Medlin v. County of Henrico Police

• Decision Date: 27 February 2001
• Docket Number: Record No. 1048-00-2.,Record No. 1047-00-2
• Parties: James Isaac MEDLIN, Jr. v. COUNTY OF HENRICO POLICE. Stephen Douglas Vass v. County of Henrico Police.
• Court: Virginia Court of Appeals

542 S.E.2d 33

34 Va. App. 396

James Isaac MEDLIN, Jr. v. COUNTY OF HENRICO POLICE.

Stephen Douglas Vass v. County of Henrico Police.

Record Nos. 1047-00-2, 1048-00-2.

Court of Appeals of Virginia, Richmond.

February 27, 2001.

Malcolm Parks (Maloney, Parks, Clarke & Nathanson, P.C., on briefs), Richmond, for appellants.

Ralph L. Whitt, Jr. (John T. Cornett, Jr.; Williams, Lynch & Whitt, on briefs), Richmond, for appellee.

Present: ELDER and ANNUNZIATA, JJ., and COLEMAN,¹ Senior Judge.

ANNUNZ TATA, Judge.

Appellants, James Isaac Medlin, Jr. and Stephen Douglas Vass, Henrico County police officers, were diagnosed with heart disease and filed for workers' compensation benefits. Following separate hearings, each was awarded compensation. The employer appealed to the full commission and the full commission reversed both awards of the deputy commissioner and denied Medlin's and Vass' claims. Medlin and Vass contend the full commission erred in finding that the employer had carried its burden of proving in each case, by a preponderance of the evidence, that Medlin's and Vass' work was not a proximate cause of heart disease.²

The employer responds that the commission properly found the employer rebutted the Code § 65.2-402 presumption and that Medlin and Vass both failed to prove, "by clear and convincing evidence," that their heart disease arose out of and in the course of their employment. See Code § 65.2-401.

For the following reasons, we reverse and remand both cases.

I. BACKGROUND

Medlin v. County of Henrico Police

Medlin, age fifty-three, began work as a police officer for the County of Henrico on October 30, 1974 and continued to be employed in that position at all times relevant to this case. As required by his employer, he underwent a physical examination in 1976. At that time Medlin was found to be free of heart disease and hypertension.

In the course of his twenty-four-year career as a law enforcement officer with the County, Medlin held "street duty" positions for nineteen of those years and had administrative assignments for the remaining five years. Medlin described the numerous physically demanding and dangerous activities that his job required, and stated that he found these activities to be stressful.³

On May 2, 1997, Medlin consulted his family physician, Dr. Donald B. Longest, after experiencing some chest "tightness" and shortness of breath while taking a walk. Dr. Longest ordered a cardiac stress test and referred Medlin to a cardiologist. Significant coronary artery blockages were found, and Medlin underwent three-vessel coronary artery bypass grafting on May 5, 1997. Medlin was incapacitated from work from May 2, 1997 until he was cleared to resume his police work on January 21, 1998.

One of Medlin's treating cardiologists, Dr. Robert M. Bennett, noted after his initial consultation with Medlin that he had several "cardiac risk factors," including high cholesterol, hypertension, and a family history which included a father who had died of a heart attack at age forty-one or forty-two, a brother who had bypass surgery at age fortysix, and a mother who had bypass surgery at age seventy-nine. Dr. Bennett and Dr. Bradford Matthews, another one of Medlin's treating cardiologists, answered interrogatory-type questions in which they indicated that they could not exclude Medlin's workrelated stress "as a contributing factor in the development, acceleration and/or aggravation" of his heart disease. Both doctors concluded that Medlin's heart disease was "multi-factorial" and that it was "more probable than not" that Medlin's employment contributed in some degree to his disease.

Cardiologist Dr. Richard A. Schwartz examined Medlin on January 8, 1998 and reviewed his medical records. Dr. Schwartz concluded that Medlin had several risk factors, including family history, high cholesterol and occupational stress, and that "it is more probable than not that Officer Medlin's work was a contributing factor in the development of his heart disease." Dr. Schwartz also submitted a supplemental report to which he appended a chapter in a medical textbook published in 1998, which linked stress to cardiovascular disease. On December 3, 1997, Dr. Michael Hess examined Medlin at the request of the employer. Dr. Hess met briefly with Medlin but did not discuss with him the details of his employment. In his deposition, Dr. Hess conceded that he knew nothing about the dangers or physical and emotional demands of Medlin's job. Rather, Dr. Hess concluded that, as a general matter, there is no link between stress and heart disease. Specifically, he stated, "[t]here is no evidence in the literature that stress or work-related factors play any primary cause in the development of coronary artery disease. Further there is absolutely no evidence that employment as a police officer is a factor in causing the coronary artery disease." Dr. Hess admitted that he could not identify any authority that disproved the connection between law enforcement work and hypertension but, rather, based his opinion on what he perceived to be a lack of affirmative proof of a connection. Dr. Hess concluded that Medlin's heart disease was caused by family history, high cholesterol, and hypertension. However, he also stated that "emotional stress on the job can contribute to hypertension or aggravate hypertension." Dr. Hess conceded that Medlin was free of heart disease and hypertension when he began his employment with the County and that Medlin's earliest elevated blood pressure measurement was taken in 1990.

Dr. Mark Bladergroen, who performed the bypass surgery on Medlin, answered the same interrogatory-type questions answered by Drs. Bennett and Matthews. Dr. Bladergroen indicated that he could exclude Medlin's work as a contributory factor in his disease but then stated that the cause of Medlin's disease was multi-factorial and that it was "unknown" whether it was more probable than not that the demands and stresses of Medlin's work as a police officer contributed to his heart disease.

Vass v. County of Henrico Police

Vass, age fifty-one, began his employment as a police officer for Henrico County in 1974, and has worked in that capacity ever since. In 1976, Vass' employer required him to undergo a physical examination. He was found to be free of heart disease and hypertension at that time.

In the course of his career as a law enforcement officer for the County, Vass held a "uniform," or "front-line" position for the first eight years. During that period, he was concurrently assigned to the County's tactical squad, commonly known as the "SWAT" team. Since 1982, Vass has been assigned to the Investigative Section. Vass described numerous physically demanding and dangerous activities that his job required and stated that he found these activities to be stressful.⁴

In February, 1997, Vass experienced back pain and two episodes of shortness of breath. On February 11, 1997, he visited his family physician, Dr. Richard Overmeyer, who referred Vass to a cardiologist, Dr. Charles M. Zacharias. Dr. Zacharias diagnosed Vass with coronary artery disease and performed a heart catheterization and coronary angioplasty. Vass returned to work on March 17, 1997.

Vass' medical records indicate that in February, 1997, he had several "risk factors," including high blood pressure, high cholesterol, a history of cigarette smoking, and heart disease suffered by two of his family members, an uncle and a cousin, Vass' family physician, Dr. Overmeyer, answered interrogatory-type questions in which he indicated that he could not exclude Vass' work-related stress "as a contributing factor in the development, acceleration and/or aggravation" of his heart disease. Dr. Overmeyer concluded that Vass' heart disease was "multi-factorial" and that it was "more probable than not" that Vass' employment contributed in some degree to his disease.

Vass' cardiologist, Dr. Zacharias, answered the same interrogatory-type questions answered by Dr. Overmeyer. Dr. Zacharias indicated that Vass' disease was "multifactorial" and that he could not exclude Vass' work as a contributing factor in his disease. However, Dr. Zacharias answered "no" to the question whether it was more probable than not that the demands and stresses of work as a police officer contributed to his heart disease.

Dr. Richard A. Schwartz reviewed Vass' medical records but did not examine Vass. Dr. Schwartz concluded that "it is probable that officer Vass' occupational risk factor was contributory in that insofar as any risk factor is contributory to the development of coronary artery disease" and that "[Vass] occupational stress can be considered a contributing factor."

Drs. Michael Hess and Stuart Seides reviewed Vass' medical records at the request of the employer but neither examined Vass. Both doctors concluded that, as a general matter, there is no link between stress and heart disease. Specifically, Dr. Hess stated in his deposition, "I do not believe that stress leads to the development of coronary artery disease," and he agreed with the statement that "there is no persuasive evidence that stress, in whatever form, contributes to the development of coronary artery disease." Dr. Seides stated in his deposition that "a person's occupation as a police officer ... cannot in any reasonable way be linked with the development of coronary artery disease." Dr. Seides admitted that his opinion that Vass' work did not contribute to his disease was based on what Dr. Seides perceived to be a lack of affirmative proof of such a causal connection.

II. ANALYSIS

A. Code § 65.2-402 Presumption— Prima Facie Case

In this matter of first impression before the Virginia appellate courts, we address the question of whether testimony which only generally refutes the existence of a causal relationship between work-related stress and heart disease rebuts the statutory presumption established under Code §...