Opinion
CASE NO. 1534 CRB-3-92-10
JULY 5, 1994
The claimant was represented by Richard W. Lynch, Esq., Lynch, Traub, Keefe Errante.
The respondents were represented by Carolyn A. Signorelli, Esq., Maher Williams.
This Petition for Review from the October 15, 1992 Finding and Award of the Commissioner for the Third District was heard September 10, 1993 before a Compensation Review Board panel consisting of the Commission Chairman Jesse Frankl and Commissioners Donald H. Doyle, Jr. and Angelo L. dos Santos.
OPINION
The respondents have petitioned for review from the Third District Commissioner's October 15, 1992 Finding and Award. On appeal, the respondents challenge (1) the commissioner's finding that the decedent's death was caused by his compensable injury and (2) the commissioner's finding that the decedent's son, Martin Conroy, was living with the decedent at the time of his injury, rendering him a dependent of the decedent. We affirm the trial commissioner.
On March 16, 1989, the decedent sustained a work-related myocardial infarction. Hospital tests performed on the decedent soon thereafter revealed significant stenosis, or blockage, in the decedent's proximal left anterior coronary artery. Angioplasty was performed to reduce the arterial blockage. The decedent died on April 26, 1989, as a result of complications arising from the angioplasty procedure.
The trial commissioner concluded that the decedent's dependents were entitled to death benefits because "the decedent, George Conroy, sustained a work-related myocardial infarction on March 16, 1989 which linked up a series of medically reasonable diagnostic and therapeutic procedures which eventually caused [his] death . . . ." The trial commissioner also found that the decedent had a disabled son, Martin Conroy, living with him at the time of his death and that Martin Conroy therefore qualified as a dependent pursuant to Sec. 31-306.
The respondents first challenge the commissioner's conclusion that the decedent's death is causally related to the compensable myocardial infarction. The cause of death in this case was the failed angioplasty. The angioplasty was performed to reduce or eliminate the arterial blockage which pre-existed the compensable heart attack. The compensable heart attack did not cause the arterial blockage; in fact, it was that blockage which set the state for the work-related heart attack. From these undisputed facts, the respondents argue that the myocardial infarction merely led to the discovery of the arterial blockage. They contend in their brief, that "[t]his circumstantial connection alone is insufficient to establish that the decedent's death was a complication of the myocardial infarction or the direct and natural consequence of the myocardial infarction."
The respondents correctly point out that a claimant must prove a causal connection between a compensable injury and a subsequent event for which compensation is sought. "If the primary injury arises out of the employment, every consequence which flows from it likewise arises out of the employment . . . . All physical consequences and disease result from an injurywhen there is a causal connection between them." (Emphasis added.)Larke v. Hancock Mutual Life Ins. Co., 90 Conn. 303, 311-12 (1916); see also Cole v. Norwalk Wilbert Vault Co., 4 Conn. Workers' Comp. Rev. Op. 155, 330 CRD-2-84 (1988); 1 A. Larson, Workmen's Compensation Law Sec. 13.00. Thus, our cases have recognized the compensability of subsequent injuries resulting from weakened resistance due to the original compensable injury;Bratz v. Harry Maring, Jr., Inc., 116 Conn. 186, 191-92 (1933); and the compensability of the consequences of malpractice occurring during surgery to treat a compensable injury. Conrad v. Haggerty Pool Service, 3 Conn. Workers' Comp. Rev. Op. 96, 174 CRD-7-82 (1986). In all such cases, however, there was a causal connection between the work injury and the consequent injury.
On the other hand, where a compensable injury leads to the discovery of another medical condition and does not otherwise affect the treatment of that other condition, the link between the two medical conditions is coincidental and not causal. Under such circumstances, the treatment of the discovered condition and the consequences of that treatment are not compensable. See, e.g., Baird-Ray Datsun v. Butler, 400 So.2d 1038 (Fla.App. 1981) (pre-existing back conditions discovered during treatment of compensable knee injury; award of compensation for back condition reversed in absence of medical evidence to support finding that knee injury caused back condition); Bolen v. Wallace, 338 S.W.2d 73 (Mo. 1960) (pre-existing malignant tumor discovered after claimant hit in stomach at work; claimant's death during surgery to remove tumor not compensable since work injury did not cause need for surgery).
In the present case, the trial commissioner found a causal link between the compensable heart attack and the later medical procedure which led to the decedent's death. We cannot disturb factual findings unless contrary to law, without evidence or based on unreasonable or impermissible factual inferences. Fair v. People's Savings Bank, 207 Conn. 535, 539 (1988); Tomkus v. Upjohn Company, 9 Conn. Workers' Comp. Rev. Op. 163, 165, 972 CRD-3-90-1 (1991). The causal link in this case is supported by the following testimony of Dr. Lawrence S. Cohen: "In Mr. Conroy's case, the artery to the front surface of the heart had a ninety per cent narrowing. There was only ten per cent of the channel that remained. And, the concern, appropriate concern, was that if that artery closed completely that would have led to yet a much larger heart attack. So, the decision to go ahead with an angioplasty wasn't in any way vitiated by the recent heart attack. If anything, it made the procedure a more likely means of helping." (Emphasis added.) Transcript of September 24, 1991, p. 18. Because the compensable injury made the death-causing angioplasty "a more likely means" of treating the decedent's pre-existing condition, there is both factual support for the commissioner's critical finding and legal support for his conclusion that the decedent's death arose out of the compensable workplace injury.
The respondents also challenge the commissioner's finding that Martin Conroy, the decedent's disabled son, lived with the decedent at the time of his heart attack. The respondents argue that Claimant's Exhibit D establishes that Martin Conroy did not live with the decedent. Claimant's Exhibit D is a statement taken of the decedent on April 11, 1989 which states in pertinent part: "I have 2 children, Martin, age 29 (DOB: 8/20/60) and George, age 20 (DOB: ???). Only George resides at home with my wife and I." This, however, was not the only evidence before the commissioner concerning Martin Conroy's status as a presumptive dependent. Martin Conroy testified that he was physically incapacitated, living with his parents and supported by his father at the time of the decedent's heart attack.
The respondents do no more than ask this tribunal to retry the facts by contending that the commissioner should have resolved this factual dispute based on Claimant's Exhibit D. But we cannot substitute our findings for those of the commissioner, the trier of facts. Fair v. People's Savings Bank, supra, 538-42. It was within the province of the commissioner to resolve this apparent conflict in the evidence. Pinto v. B.C. Hardware Superior Products, 11 Conn. Workers' Comp. Rev. Op. 210, 1351 CRD-6-91-12 (1993); Goodrow v. W.J. Barney Corporation, 11 Conn. Workers' Comp. Rev. Op. 207, 1315 CRD-2-91-9 (1993). As the conclusions reached from the facts found did not result from incorrect applications of law or from inferences illegally or unreasonably drawn from those facts, those conclusions must stand. Fair v. People's Savings Bank, supra, 539.
We, therefore, affirm the trial commissioner and deny the respondents' appeal.
Additionally, pursuant to Sec. 31-301c(b), we grant interest at the rate permitted by statute on any amount remaining unpaid during the pendency of the appeal.
Commissioners Donald H. Doyle, Jr. and Angelo L. dos Santos concur.