Guillory v. U.S. Fidelity & Guar. Ins. Co.

• Decision Date: 02 July 1982
• Docket Number: No. 81-C-2471,81-C-2471
• Citation: 420 So.2d 119
• Court: Louisiana Supreme Court
• Parties: Buering GUILLORY v. UNITED STATES FIDELITY & GUARANTY INSURANCE COMPANY.

Page 119

420 So.2d 119

Buering GUILLORY v. UNITED STATES FIDELITY & GUARANTY INSURANCE COMPANY.

No. 81-C-2471.

Supreme Court of Louisiana July 2, 1982.

Guillory, McGee, Mayeux & Fontenot, Donald L. Mayeux, Eunice, for applicant.

James G. Dubuisson, Dubuisson & Dubuisson, Oplousas, for respondent.

CALOGERO, Justice.

In this worker's compensation case, a forty-two year old laborer with twenty-one consecutive years of apparent good health and essentially uninterrupted work record fainted at the conclusion of a strenuous work day. He was thereupon, for the first time, diagnosed as having had a long standing heart disease, aortic valvular stenosis. ¹ The undisputed medical evidence was that 1) the fainting spell was caused by a combination of the stenosis and the stress occasioned by virtue of plaintiff's work that day, 2) the condition of his defective heart valve was not essentially different following the fainting incident than before the accident, 3) the diagnosed condition disabled plaintiff from returning to his accustomed work and 4) absent corrective heart surgery the prognosis was that plaintiff would not live another five years. ²

The trial judge awarded plaintiff permanent and total disability benefits under the compensation law. The Court of Appeal in a five judge opinion with two judges dissenting reversed the trial court judgment and dismissed plaintiff's lawsuit upon finding no causal connection between the job accident and plaintiff's ensuing disability. 401 So.2d 543 (La.App. 3rd Cir. 1981). We granted writs on relator's application. ³

For the reasons which follow, we reverse the judgment of the Court of Appeal and reinstate the trial court judgment awarding total and permanent disability benefits.

Buering Guillory, an illiterate forty-two year old laborer, had been employed as a carpenter's helper for over twenty years working out of a labor union hall at different job sites around the state. When this incident occurred he was hired through Carpenter's Local 117 in Baton Rouge by defendant U.S.F. & G's insured (an employer whose name in the record is P.A.L.A.), and assigned to work at an Exxon construction site in Baton Rouge where his job was excavating and grading land with a pick and shovel just prior to the pouring of concrete slabs. Monday through Thursday of the week in question, he had worked alongside as many as five other laborers.

On Friday, December 15, 1978, however, he was required to work alone. He had awakened as usual at about 3:45 a.m. at his home in Lawtell, La. He rode a bus from Opelousas to Baton Rouge, and began working at approximately 7:30 a.m. About an hour later, he was assigned, alone, to dig out an area where three carpenters were waiting to build forms for another slab shortly to be poured. Guillory continued to work alone, and steadily, without a break, until noon, using a pick and then removing the debris with a shovel. After a half hour break for lunch, he resumed the same work until 3:30 p.m. As in the morning, he took no breaks; again he was working alone, and under pressure, because the carpenters were right behind him building the forms. By 3:30 p.m. he was very tired, more tired according to him than on any other day that he could remember. After he had put his tools in the shed and was walking toward the plant gate, he experienced dizziness, and then fainted. He remained unconscious for several minutes.

After an examination by an Exxon doctor, he was rushed to Baton Rouge General Hospital where he was treated by Dr. Boyd E. Helm, a cardiologist. Dr. Helm's diagnosis was syncope, or fainting, related to aortic valvular stenosis and caused by a deficiency in the amount of blood reaching the brain. The stenosis, or constriction, was brought on by the calcification of a defective valve over a period of years. The calcification was the result of an aortic valve disease which may have been congenital or may have been caused by other disease such as rheumatic fever, syphilis or bacterial infections at some earlier time in his life. On the day in question, the outflow valve from the left ventricular chamber of the heart had not opened wide enough to let sufficient blood pass through, and then had not completely closed, allowing some of the blood to rush back into the heart.

Dr. Helm advised Guillory to undergo a heart catheterization to determine whether surgery was needed to replace the valve, and/or to by-pass any of his coronary arteries. The prognosis, according to Dr. Helm, based on the presence of syncope (fainting) upon exertion, was a rapid progression of the stenosis and probable death within five years unless the valve were to be replaced. For reasons not entirely clear from the record, Guillory did not have the catheterization performed; nor the heart surgery which would evidently have been recommended after the catheterization.

Following his release from the hospital on December 19, 1978, Guillory remained under Dr. Helm's care for several months. On February 14, 1979, he began seeing Dr. Charles Fontenot, a general practitioner in Ville Platte, Louisiana; on May 24, 1979, Guillory consulted Dr. Donald Gremillion, an internist in Opelousas, Louisiana. Both doctors confirmed Dr. Helms' diagnosis of aortic stenosis, treated his continuing symptoms of dizziness, chest pain, shortness of breath, and weakness, and found him to be totally and permanently disabled.

The defendant insurer paid most of plaintiff's medical bills incurred at Baton Rouge General Hospital, but refused to pay the bills of Drs. Gremillion and Fontenot, the bills for medication, and any workers' compensation benefits whatsoever, contending that Guillory's disability was not caused by the accident of December 15, 1978.

Plaintiff sued for permanent and total disability compensation payments, medical bills, penalties and attorney's fees. After trial on the merits, the trial judge concluded that "plaintiff has made out his case on the question of disability and causal connection with employment and should be awarded total and permanent disability." Defendant appealed suspensively and plaintiff answered the appeal requesting penalties and attorney's fees. In a three to two decision the Court of Appeal for the Third Circuit reversed the trial court's ruling on the merits and dismissed plaintiff's lawsuit with the order that he pay all costs in the trial and appellate courts.

In his writ application, and now in brief in this Court, plaintiff contends that the Court of Appeal erred in two respects; (1) in finding that there was no causal connection between the fainting spell and the disability; and (2) in not awarding penalties and attorney's fees.

Eligibility for worker compensation disability benefits in Louisiana is governed by R.S. 23:1021 et seq. In particular R.S. 23:1031 provides:

If an employee ... receives personal injury by accident arising out of and in the course of his employment, his employer shall pay compensation in the amounts, on the conditions, and to the person or persons hereinafter designated. (Emphasis supplied)

The requirements for a successful claim under this statute are thus personal injury which is the result of an accident, which accident in turn arises out of and in the course of employment. The Louisiana compensation act does not require that the employment cause the disability. The chain of causation required by the statutory scheme as adopted by the Legislature in R.S. 23:1031 is that the employment causes the accident, the accident causes injury, and the injury causes disability.

An accident is defined in La.R.S. 23:1021(1) as

... an unexpected or unforeseen event happening suddenly or violently, with or without human fault and producing at the time objective symptoms of an injury."

It is conceded by the parties, and the Court of Appeal so held, that Guillory suffered an accident, ⁴ by statutory definition, on Friday, December 15, 1978, which accident arose out of and in the course of Guillory's employment for PALA at the Exxon construction site in Baton Rouge, Louisiana. Furthermore, it is conceded by all that Guillory was totally and permanently disabled following December 15, 1978. The Court of Appeal stated, supra at 545:

All three physicians testified the fainting spell on December 15, 1978, was probably causally related to the strenuous physical labor performed by plaintiff that day. Furthermore, all three were of the opinion that plaintiff is now permanently and totally disabled from performing strenuous physical labor. Under this expert medical testimony, defendant concedes that plaintiff suffered a job related accident on December 15, 1978, and that he is presently disabled.

It is the intervening link of causation that is disputed: that is, whether the disability followed and was caused by the fainting spell, or instead whether plaintiff's disabled condition pre-existed, and was not caused by, the fainting. The Court of Appeal, supra at 547, concluded that the causation required by Louisiana compensation scheme was not satisfied.

Thus, all three of the doctors testified plaintiff's pre-existing aortic valve disease was not aggravated or made worse by the fainting spell on December 15, 1978. This fainting spell was only a symptom which made the doctors aware of the pre-existing heart disease and that it had progressed to the point that it was disabling.

In other words, the defendant argued, and the Court of Appeal agreed, that although the accident chronologically preceded the diagnosis of the disability, it was only coincidental with and did not cause that disability since the defective condition of the heart was essentially identical both shortly before and after the fainting spell. ⁵

In resolving the question before us, i.e., whether plaintiff's condition caused his disability, several factors, some factual, some legal, bear upon our decision.

The first, factual considerations, relate to plaintiff's condition and work...