Keystone Automotive v. Hall

• Decision Date: 10 July 2008
• Docket Number: No. A08A0086.,A08A0086.
• Citation: 292 Ga.App. 645,665 S.E.2d 392
• Parties: KEYSTONE AUTOMOTIVE et al. v. HALL.
• Court: Georgia Court of Appeals

665 S.E.2d 392

292 Ga.App. 645

KEYSTONE AUTOMOTIVE et al. v. HALL.

No. A08A0086.

Court of Appeals of Georgia.

July 10, 2008.

Drew, Eckl & Farnham, David Austin Smith, Atlanta, for Appellant.

Westmoreland, Patterson, Moseley & Hinson, Thomas W. Herman, Macon, for Appellee.

BARNES, Chief Judge.

We granted this discretionary appeal to Keystone Automotive, the employer of the late Gordon Luther Hall, Sr., and its insurer, Hartford Insurance Company of the Midwest/SRS (collectively "Keystone Automotive") to challenge the judgment of the superior court reversing the award of the Appellate Division of the State Board of Workers' Compensation and granting death benefits to his widow, Holly Hall. Finding no error, we affirm.

The following facts were stipulated by the parties: Mr. Hall was a route salesman for Keystone Automotive. On the date of his injury he reported to work as usual, and after speaking with his general manager, he walked through the warehouse area to the front counter where, after speaking with two employees, he walked to the back of the warehouse. He was not seen again until he was discovered by other employees on the ground outside of the warehouse bay door beside his truck. Although the employees performed CPR and called for an ambulance, Hall never regained consciousness and died after three weeks of hospitalization.

Mr. Hall's widow filed a claim for workers' compensation benefits which the employer contested. The claim was referred to a Workers Compensation Administrative Law Judge ("ALJ") for resolution. The parties stipulated that Hall performed none of the work-related tasks that might be described as strenuous before he was discovered lying beside his truck. The ALJ concluded that because the employee was in a place where he would reasonably be expected to be while on the job and his death was unexplained, Hall's widow was entitled to the presumption that the death arose out of Hall's employment. See Zamora v. Coffee Gen. Hosp., 162 Ga.App. 82, 84-85, 290 S.E.2d 192 (1982).

Apparently relying on the failure of doctors to reach a consensus on the exact cause of Hall's death, the ALJ further reasoned that the employer failed to overcome the Zamora presumption by affirmatively demonstrating that the death did not arise out of his employment. The ALJ noted that the claim would not be compensable absent the presumption established in Zamora.

Keystone Automotive appealed, and the State Workers' Compensation Board appellate division reversed in a 2-1 decision. The majority concluded that the presumption of compensability discussed in Zamora did not arise here as all of the medical evidence indicated that Hall died of a naturally occurring event unrelated to his work duties. The majority further opined that even if the presumption applies here, the medical evidence was sufficient to overcome the presumption of compensability.

The dissenting judge, however, agreed with the ALJ that Zamora controls and compels a contrary outcome. The dissent further found that the physicians' opinions were speculative, and that this was not a "heart attack case" because Mr. Hall's medical records from the three weeks he survived in the hospital "were consistent with a normal heart."

The Appellate Division's award states that Mr. Hall's treating physician found that the cause of his "cardiopulmonary arrest was most likely due to underlying cardiac dysrhythmia and that during the course of resuscitation, he did suffer anoxic encephalopathy, which eventually led to his death." (Emphasis supplied.) Another physician who performed an independent review of Mr. Hall's medical record opined that "the most likely explanations" for Mr. Hall's cardiac arrest were that he "could have" suffered primary "ventricular hypertrophy or he could have had a markedly slow or absent pulse from a cardiac conduction system failure." (Emphasis supplied.)

The Appellate Division apparently placed great weight upon the opinion of the physician who conducted the independent medical review of Mr. Hall's records, who further said that "[w]hile it is not crystal clear exactly what [caused Mr. Hall to collapse], none of the plausible causes of his collapse have any relationship whatsoever to Mr. Hall's employment. This unexpected and tragic event was clearly the result of a naturally occurring event unrelated to his usual work of employment." (Emphasis in original.)

Mrs. Hall appealed to the superior court, which reversed. She successfully argued that the appellate division erred by confusing the "immediate" cause of death with the "precipitating" cause of death, which may be described as the event or chain of events leading to Hall's death. The superior court found that because no evidence suggested what exactly caused Hall's cardio-pulmonary arrest, there is no evidence to suggest a non-work-related, precipitating cause of death. Based on this reasoning the superior court reversed the award of the Appellate Division.

1. Keystone Automotive contends the superior court erred by reversing the appellate division, in what Keystone Automotive's counsel contends was "a shockingly sloppy decision," because the court misapplied the "any evidence" standard. Keystone Automotive alleges that because the award of the board was supported by some evidence, the board's findings were conclusive and binding on the court.

On appeal from an award of the Appellate Division

of the State Board of Workers' Compensation, this Court examines the record to see if there is competent evidence to support the award and construes the evidence in a light most favorable to the prevailing party. The question of whether the trial court applied the correct legal standard in evaluating the evidence, however, is one of law, which we review de novo.

(Citation and punctuation omitted.) Bayer Cor. v. Lassiter, 282 Ga.App. 346, 347, 638 S.E.2d 812 (2006). Further, "[i]t is axiomatic that the findings of the State Board of Workers' Compensation, when supported by any evidence, are conclusive and binding, and that neither the superior court nor this court has any authority to substitute itself as a fact finding body in lieu of the board." (Citation and punctuation omitted.) South Ga. Timber Co. v. Petty, 218 Ga.App. 497, 498, 462 S.E.2d 176 (1995).

The Workers' Compensation Act was enacted to "alleviate the suffering of the injured workers and their families by providing immediate and certain financial assistance, regardless of whether the injury resulted from the fault of the employer, as long as the injury arose out of and in the course of employment." Travelers Ins. Co. v. Southern Elec, 209 Ga.App. 718, 719(1), 434 S.E.2d 507 (1993). In furtherance of these aims an injury

means only injury by accident arising out of and in the course of the employment and shall not, except as provided in this chapter, include a disease in any form except where it results naturally and unavoidably from the accident.... "Injury" and "personal injury" shall not include injury caused by the willful act of a third person directed against an employee for reasons personal to such employee, nor shall "injury" and "personal injury" include heart disease, heart attack, the failure or occlusion of any of the coronary blood vessels, stroke, or thrombosis unless it is shown by a preponderance of competent and credible evidence, which shall include medical evidence, that any of such conditions were attributable to the performance of the usual work of employment....

OCGA § 34-9-1(4).

Keystone Automotive further contends the superior court erred in applying the presumption arising from an unexplained death because the medical evidence explained the precipitating cause of Mr. Hall's death, and erred by ignoring the definition of "injury" in OCGA § 34-9-1(4) which excludes heart attacks from "injury" unless a preponderance of competent and credible evidence, including medical evidence, shows that the heart attack was attributable to the employee's performance of his usual work.

Mrs. Hall contends the precipitating cause of her husband's death was unknown and, therefore, the presumption that his death arose from his employment was properly applied by the superior court. She contends the precipitating cause of her husband's death was not explained, and the medical opinions merely go to the immediate cause of his death. Thus, the lack of any evidence showing why his heart went into dysrhythmia means the presumption should apply. She further contends that Keystone Automotive's theories to the contrary are based upon mere speculation. We agree.

The medical evidence in this case is far from conclusive. Mr. Hall's death certificate says that the immediate cause of death was "cardio pulmonary arrest due to, or as a consequence of cardiac dysrhythmia." In his report, the independent medical reviewer states that

[d]uring the course of [Hall's] hospitalization a CT scan of the brain was done which showed evidence of anoxic encephalopathy but no hemorrhage or ischemic stroke was seen. A cardiac catheterization done on the day of admission showed calcification in the left main coronary artery but no significant obstruction was seen throughout the coronary arteries. Left ventricular function was normal. The admission ECG showed sinus rhythm with a right bundle branch block and left anterior fascicular block with a normal PR interval. Throughout his hospitalization Mr. Hall remained electrically and hemodynamically stable. ...

There are two most likely causes for Mr. Hall's cardiac arrest: he could either have suffered primary ventricular tachycardia or fibrillation on the basis of just having left ventricular hypertrophy or he could have had a markedly slow or absent pulse from a cardiac conduction system failure. His underlying `bifasciular block' manifested by his right bundle branch block and leftward axis on the ECG does speak to some conduction problems. Mr. Hall did not manifest either ventricular...