Summary
holding obvious causal relationship established when claimant suffers back pain after lifting 140 pound child on to a school bus
Summary of this case from U.S. Airways & Chartis Ins. v. Workers' Comp. Appeal Bd.Opinion
Argued March 8, 1979
June 6, 1979.
Workmen's compensation — Medical testimony — Causation — Burden of proof — Immediate disabling pain.
1. In a workmen's compensation case the burden is upon the claimant to establish a causal connection between an employment incident and a condition of disability, and, although unequivocal medical testimony is generally necessary to establish that connection, the requisite causal connection can be established without direct medical testimony when disabling pain occurred at the time of the incident and was reported to the employer and when medical testimony did establish that one aspect of the disabling condition typically results from incidents such as the one related by the claimant. [261-2]
Argued March 8, 1979, before President Judge BOWMAN and Judges WILKINSON, JR. and MENCER, sitting as a panel of three.
Appeal, No. 683 C.D. 1978, from the Order of the Workmen's Compensation Appeal Board in case of William H. Sacks v. James O. Sacks, No. A-73909.
Petition with the Department of Labor and Industry for disability benefits. Benefits awarded. Employer and insurer appealed to the Workmen's Compensation Appeal Board. Award affirmed. Employer and insurer appealed to the Commonwealth Court of Pennsylvania. Held: Affirmed.
Paul A. Lockrey, for petitioners.
Emory W. Buck, with him William R. Cooper, Stewart J. Greenleaf, and Cooper Greenleaf, for respondents.
James O. Sacks (employer) and his workmen's compensation insurance carrier have appealed from an order of the Workmen's Compensation Appeal Board (Board) awarding benefits to William H. Sacks (claimant). We affirm.
Claimant was employed as a school bus driver, and he was responsible for transporting handicapped children. On April 2, 1973, he stopped to pick up a 17-year-old boy in a wheelchair. Claimant grasped the boy, who weighed 142 pounds, under the arms, lifted him out of the wheelchair, stood up, pivoted to his right, and set the boy down in a seat of the bus. Claimant then felt severe pain in his right knee and foot. With some difficulty, claimant drove the bus to its destination and reported the incident to his employer, indicating he would not be able to continue working because of the pain.
The pain persisted for several weeks, and it was eventually determined that claimant suffered from Sudeck's atrophy in his foot and a torn tendon in his knee. After treatment, claimant was eventually able to return to work without any loss of earnings on August 27, 1974.
At a hearing on his claim for compensation, claimant testified concerning the April 2, 1973 incident. He also presented the testimony of two physicians, but neither physician expressed any opinion on the relationship, if any, between claimant's disability and the incident of April 2. However, one physician did state that Sudeck's atrophy was typically caused by minor trauma. Relying upon this testimony, a referee awarded benefits, the Board affirmed, and this appeal followed.
The issue in this case is whether or not claimant's failure to produce unequivocal medical testimony to establish a causal relationship between the incident on April 2, 1973 and his disability precludes an award of compensation. The general and well-established rule is that such testimony is an essential element of the claimant's case. See, e.g., Westmoreland Casualty Co. v. Workmen's Compensation Appeal Board, 36 Pa. Commw. 307, 387 A.2d 683 (1978); Columbus Service International v. Workmen's Compensation Appeal Board, 17 Pa. Commw. 441, 333 A.2d 233 (1975); cf. Hamil v. Bashline, 481 Pa. 256, 267-8, 392 A.2d 1280, 1285-86 (1978) (unequivocal medical testimony usually necessary to establish cause of pain and injury in negligence action). Where, however, a claimant's disability is immediately and directly the result of a work incident, the factfinder is not required to depend upon medical testimony to find the causal connection. See, e.g., Yellow Cab Co. v. Workmen's Compensation Appeal Board, 37 Pa. Commw. 337, 390 A.2d 880 (1978); Workmen's Compensation Appeal Board v. Bethlehem Mines Corp., 22 Pa. Commw. 437, 349 A.2d 529 (1975).
We believe that the recent Supreme Court decision in Morgan v. Giant Markets, Inc., 483 Pa. 421, 397 A.2d 415 (1979), requires us to hold that this case comes within the latter rule. In Morgan, the Court held that
[w]here one is doing an act that requires force or strain and pain is experienced at the point of force or strain, the injury may be found to have been established. Pain is an excellent symptom of an injury. Of course, the trier of fact will determine the credibility of the witness's testimony as to the total situation. We, therefore, find substantial competent evidence in the record to support the conclusion of the Workmen's Compensation Board of Appeals, that the above facts establish a causal connection between the work incident and appellant's injury.
483 Pa. at 424, 397 A.2d at 416.
The Supreme Court reached this conclusion despite the fact that Morgan had a history of prior back trouble to which his disability could have been attributed.
Although this fact was not mentioned by the Supreme Court, it was a factor in our earlier decision to deny compensation, see Giant Markets, Inc. v. Morgan, 28 Pa. Commw. 439, 368 A.2d 885 (1977), a decision which was reversed by the Supreme Court.
In this case, claimant had no prior history of foot or knee trouble, and he testified that the disabling pain began immediately after lifting the 140-pound boy into the bus, exertion which necessarily put strain on his foot and knee. In addition, the incident was immediately reported upon claimant's arrival. Finally, the medical testimony was that at least one aspect of claimant's disability, the Sudeck's atrophy, is typically the result of minor trauma. In light of Morgan, we must hold that this evidence is sufficient to sustain the referee's finding that claimant's disability was the result of his activities on April 2, 1973. See also Yellow Cab Co. v. Workmen's Compensation Appeal Board, supra (medical testimony unnecessary where claimant's headaches and dizziness began immediately after accident).
Accordingly, we enter the following
ORDER
AND NOW, this 6th day of June, 1979, the order of the Workmen's Compensation Appeal Board, dated March 23, 1978, affirming the determination of Referee Frank M. Perna, is hereby affirmed. Accordingly, it is hereby ordered that judgment be entered in favor of William H. Sacks and against James O. Sacks and Harleysville Mutual Insurance Company, in the amount of $99.76 per week for the period from April 4, 1973 through August 27, 1974, together with interest at the rate of 10 percent per annum on deferred payments of compensation from the date due to the date paid, within the terms and limits of The Pennsylvania Workmen's Compensation Act.
In addition, James O. Sacks and/or Harleysville Mutual Insurance Company shall pay the following medical expenses:
Dr. Ronald K. Magargle $85.00
Reimbursement to claimant for x-rays 29.00