DeSchaaf v. Industrial Com'n of Arizona

Decision Date08 May 1984
Docket NumberCA-IC,No. 1,1
Citation141 Ariz. 318,686 P.2d 1288
PartiesJosephine M. DeSCHAAF, c/o Wilfred DeSchaaf, Guardian, Petitioner, v. The INDUSTRIAL COMMISSION OF ARIZONA, Respondent, Aspen Care Center of Glendale, Respondent Employer, State Compensation Fund, Respondent Carrier. 2914.
CourtArizona Court of Appeals
Law Offices of Richard E. Taylor by Don F. Schaar, Phoenix, for petitioner
OPINION

MEYERSON, Presiding Judge.

I. FACTS

This is a special action review of an Industrial Commission award denying compensability for a stroke occurring at work. The sole issue presented is whether A.R.S. § 23-1043.01.A. violates the Arizona constitutional provision regarding workers' compensation, Ariz. Const. art. 18, § 8, and the federal constitutional guarantee of equal protection. We find no constitutional violations and affirm the award.

Petitioner (claimant), who worked as a nurse for a rest home, had a history of high blood pressure, which was medically managed during the year before her misfortune. Working conditions were appalling; the rest home was threatened with loss of its license. The claimant, a conscientious nurse, was visibly upset by her inability to remedy these conditions.

On the date of the injury, claimant was at work supervising the evening shift. Three upsetting events occurred. First, she was notified that an employee could not come to work because of an automobile accident; she subsequently discovered that this was not true. Second, a missing medical chart hindered her treatment of a patient. Third, she had a dispute with one of her subordinates. Approximately a half-hour to forty-five minutes after this last incident, the claimant suffered a stroke. She was left severely disabled, confined to a wheelchair and unable to speak.

The claimant's theory was that these upsetting events caused transient elevated blood pressure, and this elevated blood pressure in turn caused an admittedly pre-existing cerebral aneurysm to burst. She produced two medical experts to support this theory of compensability. The respondents' medical expert, J. Michael Powers, a neurologist specializing in stroke etiology and patient care, disagreed. He testified that the relationship between stroke and elevated blood pressure is speculative and medically undocumented. In his opinion, even assuming the upsetting events caused elevated blood pressure, this transient elevation did not contribute to the stroke.

The administrative law judge entered the award denying compensability finding that claimant failed to establish that her employment-related stress was a substantial contributing cause of the injury. This special action followed.

II. LAW

Claimant argues that A.R.S. § 23-1043.01.A. violates Article 18, § 8 of the Arizona Constitution. A.R.S. § 23-1043.01.A. states:

A heart-related or perivascular injury, illness or death shall not be considered a personal injury by accident arising out of and in the course of employment and is not compensable pursuant to this chapter unless some injury, stress or exertion related to the employment was a substantial contributing cause of the heart-related or perivascular injury, illness or death.

(Emphasis added.) Article 18, § 8 in relevant part, states:

The Legislature shall enact a Workmen's Compensation Law applicable to workmen engaged in manual or mechanical labor ... by which compensation shall ... be paid ... if in the course of such employment personal injury to or death of any such workman from any accident arising out of and in the course of, such employment, is caused in whole, or in part, or is contributed to, by a necessary risk or danger of such employment, or a necessary risk or danger inherent in the nature thereof ....

(Emphasis added.)

Relying on the general rule that an industrial accident need only partially cause an injury, e.g., Allen v. Industrial Commission, 124 Ariz. 173, 602 P.2d 841 (App.1979), claimant interprets the constitutional phrase, "is caused in whole, or in part, or is contributed to," to prohibit the statutory requirement of substantial contribution. 1 Claimant misinterprets the meaning of the constitutional phrase.

Compensability requires both legal and medical causation. 1B A. Larson, Workmen's Compensation Law § 38.83 (1982) (Larson); Coday v. Willamette Tug & Barge Co., 250 Or. 39, 47-48, 440 P.2d 224, 228 (1968); cf. Allen v. Industrial Commission, 124 Ariz. at 175, 602 P.2d at 843. Legal causation concerns whether the injury arose out of and in the course of the employment. See generally 1, 1A Larson §§ 6.00-29.20. On the other hand, medical causation ordinarily requires expert medical testimony to establish that the industrial accident caused the injury. E.g., Allen v. Industrial Commission, 124 Ariz. at 175, 602 P.2d at 843.

The constitutional phrase relied upon by claimant qualifies the causal connection between the injury and a risk of the employment. This relationship between injury and risk is the classical definition of "arising out of" the employment. See 1 Larson §§ 6.00-7.40. The constitutional language at issue here was expressly considered by the Arizona Supreme Court in Goodyear Aircraft Corp. v. Industrial Commission, 62 Ariz. 398, 158 P.2d 511 (1945). The claimant was injured on the employer's premises when a soda bottle exploded during the lunch hour. The employer argued that the injury did not arise in the course of the employment. The court first noted:

[W]hen an accident to an employee in the course of his employment is caused in whole or in part, or is contributed to by a necessary risk or danger of such employment, or a necessary risk or danger inherent in the nature thereof, this would be one arising out of the employment. The test to be applied in accidents mentioned in the constitutional mandate to determine whether they arise out of the employment is, were they caused in whole or in part, or contributed to by a necessary risk or danger of the employment, or inherent in its nature.

Id. at 408-09, 158 P.2d at 516. The court concluded, however, that the legislature had widened the field of compensable accidents by providing compensation for accidents "arising out of and in the course" of employment. Ariz.Code Ann. § 56-936 (1939), now A.R.S. § 23-1021.B. The court found the accident to be compensable. The court's discussion, however, makes it clear that the phrase "is caused in whole, or in part, or is contributed to" refers to the relationship between injury and the risk of employment--legal causation. 2

In contrast, the substantial contribution requirement within A.R.S. § 23-1043.01.A. applies to medical causation. See Bush v. Industrial Commission, 136 Ariz. 522, 667 P.2d 222 (1983); Findley v. Industrial Commission, 135 Ariz. 273, 276, 660 P.2d 874, 877 (App.1983). Before A.R.S. §...

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