Opinion
33880.
DECIDED FEBRUARY 19, 1952. REHEARING DENIED MARCH 6, 1952.
Appeal; from DeKalb Superior Court — Judge Vaughn. September 27, 1951.
James R. Venable, D. M. Johnson, for plaintiff.
W. Neal Baird, Neely, Marshall Greene, Ferdinand Buckley, for defendant.
A medical expert witness may give his opinion as to the cause of an injury; but where the cause of the injury constitutes the ultimate issue of fact to be determined by the fact-finding tribunal, this opinion is not absolutely binding on such tribunal. To hold otherwise would preclude such tribunal from exercising its proper function. The fact finding body must take the evidence of the medical expert along with all the other facts and circumstance of the case, and thus determine the ultimate issue.
DECIDED FEBRUARY 19, 1952 — REHEARING DENIED MARCH 6, 1952.
The claimant in this workman's-compensation case, Thomas H. Autry, filed a claim with the Board of Workmen's Compensation for benefits for injuries to his right foot, growing out of an accident in the course of his employment in the General Motors BOP Assembly Plant on January 27, 1951, when the hood of a Buick automobile in the assembly line in which he was working dropped several inches, hitting his foot and at the same time cutting the index finger of his hand. The claimant went immediately to the infirmary, where his hand was bound and a record made of this injury. No record was made of any injury to the foot. The claimant testified that he told the nurse at that time that the hood had dropped on his foot, but he did not think it was injured; that, some days later, on February 24, he returned to the infirmary because the foot was hurting and swollen and had it soaked, and that Dr. Kelly bandaged it for him; that within a few days thereafter, as the foot continued to swell and give him great pain, with discoloration, he visited his family physician and again returned to Dr. Kelly for examination, and was sent by him to Dr. Jernigan. The foot continued to grow worse and became more painful with a definite enlargement under two of the bones on the ball of the foot; on February 26 the claimant returned and was given lighter work at which he could sit, and by March 22 the foot had become so painful that he was forced to leave his employment.
Dr. Kelly first diagnosed the injury as epidermolysis, a condition of skin irritation somewhat related to athlete's foot, and thereafter changed his diagnosis to metatarsalgia, a "term used for a painful condition in the metatarsal bone." Dr. Jernigan diagnosed the case as a neuroma or enlargement of the nerve between the third and fourth toes resulting from a flattening out of the anterior arch of the foot and traumatizing of the nerve by the bones rubbing together over a period of time. Both physicians stated that in their opinion the injury did not result from the accident, but admitted that the cause of these ailments is controversial. Dr. Kelly testified that in his opinion there was a permanent disability of approximately 25%.
The single director before whom the claim was heard entered an award in favor of the claimant on a basis of 20% disability. Upon appeal by the employer and its insurance carrier to the Judge of the Superior Court of DeKalb County, this ruling was reversed on the grounds that there is not sufficient competent evidence in the record to support the award, that the award is contrary to law, and that the director acted in excess of his powers in making the same. The exception is to this judgment.
The question is whether there is any competent evidence in the record which would support a finding that the disability which the claimant now suffers is the result of the accident of January 27, 1951. The defendant in error contends that there is none, since the matter of the cause of the disability is essentially one of opinion, and a lay witness is incapable of testifying when such testimony is necessarily a matter of expert opinion, such as whether a sore on the back caused the insured's death ( Johnson v. Aetna Life Insurance Co., 24 Ga. App. 431, 101 S.E. 134), or whether the injuries are permanent in character ( Cone v. Davis, 66 Ga. App. 229 (6), 17 S.E.2d 849). The diagnosis and treatment of injury and disease are essentially medical questions to be established by physicians as expert witnesses and not by laymen. Mayo v. McClung, 83 Ga. App. 548 ( 64 S.E.2d, 330). However, although these are apt subjects for expert medical testimony, and the physician may testify as to his opinion of the cause of an injury, he may not testify to the ultimate fact in such manner as to invade the province of the fact-finding body, for whether the particular injury was or was not caused in such manner as to render it compensable is the issue to be tried, and no testimony in the nature of opinion evidence will preclude the fact-finding tribunal from reaching its own conclusion on this matter, given the facts of the case and aided by the interpretation of experts. See Travelers Insurance Co. v. Thornton, 119 Ga. 455 (1) ( 46 S.E. 678); U.S. Casualty Co. v. Smith, 34 Ga. App. 363, 372 ( 129 S.E. 880); Liberty Mutual Insurance Co. v. Williams, 44 Ga. App. 452 (1) ( 161 S.E. 853); Atlantic Steel Co. v. McLarty, 74 Ga. App. 300, 304 ( 39 S.E.2d 733). The director was not bound by the testimony of the physicians on the ultimate issue of fact, that of causation. The undisputed evidence showed that the claimant did suffer an injury to his left foot; that in about three works thereafter it developed a thickening and extreme localized pain, together with discoloration; that the condition of the foot continued to deteriorate, as a result of which he suffers a disability, according to the company doctor, of 25%. Three doctors disagreed upon the precise medical diagnosis of the ailment, although the diagnoses of Drs. Kelly and Jernigan are closely related. Metatarsalgia of the foot is a causalgia, which is defined in the authoritative new work, Gray's "Attorney's Textbook of Medicine", Vol. II, § 107.28, in part as follows: "Causalgia was described by Weir Mitchell in 1864 as a most intense form of neuritis, found among the wounded of the Civil War. . . The cause is not known. Symptoms appear most frequently from four to five days following injury, gradually increasing until reaching a maximum within three to four weeks. Pain is generally superficial rather than deep, usually at the end of the nerve, such as the palm of the hand or the sole of the foot."
Dr. Jernigan testified as follows: "I don't believe it is the result of an injury. I believe it is the result of a flattening out of the anterior arch of the foot and a traumatizing of the nerve by the bones rubbing together over a period of time. To the best of my knowledge that is what causes a neuroma. Sometimes there is a controversy among doctors, however.: Traumatism" is defined in Black's Law Dictionary as "A diseased condition of the body or any part of it caused by a wound or external injury." It follows, therefore, that, while the opinion of the doctors who testified was that the injury was not caused by an accident, yet the facts upon which this opinion was based are sufficient to have authorized the director to find otherwise. The director, not being a physician, could not diagnose the physical condition of the claimant. Nevertheless, when it was diagnosed by the physicians, it became the province of the director to apply this diagnosis to the facts of the case. In considering this diagnosis and these facts, including the fact that prior to the occurrence the claimant's foot had given him no trouble, and that he first began to experience pain in the foot a few days thereafter, which became very acute within three or four weeks thereafter, the director was authorized to find that the claimant was injured by the falling of a heavy object on his foot, which resulted in a flattening out of the anterior arch and a traumatizing of the nerve as a result thereof. The award was supported by some evidence and, no fraud appearing, it must be upheld.
The judge of the superior court erred in reversing and setting aside the award of the Board of Workmen's Compensation.
Judgment reversed. MacIntyre, P. J., and Gardner, J., concur.