Caskey v. Dan River Mills, Inc.

• Decision Date: 29 April 1983
• Docket Number: No. 820537,820537
• Citation: 225 Va. 405,302 S.E.2d 507
• Parties: John L. CASKEY, Jr. v. DAN RIVER MILLS, INC. Record
• Court: Virginia Supreme Court

Page 507

302 S.E.2d 507

225 Va. 405

John L. CASKEY, Jr. v. DAN RIVER MILLS, INC.

Record No. 820537.

Supreme Court of Virginia.

April 29, 1983.

Edwin A. Gendron, Jr., Martinsville (Gendron & Kirby, Martinsville, on briefs), for appellant.

Gregory B. Robertson, Richmond (Michael P. Regan, James A. Harper, Jr., Michael H. Corley, Hunton & Williams, Richmond, on brief), for appellee.

Before CARRICO, C.J., COCHRAN, POFF, COMPTON, STEPHENSON and RUSSELL, JJ., and HARRISON, Retired Justice.

ALBERTIS S HARRISON, Jr., Retired Justice.

John L. Caskey, Jr., contends that the Industrial Commission of Virginia erred in holding that he failed to establish by a preponderance of the evidence that the disability he suffers is from an occupational disease which is causally related to his employment by Dan River Mills, Inc.

On May 4, 1981, Caskey filed an application with the Commission, alleging that he suffered from byssinosis, an occupational disease, and had been totally disabled since August 1977. Claimant retired in July 1976, after approximately twenty years employment by Dan River, allegedly because of a disagreement with a work supervisor. Caskey had previously worked with other textile companies from 1935 until 1956. During this period claimant had worked as a doffer, a fixer or repairman, and as a maintenance worker in the mills. At times he was exposed, in varying degrees, to cotton dust and lint.

Claimant alleges that as a result of this employment and exposure he developed "classic" symptoms of byssinosis, such as Monday morning syndrome, ^* persistent cough, phlegm production, and shortness of breath which was intermittent in its earlier years and later became constant and severe.

Caskey is 69 years old and has a history of being a heavy cigarette smoker beginning at the age of eight or nine and continuing uninterruptedly throughout his adult life. The testimony and exhibits show that Caskey has received treatment over a period of years for various ailments, including alcoholism, peripheral neuritis and dizziness, chronic bronchitis, chronic laryngitis, obesity, emphysema, and hypertension. On June 14, 1980, Caskey suffered a stroke, apparently unrelated to his respiratory problems, which resulted in a partial paralysis of a significant portion of the right side of his body, including some impairment of his right lung.

Medical evidence was given by Dr. Herbert O. Seiker, Director of the Pulmonary Disease Service at the Department of Medicine at Duke University, on behalf of the claimant, and by Dr. Thomas J. O'Neill of Danville, Virginia, on behalf of the employer. Both physicians qualified as pulmonary specialists.

On March 19, 1980, some four years after Caskey's retirement from Dan River, he consulted Dr. Seiker and was examined by him. The claimant and his wife provided the physician with claimant's history. Laboratory tests were conducted, chest X-rays taken, and pulmonary stress tests given Caskey on that day. Dr. Seiker gave a diagnosis of "chronic obstructive lung disease--byssinosis," and recorded his impressions of the claimant as follows:

The patient has impaired pulmonary function and by stress testing, should not be expected to perform work more strenuous than sweeping floors. He also has a history of exacerbation of symptoms with exposure to cotton dust, which is typical for the diagnosis of byssinosis. He is overweight and has been a cigarette smoker both of which contribute to impaired function of his lungs. It is my impression that he is 50% disabled for work because of cotton dust lung disease and he is 100% disabled for working in the cotton dust environment.

On July 23, 1981, at the request of Dan River, Caskey was examined by Dr. Thomas J. O'Neill. Dr. O'Neill had available at that time claimant's prior medical records, a history provided by the claimant and his wife, laboratory tests, blood tests, and X-rays. Following his examination of claimant and a review of the medical records and tests, Dr. O'Neill concluded that although the claimant was disabled as the result of his stroke, he was not in fact suffering from byssinosis. In O'Neill's opinion, Caskey had "moderate-moderately severe chronic obstructive pulmonary disease that is multifactorial in origin." It was O'Neill's judgment that the dominant cause of claimant's respiratory impairment was cigarette smoking and that his pulmonary function was further impaired by his being overweight and by the intercostal and diaphragmatic muscle impairment secondary to the cerebrovascular accident in June of 1980.

Dr. O'Neill testified that during the course of his examination he requested a blood test on Caskey's immunoglobulins. He described this as a specific test felt to be of significance by many experts in textile industry related diseases. He said that the serum IgG level reflected by the test was of marked significance in deciding whether or not the case "is what they would term byssinosis," and that in clear-cut cases of byssinosis the level is usually significantly elevated. Dr. O'Neill testified that an IgG level of over 1800 would be highly corroborative of a diagnosis of byssinosis and that claimant's "IgG level was 955 units with a normal [level] of 800 to 1800, with a mean of 1250," and was "well within normal limits."

The physicians agreed that byssinosis does not show up on X-rays and that there is no objective evidence of the disease. Byssinosis is not an ordinary disease of life and while anyone is susceptible, exposure to cotton dust in one of the fiber industries is necessary to contract the disease.

The thrust of Caskey's argument is that Dr. Seiker testified positively and unequivocally that 50% of claimant's disability resulted from his having contracted byssinosis. He says that in denying his claim the Commission has improperly substituted its medical opinion for that of claimant's medical expert. Although claimant concedes that Dr. O'Neill testified that his condition was multifactorial in origin and that its dominant cause was cigarette smoking, he finds comfort in O'Neill's statement that he was not prepared to say categorically that claimant's cotton dust exposure played no part in his illness.

Dan River responds that there is a clear conflict in the medical evidence given by the two physicians. It relies on the testimony of Dr. O'Neill that claimant suffered from chronic obstructive pulmonary disease primarily attributable to excessive cigarette smoking. It argues that while Dr. O'Neill was understandably unwilling to make a categorical statement that claimant's cotton dust exposure played no part in his physical condition, it was clearly Dr. O'Neill's conclusion and testimony that Caskey did not have byssinosis.

Dr. O'Neill testified that Caskey "has the physical...