Haughton v. Fireman's Fund Am. Ins. Companies

Decision Date06 March 1978
Docket NumberNo. 60765,60765
Citation355 So.2d 927
PartiesSamuel HAUGHTON v. FIREMAN'S FUND AMERICAN INS. COMPANIES.
CourtLouisiana Supreme Court

Jerome P. Halford, New Orleans, for plaintiff-applicant.

Lawrence J. Duplass, Johnston & Duplass, New Orleans, for defendant-respondent.

DIXON, Justice.

Samuel Haughton brought this action claiming workmen's compensation for a total disability allegedly caused by a work related injury. The trial court judgment denying compensation was affirmed by the Court of Appeal. 349 So.2d 385 (La.App. 4th Cir. 1977). We granted certiorari to review that judgment on October 14, 1977. 1

Samuel Haughton was employed as a common laborer by the Jefferson Parish Sewerage Department. On November 4, 1974 he stumbled on a stick lying on the ground while carrying one end of a heavy timber and fell, breaking his left thigh just above the knee. He was hospitalized, and the fracture was surgically reduced and fixed with a steel plate and screws.

Tests made after the initial hospitalization suggested a bone marrow disorder, which was subsequently diagnosed as multiple myeloma. The break was thought to have been a "pathological fracture," caused by weakening of the walls of the bone. In addition to the orthopedic treatment, Haughton was placed under the care of a hematologist for the control and treatment of the myeloma. The hematologist did not testify, nor were his reports introduced in evidence.

The orthopedic surgeon testified to a long period of recuperation and treatment, during which Haughton complained of some pain and weakness, reaching a point at which he could walk with a cane, depending on muscle relaxants and tranquilizers for control of the pain. The orthopedist found that Haughton could only bend his leg to about a 90 degree angle, and that the steel plate "probably impinges against the lateral border of the patella periodically." The doctor ascribed a 25% Residual disability to the left leg of Haughton "as a result of the injury and subsequent surgery."

On June 4, 1976 the defendant insurance company terminated payment to Haughton. The claims manager testified that two medical reports prompted the termination. One was from the orthopedist, saying that the fracture had healed; the other was from the hematologist, relating his opinion that Haughton "will never be able to return to work because of his myeloma." 2

The orthopedic surgeon testified to the effect that the fracture had healed, but that Haughton's "myeloma condition does preclude his return to work." On this testimony, the trial judge found that Haughton's myelomata, not the accident, caused his disability. The Court of Appeal concluded that the "medical evidence is controlling in this case and that plaintiff's present disability is not causally connected to the work-related accident." Haughton v. Fireman's Fund, 349 So.2d 385, 387.

Causation is not necessarily and exclusively a medical conclusion. It is usually the ultimate fact to be found by the court, based on all the credible evidence.

The orthopedic surgeon's conclusion that Haughton could have returned to work in the absence of the myelomata is inconsistent with his other findings. First, Haughton probably would not have suffered the broken leg (the "pathological fracture") except for the weakening of the bone at the fracture site by the multiple myeloma. Second, the conclusion ignored other findings by the physician, that Haughton had a 25% Disability of the left leg, could hardly bend it more than 90 degrees, and was unstable and painful. There was no medical evidence that these symptoms, nor the necessity for the cane in walking, were caused by anything other than the fracture. Finally, there was only slight consideration given to the nature of Haughton's employment, which was of the most strenuous nature.

The uncontradicted medical opinions in the record do establish that the multiple myeloma was disabling, but the orthopedist's opinion that the fracture was not disabling is contradicted by his own findings.

Professor Malone writes:

"In the trial of compensation cases medical experts are frequently requested to give their opinions as to the extent of the disability involved. The estimate of disability offered by the medical expert should not be confused with the estimate of disability which must eventually be made by the judge. The medical expert defines disability in terms of the physiological injury and its effect upon the performance of the mechanical operations which the claimant can perform prior to and after the accident. The material upon which he draws is largely that of anatomy, physiology, and...

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