial neck surgery of May, 1981, and the stress attendant thereto, the claimant developed a condition of the heart diagnosed as cardiac arrythmia. This condition was not fixed but was in need of further treatment as of the date of the Department's closing order of May 26, 1983.
CONCLUSIONS OF LAW
- The Board of Industrial Insurance Appeals has jurisdiction of the parties and subject matter of this appeal.
- The order of the Department of Labor and Industries dated May 26, 1983, closing this claim with a permanent partial disability award of 20% as compared to total bodily impairment for the [4] claimant's cervico-dorsal condition, is incorrect, and should be reversed, and this claim remanded to the Department with instructions to reopen the claim and direct the self-insured employer to accept responsibility for the claimant's cardiac arrythmia, provide treatment therefor, and to take such order and further action as may be authorized or required by law.
It is so ORDERED.
Dated this 22nd day of July, 1986.
BOARD OF INDUSTRIAL INSURANCE APPEALS
/s/
GARY B. WIGGS Chairperson
/s/
FRANK E. FENNERTY, JR. Member
DISSENTING OPINION
I agree with the Board majority, to the extent that they find that the claimant's cardiac arrhythmias occurring in May, 1981 were produced by the stresses attendant to his industrial neck surgery at that time, acting upon his pre-existing cardiomyopathy and mitral valve prolapse.
However, it is clear to me that those surgery-connected episodes constituted temporary aggravations only. Whatever later cardiac arrhythmic symptoms the claimant has had are not continuations of those which developed in 1981, but new episodes manifesting the underlying unrelated conditions of cardiomyopathy and/or mitral valve prolapse. To me, the controlling expert opinion on this point is that of Dr. Reisig, cardiologist who monitored and attended the claimant in 1981, and performed further heart evaluations in November, 1983 and November, 1984. The doctor's key testimony was as follows: [5]
"Q. (By Mr. Moore) Doctor, as I understand it, you indicated the arrhythmia is physically caused by the cardiac myopathy and the mitral valve prolapse in some combination of one.
A. Most likely.
Q. The actual arrhythmic symptoms are probably brought on by whatever stresses he has in his daily life.
A. Aggravated and more frequent because of that.
Q. If he were able to be very relaxed and not stressed, then it would be likely that he would have less symptoms of arrhythmia?
A. Correct.
Q. As I understand it from your testimony previously, you have stated that the specific arrhythmic condition that he experienced in May of 1981 was related to the surgery and the pre-surgery induction he experienced at that time and the stresses or anesthesias related to that.
A. More likely than not.
Q. But since that time, any arrhythmic symptoms that he's had have been related to a combination of the pre-existing myocardial myopathy and the mitral valve prolapse and whatever stresses he has experienced at the time he has the arrhythmia.
A. Yes.
Q. And the stresses from the surgery are not related to these later arrhythmic situations.
A. Correct."
And further:
"Q. Would it be fair to state, Doctor, that whatever effect the surgery had, and whatever it was at the time of surgery, whether it was stress or the anesthesia, whatever it was, but what you saw at the time of the surgery and what they saw prior to surgery that was causing the arrhythmia was a temporary aggravation that ceased by the time you saw him in November of 1983? [6]
A. Correct."
Furthermore, since 1981 the claimant has had less heart symptoms and arrhythmic episodes, and his myopathy appears to have improved, according to Dr. Reisig as well as his family physician, Dr. Paul Russell. Claimant is taking prescribed medications for his heart, to control the underlying conditions and to prevent arrhythmic episodes, and to mitigate such episodes as do occur. Clearly, this is sound medical management; but payment for such ongoing treatment, as of May, 1983 and into the indefinite future, is not the responsibility of this claim.
All the medical evidence agrees that whatever permanent disability the claimant may have at or near the closing date from his heart condition is not related to his industrial neck condition. Furthermore, this record establishes that, since the industrial injury and the neck surgeries performed for it in May and November, 1981, the claimant has developed additional conditions of peripheral neuropathy, diabetes, and some rheumatoid arthritis. These developments may well partly explain why he chose a retirement pension from Kaiser as of December 31, 1982, and is also now receiving a Social Security disability pension. None of these more recently developing conditions, of course, are related to the January, 1981 neck injury.
As to the correct evaluation of claimant's permanent disability due solely to the neck injury, the record fully supports the permanent partial disability award based on Category 3 of permanent cervical-dorsal impairments.
In sum, I would direct acceptance of responsibility under this claim for whatever medical attention and treatment was rendered for the [7] claimant's cardiac arrhythmia episodes connected with the May, 1981 surgery (and perhaps such further treatment as may have been given for further cardiac arrhythmia problems, if any, up through the November, 1981 surgery). Otherwise, I would affirm the Department closing order of May 26, 1983.
Dated this 22nd day of July, 1986.
/s/
PHILLIP T. BORKMember