Ex parte Price

• Decision Date: 17 February 1989
• Citation: 555 So.2d 1060
• Parties: Ex parte Donald C. PRICE. (Re CANTERBURY ELECTRIC COMPANY v. Donald C. PRICE). 87-1457.
• Court: Alabama Supreme Court

Page 1060

555 So.2d 1060

Ex parte Donald C. PRICE (Re CANTERBURY ELECTRIC COMPANY v. Donald C. PRICE).

87-1457.

Supreme Court of Alabama.

Feb. 17, 1989.

Rehearing Denied April 7, 1989.

Curtis W. Gordon, Jr. of Gordon, Harrison & Lathum, Birmingham, for petitioner.

John J. Coleman III of Balch & Bingham, Birmingham, for respondent.

JONES, Justice.

We granted the petition for writ of certiorari, which alleged a conflict in the holding of the Court of Civil Appeals in this case and prior holdings of this Court and the Court of Civil Appeals. The petition specifically makes reference to the essence of the Court of Civil Appeals' holding as contained in the following language from its opinion:

"To establish medical causation the employee must show that the accident caused or was a contributing cause of the injury for which compensation is sought. [County of Mobile v.] Benson, 521 So.2d 992 [ (Ala.Civ.App.1988) ]. See Valley Steel Construction v. Prater, 479 So.2d 1259 (Ala.Civ.App.1985). Medical causation must be established through medical testimony, i.e., the testimony of doctors. Benson, 521 So.2d 992; [Ragland Brick Co. v.] Campbell, 409 So.2d 443 [ (Ala.Civ.App.1982) ].

"The only medical testimony in this case was provided by the depositions of two doctors who had treated the employee, Dr. J. Clayton Davie, a neurosurgeon, and Dr. Donald Autry, an orthopedic surgeon. Each doctor testified regarding his diagnosis and treatment of the employee.

"Neither doctor, however, was asked to give--and neither gave--an opinion as to whether the employee's present disability or back condition could have been caused by the alleged pull box accident of November 8, 1983. In this instance without such testimony there is no proof of medical causation."

To the extent that the Court of Civil Appeals' opinion 555 So.2d 1059, appears to establish the invariable, abstract rule that, in all circumstances, medical causation, as an element of the employee's burden of proof, can never be found by the trial court from evidence other than that supplied by the "testimony of doctors," we agree with the petitioner. As Professor Larson points out in his treatise on the law of workmen's compensation:

"To appraise the true degree of indispensability which should be accorded medical testimony, it is first necessary to dispel the misconception that valid awards can stand only if accompanied by a definite medical diagnosis. True, in many instances it may be impossible to form a judgment on the relation of the employment to the injury, or relation of the injury to the disability, without analyzing in medical terms what the injury or disease is. But this is not invariably so. In appropriate circumstances, awards may be made when medical evidence on these matters is inconclusive, indecisive, fragmentary, inconsistent, or even nonexistent."

3 A. Larson, The Law of Workmen's Compensation, § 79.51(a), at p. 15-426.128 (1988). Indeed, "[o]ur courts have explicitly stated that expert medical testimony is not a prerequisite to a finding of a physical disability, its degree or duration." Fruehauf Corp. v. Prater, 360 So.2d 999, 1002 (Ala.Civ.App.), cert. denied, Ex parte Fruehauf, 360 So.2d 1003 (Ala.1978). See, also, Grumm v. Neptune Meter Co., 472 So.2d 1067 (Ala.Civ.App.1985); City of Mobile v. Ludgood, 455 So.2d 41 (Ala.Civ.App.1984); Bankhead Forest Industries, Inc. v. Lovett, 423 So.2d 899 (Ala.Civ.App.1982); Conagra v. White, 348 So.2d 502 (Ala.Civ.App.1977); and Stewart v. Busby, 51 Ala.App. 242, 284 So.2d 269 (1973).

In his discussion of the necessity, or not, of medical evidence on the issue of causation, Professor Larson gives several examples where the factfinder is authorized to find the causation element absent medical evidence to that effect:

"This view--that in appropriate circumstances medical testimony need not necessarily establish specifically and positively the pathological diagnosis and etiology of a disease or condition--has been accepted by most courts. For example, an award based on the theory that a strain, accompanied by a sharp pain at the base of the neck, and followed by continuous pain, caused or accelerated the cancer that later led to the worker's death, would not be reversed because the doctors all admitted that the cause of cancer was not known. Two doctors testified that the strain probably aggravated the cancer, and that was enough to support the award.

"The Rhode Island Supreme Court's opinion in Valente [v. Bourne Mills, 77 R.I. 274, 75 A.2d 191 (1950) ], continued, on the subject of the lack of medical testimony on causation, as follows:

" 'Thus where, as in the instant case, injury appears in a bodily member reasonably soon after an accident, at the very place where the force was applied and with symptoms observable to the ordinary person, there arises, in the absence of believed testimony to the contrary, a natural inference that the injury, whatever may be the medical name, was the result of the employment.' [77 R.I. at 279, 75 A.2d at 194.]

"One of the most familiar applications of this approach is to back injuries that occur suddenly as a result of an obvious accident or strain."

3 A. Larson, The Law of Workmen's Compensation, § 79.51(b), (c), at pp. 15-426.149--.160 (1988).

As the finder of facts, then, the trial court is authorized to draw any reasonable inference from the evidence, including conclusions of medical facts that are not within the peculiar knowledge of medical experts. Warrior Stone & Contracting Co. v. De Foor, 241 Ala. 227, 2 So.2d 430 (1941). As the Court of Civil Appeals' opinion recognizes, the test is set out in Fordham v. Southern Phenix Textiles, Inc., 387 So.2d 204, 205 (Ala.Civ.App.), cert. denied, 387 So.2d 206 (Ala.1980):

"To establish medical causation the employee must show that the exertion or strain or the exposure to conditions was, in fact, a contributing cause of [the employee's] injury."

Whether the claimant has satisfied this test in the absence of medical testimony, or by lay testimony coupled with medical evidence, must be determined on a case-by-case basis.

This point is also recognized by the Court of Civil Appeals: "In this instance without such testimony there is no proof of medical...