| IN RE: ANN WOOLNOUGH | ) | DOCKET NO. 85 2816 |
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| CLAIM NO. S-759286 | ) | FURTHER DECISION AND ORDER ON REMAND FROM SUPERIOR COURT |
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- APPEARANCES
- Claimant, Ann Woolnough, by
- H. Frank Stubbs, per
- William L. Shaffer
- Employer, Tacoma School District, by
- Kane, Vandeberg, Hartinger and Walker, per
- James Verellen, Darrell B. Addington, and
- Darija Lovrin, Claims Administrator
This is an appeal filed by the claimant on October 1, 1985 from an order of the Department of Labor and Industries dated August 6, 1985 which adhered to the provisions of an order dated March 27, 1985. That order rejected the claim for the reasons that there was no proof of a specific injury at a definite time and place in the course of employment; that the condition was not the result of an industrial injury as defined by the industrial insurance laws; and that the condition was not an occupational disease. Affirmed.
PROCEDURAL HISTORY
On January 21, 1987 a Proposed Decision and Order was entered, sustaining the Department order of August 6, 1985. On March 30, 1987 this Board entered an Order Denying Petition for Review filed by the claimant on March 16, 1987 in response to the January 21, 1987 Proposed Decision and Order. On April 27, 1987 the claimant appealed to the [2] Superior Court for Pierce County. Pursuant to an order upon stipulation of parties entered in the Superior Court for Pierce County on March 20, 1989, this matter was remanded to the Board with direction to reconsider the record developed at the original hearings in this matter and issue a new Decision and Order which fully considers changes in the applicable law to this case, to wit, Dennis v. Dept. of Labor & Indus., 109 Wn.2d 467 (1987). The Superior Court order was received at the Board on May 25, 1989.
DECISION
Although this case was originally tried on the basis that Ms. Woolnough suffered either from an industrial injury or an occupational disease, we interpret the remand from Superior Court as limiting our reconsideration to the question of whether Ms. Woolnough suffers from an occupational disease. The Superior Court remand clearly directs the Board to reconsider its decision based on the Dennis decision, supra, which decision had no impact on the law relating to the definition of an industrial injury. Therefore we stand by our earlier determination that Ms. Woolnough did not sustain an industrial injury, and our discussion of the evidence and law will be restricted to that which is necessary to a proper analysis of whether Ms. Woolnough suffers from an occupational disease.
Ann Woolnough was 40 years old at the time of her hearing in July of 1986. Since her graduation from high school in 1963 she has worked in a variety of occupations. In 1975 she began her employment with the Tacoma School District in skilled clerical positions. In December of 1982 she was promoted to the position of Accounting Technician 3 in the business office. This job included responsibilities with the revolving [3] fund account, advance travel fund account, copy center order forms, and all the accounting for the copy center, including withdrawals and invoices. Ms. Woolnough testified that, in her perception, after her promotion her work immediately became very stressful. She testified that she was required to work through her breaks, shorten her lunch hours, work an inordinate amount of overtime, and at times sneak work out of the office to be completed at home.
Ms. Woolnough indicated that she experienced additional stress when her supervisor told her that a state auditor would be coming in and that she would need to get everything cleared up for the audit. Ms. Woolnough also felt that she had been given additional work relative to federal funding and had been asked to develop a work study program. She testified that the circumstances became increasingly stressful. Ms. Woolnough then described an incident occurring on December 14, 1984 which she felt precipitated her having to leave her job in February of 1985.
Ms. Woolnough was the president-elect of the Professional and Technical Employees Association, a voluntary labor union position which was not a required part of her job duties as an Accounting Technician 3. As she described it, the president of the Association had asked her to distribute some salary information to union members, which resulted in an acrimonious exchange of words at a school board meeting on December 13, 1984 between the superintendent and the president of the Association. The following day she recalls the superintendent coming by her office and "glaring" at her, after which he met with the business manager and then left the building. She felt that this created a great degree of anxiety and on the afternoon of December 14, [4] 1984 she began experiencing heart palpitations. While she was experiencing palpitations, her supervisor walked into her office and went to a filing cabinet and then left the room, without noticing that Ms. Woolnough was having difficulty breathing, was not able to respond verbally, and was slumped over.
The employer presented several lay witnesses, including Delores Olson, the claimant's supervisor, and Nicholas Shaefer, business manager for Tacoma School District. Ms. Olson's testimony did not corroborate Ms. Woolnough's testimony concerning her working conditions. Ms. Olson had no recollection of an occurrence on December 14, 1984. She did corroborate that Ms. Woolnough worked significant overtime in 1983 for the months of June, July, and August, and in July and October of 1984. However, somewhat contradicting the testimony of Ms. Woolnough, she indicated that Ms. Woolnough's workload was no different from that of the other Accounting Technician 3's working under Ms. Olson; that Ms. Woolnough's job description did not change over the two years that she had worked there; that there were five people working in payroll; and that additional job duties, if any, did not occur during the time that Ms. Woolnough testified her stress became so great that she had to quit work. According to Ms. Olson, the job stresses required by Ms. Woolnough's position were no different from those experienced by the other Accounting Technician 3's working under Ms. Olson.
In addition, Ms. Olson said that the federal problems were not assigned to Ms. Woolnough and that because Ms. Woolnough was falling behind in her work, Ms. Olson approved the overtime. She did not consider reassigning the work because Ms. Woolnough was not fulfilling [5] all the duties required of her job description at that time. This is in direct contradiction to the testimony of Ms. Woolnough, who asserts she was taking on additional duties.
Nicholas Schaefer, Business Manager for Tacoma School District, recalled the meeting when the superintendent and the president of the Professional & Technical Employees Association had exchanged angry words, but noted that Ms. Woolnough was not the focus of the superintendent's anger. He did not recall any incident occurring between the superintendent and Ms. Woolnough on December 14, 1984.
Dr. Dennis Wight, an obstetrician and gynecologist, began treating Ms. Woolnough in April of 1981, when he performed a hysterectomy. He referred Ms. Woolnough to Dr. Przanyski for an endocrinology workup and indicated that throughout her treatment he thought that she manifested symptoms of depression.
Ms. Woolnough was treated by Edward Przanyski, M.D., an internist specializing in endocrinology and problems of metabolic systems, from January of 1983 through July 1986. During this period of treatment, he diagnosed her conditions as hypothyroidism; mitral valve prolapse, which was symptomatic and required therapy at times over the past couple of years; spastic colitis and chronic bowel dysfunction; and stress, anxiety, and depression, "which has been probably the major problem over the past two years." 7/22/86 Tr. at 54. Dr. Przanyski noted that claimant's conditions were preexisting and symptomatic for the entire time of his treatment. The symptoms would wax and wane, but never became completely asymptomatic.
Dr. Przanyski saw claimant on December 18, 1984 and felt that:
something obviously happened to Ann in those previous five days or at some point in those [6] previous five days which resulted in a serious deterioration in her status healthwise from my point of view. And some such incident certainly could have precipitated her deterioration. Whether we call it a mental or nervous breakdown I don't even know if that is a specific diagnosis, but she did have a deterioration of her health that dates from about that time. The incidents probably were specifically reported to my nurse but we make it a practice not to put things like that in our records because a lot of people have access to records who have no business reading that kind of information.
7/22/86 Tr. at 57-58. Claimant's counsel then asked him the following question:
Do you have an opinion based on a reasonable medical probability if there is a causal relationship between the diagnoses that you have stated specifically with reference to anxiety and depression and the assumed incident which occurred on 12/14/84?
7/22/86 Tr. at 58. The following exchange ensued:
A. Yes, I do.
Q. What is that opinion?
A. My opinion would be that those events, whatever they were, resulted in a serious deterioration in Ann's health primarily with regard to her anxiety and depression. But spastic colon, abdominal problems, and her mitral valve prolapse. I would add to that that it is on the basis of that that I recommended that she leave her job.
7/22/86 Tr. at 58-59.
Myron Kass, M.D., a certified specialist in psychiatry, performed a psychiatric evaluation of the claimant on December 3, 1985. He diagnosed a mixed personality disorder with anxiety, passive dependent features, and emotionally traumatic features in her childhood growth and development.
He also felt Ms. Woolnough suffered from a major depressive disorder, single episode, as a result of both exogenous and endogenous [7] factors. The exogenous or external factors were the stress factors at her job, which Dr. Kass felt were at their worst in 1982 and 1983. According to Dr. Kass, claimant's depression became very severe during those years.
Primary among the job stresses, according to Dr. Kass, was conflict with a co-worker. Claimant also related the events of December 13 and December 14, 1984 to Dr. Kass and he felt that they played a role in her depression.
In addition, Dr. Kass felt that Ms. Woolnough had a genetic tendency for endogenous depressions. He also detailed certain endogenous, i.e. internal, factors contributing to her depression, in particular biochemical imbalances caused by claimant's preexisting hypothyroidism and the hysterectomy surgeries which were performed in 1981 and 1982.
Dr. Kass described the claimant variously as having a fragile personality susceptible to stress and as having excellent coping skills. What is quite apparent from his testimony is that he had little notion of what claimant's particular job duties were. It is apparent, as well, that he did not understand the events of December 13 and December 14, 1984 as perceived through claimant's eyes.
It is clear from claimant's testimony that she felt her activities as president-elect of the Professional and Technical Employees Association had caused the superintendent to be angry at her and glare at her on December 14, 1984. Yet Dr. Kass asserted in his testimony that claimant's union role was not particularly stressful, although at the same time he agreed that she perceived the position as unpopular. He also attributed claimant's worst depression to the years 1982 and [8] 1983, prior to the events of December 1984. This is, of course, contrary to both Dr. Przanyski's and claimant's testimony. Thus, not only is Dr. Kass's testimony internally inconsistent, but it also conflicts with claimant's and Dr. Przanyski's testimony.
Douglas Robinson, M.D., a psychiatrist, examined Ms. Woolnough on July 7, 1985. In his mental status examination he found the claimant appeared to be depressed, anxious, and agitated, with signs of depression. He diagnosed panic disorder with sudden episodes of extreme anxiety and physical symptoms and major depression. He did not relate either of these conditions to her work and considered her condition to be preexisting and symptomatic. He did admit that claimant's condition worsened after December 14, 1984, but felt the alleged incident involving the superintendent did not trigger a nondisabling condition into a disabling condition. In Dr. Robinson's opinion the stressful circumstances Ms. Woolnough reported were charged with her affect and probably represent distorted views of occurrences. Her depression and panic attacks also further enabled her to distort current experiences. Finally, Dr. Robinson stated his belief that, excluding "the filtering process that she imposed on her understanding of what happened to her," the incidents claimant described were not qualitatively or quantitatively different from stresses existing in other occupations or non-employment life. He noted that claimant had had panic attacks before on a weekly basis and that nothing external triggered the panic attack on December 14, 1984. In other words, it was not the superintendent "glaring" at the claimant that triggered the panic attack on December 14, 1984. Rather, something happened internally to trigger that attack. [9]
As indicated above, the hearings judge concluded that the claimant had not sustained an injury within the meaning of RCW 51.08.100 and the Superior Court has not directed us to review that determination. In analyzing the evidence, it seems clear that Ms. Woolnough's belief that the superintendent was angry at her and glared at her was seriously affected by her preexisting, symptomatic psychiatric conditions and not caused by the actions of her employer. There is nothing in the record to establish that disciplinary action was taken against the claimant for her distribution of the salary information in December 1984, nor were there any words said to reflect displeasure with her work performance, nor is it established that she had to perform an unusually burdensome quantity of work. The medical evidence clearly establishes that she was experiencing depressive type symptomatology before her promotion to Accounting Technician 3. Due to Ms. Woolnough's preexisting condition, she interpreted events differently from the way they actually occurred. This is clear from the testimony of Ms. Olson and Mr. Schaefer, which does not corroborate Ms. Woolnough's subjective perceptions of the conditions of her employment.
The Superior Court has asked that we evaluate this case under the Supreme Court's rationale set forth in the Dennis decision. That decision does not change the outcome here. Ms. Woolnough, like any claimant asserting a claim for an occupational disease, must show that the condition alleged arose naturally and proximately out of, and in the course of, employment. In our view, Ms. Woolnough has proven neither.
Dennis involved particular work-related repetitive physical trauma which rendered preexisting osteoarthritis in the worker's wrists [10] disabling. The present appeal involves the contention that mental stressors produced a mental disability with some physical manifestations.
Dennis requires a worker to prove:
. . . that his or her occupational disease came about as a matter of course as a natural consequence or incident of distinctive conditions of his or her particular employment. The conditions need not be peculiar to, nor unique to, the worker's particular employment. Moreover, the focus is upon conditions giving rise to the occupational disease, or the disease-based disability resulting from work-related aggravation of a nonwork-related disease, and not upon whether the disease itself is common to that particular employment. The worker, in attempting to satisfy the "naturally" requirement, must show that his or her particular work conditions more probably caused his or her disease or disease-based disability than conditions in everyday life or all employments in general; the disease or disease-based disability must be a natural incident of conditions of that worker's particular employment. Finally, the conditions causing the disease or disease-based disability must be conditions of employment, that is, conditions of the worker's particular occupation as opposed to conditions coincidentally occurring in his or her workplace.
Dennis, at 481.
In a case involving the allegation that mental stressors caused a psychiatric or physical disability, Favor v. Dep't of Labor & Indus., 53 Wn.2d 698 (1959) also applies. See, e.g., In re Cleveland Williams, Dckt. No. 87 0892 (July 18, 1988); In re Orville Swartz, Dckt. No. 86 0004 (August 15, 1988). Thus, we must look to both the Favor and Dennis decisions in analyzing the facts of this appeal.
Favor involved the allegation that on-the-job mental stressors had caused a heart attack. The court held that the causal relationship between an alleged occupational disease and conditions of employment [11] cannot be established on a purely subjective basis. In addition, for a stress-related condition to be compensable as an occupational disease, it must be caused by employment conditions which occur outside of the worker. A psychiatric condition caused solely by the worker's subjective perceptions which, by their very nature, can only exist within the worker, cannot be said to arise out of employment. As the court noted in Favor: "statements by a claimant as to purely subjective conditions, peculiar to himself, do not provide the objective circumstances necessary to establish that a claimant's disease arose naturally and proximately from his employment."Favor, at 704-705. Under Favor and Dennis, therefore, a psychiatric condition caused by a worker's subjective perceptions of work events cannot constitute a compensable occupational disease pursuant to RCW 51.08.140.
Favor and Dennis read together impose the following requirements in a stress claim such as this: (1) The stress must be objectively corroborated, not just a product of the worker's own subjective perceptions; (2) the stress must be a requirement or condition of the worker's employment, not just a condition occurring coincidentally at work; (3) the stress must arise out of and in the course of employment; (4) the stress must be different from the stress attendant to normal everyday life and all employments in general, i.e., the stress must be unusual; and (5) the stress must be a cause of the worker's psychiatric condition in the sense that, but for the workplace stress, the worker would not be suffering from the psychiatric condition or disability. [12]
What we have here is Ms. Woolnough's subjective perception that the superintendent was angry with her for her role as a union official in distributing salary information, her belief that he had "glared" at her, and her belief that her supervisor had deliberately ignored her distress. In addition, Ms. Woolnough subjectively perceived that she had additional job duties and responsibilities. However, these perceptions were not corroborated and in fact were contradicted by the more believable testimony of Ms . Olson and Mr. Schaefer. It is quite clear, in fact, that the stressors alleged by the claimant came from within, not from without. Ms. Woolnough certainly has not shown the existence of any unusual on-the-job stress. Ms. Woonough's job entailed no more than the ordinary stresses associated with all employments and non-employment life. Furthermore, since the job stress was a product of her own subjective perceptions and not objectively corroborated as required by Favor, neither her depression nor any disability attributable to that depression can be said to have arisen naturally and proximately out of her employment. The Department order of August 6, 1985 must therefore be affirmed.
FINDINGS OF FACT
1. On March 20, 1985 a report of accident was filed with the Department of Labor and Industries alleging an industrial injury to the claimant on March 11, 1985 during the course of her employment with Tacoma School District No. 10. On March 27, 1985 the Department issued an order rejecting the claim because there was no proof of a specific injury at a definite time and place in the course of employment; the condition was not the result of an industrial injury as defined by the industrial insurance laws; and the condition was not an occupational disease. On April 1, 1985 a protest and request for reconsideration was filed on behalf of the claimant and the Department issued an order holding the prior order of March 27, 1985 in abeyance. On August 6, 1985 the Department issued [13] an order adhering to the provisions of the prior order dated March 27, 1985 and on October 1, 1985 the Board of Industrial Insurance Appeals received a notice of appeal filed on behalf of the claimant. On October 11, 1985 the Board issued an order granting the appeal, assigning it Docket No. 85 2816, and directing that proceedings be held on the issues raised in the appeal.
On January 21, 1987 a Proposed Decision and Order was entered, sustaining the Department order of August 6, 1985. On March 30, 1987 this Board entered an Order Denying Petition for Review filed by the claimant on March 16, 1987 in response to the Proposed Decision and Order. On April 27, 1987 the claimant appealed to the Superior Court for Pierce County. Pursuant to an order upon stipulation of parties entered in the Superior Court for Pierce County on March 20, 1989, this matter was remanded to the Board with direction to reconsider the record developed at the original hearings in this matter and issue a new Decision and Order which fully considers changes in the applicable law to this case, to wit, Dennis v. Dep't of Labor & Indus., 109 Wn.2d 467 (1987). The Superior Court order was received at the Board on May 25, 1989.
2. Since at least 1981, the claimant has suffered from conditions diagnosed as hypothyroidism, mitral valve prolapse, spastic colitis, chronic bowel dysfunction, stress, anxiety, depression, and panic disorder. In 1981 and 1982 she underwent two hysterectomy surgeries. Because of the hypothyroidism and the hysterectomy surgeries, she suffers from biochemical imbalances.
3. Claimant has been employed by the Tacoma School District since 1975. In December of 1982 she was promoted to the position of Accounting Technician 3 in the business office. Her job duties were the same as those of other Accounting Technician 3's. There was no unusual stress associated with Ms. Woolnough's work for the Tacoma School District.
4. In her capacity as the president-elect of the Professional and Technical Employees Association, claimant distributed salary information to the professional staff of the Tacoma School District in December 1984 at the request of the president of the Association. At a meeting held on December 13, 1984, the superintendent of the School District and the president of the Association exchanged angry words because of the distribution of this [14] information. Claimant was not the focus of the superintendent's anger. The next day, when the superintendent looked at her, claimant subjectively interpreted that look as an angry glare. It was claimant's subjective impression that her supervisor deliberately ignored her distressed reaction to what she perceived as the superintendent glaring at her. In fact, the supervisor was unaware of her reaction.
5. None of the conditions listed in Finding of Fact No. 2 was caused or aggravated by a specific incident or event occurring from without, at a definite time and place during the course of claimant's employment with the Tacoma School District.
6. Ms. Woolnough's subjective perceptions of workload and interpersonal relationships with management were factors contributing to her stress, anxiety, depression, and panic disorder. Ms. Woolnough's subjective perception of work events was caused not by the events themselves but by her underlying nonwork-related anxiety and depressive traits. The conditions of Ms. Woolnough's employment with the Tacoma School District were not unusually stressful. Ms. Woolnough encountered no more than the ordinary stresses associated with all employment and non-employment life during the course of her employment with the Tacoma School District.
CONCLUSIONS OF LAW
- The Board of Industrial Insurance Appeals has jurisdiction over the parties and the subject matter to this appeal.
- Claimant did not sustain an industrial injury during the course of her employment with the Tacoma School District in December 1984 within the meaning of RCW 51.08.100.
- Ms. Woolnough's stress, anxiety, depression, and panic disorder and physical manifestations did not arise naturally and proximately out of and in the course of her employment with the Tacoma School District and are not occupational diseases within the meaning of RCW 51.08.140.
- The order of the Department of Labor and Industries dated August 6, 1985 adhering to the provisions of a prior Department order dated March 27, 1985 rejecting the claim for the reasons that there was [15] no proof of a specific injury at a definite time and place in the course of employment; the condition was not the result of an industrial injury as defined by the industrial insurance laws; and that the condition was not an occupational disease, is correct and should be affirmed.
It is so ORDERED.
Dated this 10th day of January, 1990.
BOARD OF INDUSTRIAL INSURANCE APPEALS
/s/
SARA T. HARMON Chairperson
/s/
PHILLIP T. BORK Member