A New Leaf, Inc. v. Webb

• Decision Date: 03 February 1998
• Docket Number: No. 0360-97-2,0360-97-2
• Parties: A NEW LEAF, INC. and Erie Insurance Exchange v. Elaine R. WEBB Record
• Court: Virginia Court of Appeals

Page 510

495 S.E.2d 510

26 Va.App. 460

A NEW LEAF, INC. and Erie Insurance Exchange v. Elaine R. WEBB

Record No. 0360-97-2.

Court of Appeals of Virginia,

Richmond.

Feb. 3, 1998.

Monica L. Taylor (Linda D. Frith; Gentry, Locke, Rakes & Moore, on briefs), Roanoke, for appellants.

Elaine R. Webb, pro se.

Present: FITZPATRICK, C.J., ^* and ELDER and ANNUNZIATA, JJ.

ELDER, Judge.

A New Leaf, Inc. and Erie Insurance Exchange (collectively "appellant") appeal a decision of the Workers' Compensation Commission ("commission") awarding medical benefits to Elaine R. Webb ("claimant"). Appellant contends the commission erred when it concluded that the allergic contact dermatitis afflicting claimant was a compensable "disease" under the Workers' Compensation Act ("Act"). For the reasons that follow, we affirm.

I. FACTS

Claimant has been employed by appellant as a floral designer since October, 1993. Her duties include designing and constructing floral arrangements and "processing" flowers that are delivered to appellant's store. Processing flowers entails removing excess foliage from the flowers, cutting their stems, and placing them in water. Two of the flowers with which claimant works are alstroemeria and tulips. In March, 1995, claimant noticed blisters and a "splotchy area" on her right index finger and palm. Claimant unsuccessfully attempted to treat this condition herself, and the irritation spread up her arms to her elbows.

On August 30, 1995, Dr. John Carpenter, claimant's family physician, examined claimant and concluded that she suffered from "dermatitis." However, Dr. Carpenter was uncertain whether claimant's dermatitis was "fungal or a contact type ... or a combination." Beginning in November, 1995, claimant was treated by Dr. Anna Magee, a dermatologist. Claimant underwent "patch tests" that revealed she was allergic to both alstroemeria and tulips. Dr. Magee diagnosed claimant with "allergic contact dermatitis to tulips and alstro[e]meria." Dr. Magee later opined that claimant's allergic contact dermatitis was caused by her exposure to alstroemeria and tulips at work. She stated that allergic contact dermatitis is "a very common problem with florists." She opined that claimant's allergic contact dermatitis "was most likely caused by at least two and probably more physical contacts with the chemicals contained in alstro[e]meria and tulips during her employment."

The record contains three articles describing the incidence, causation, and course of allergic contact dermatitis in florists. See Cindy Hoogasian, Dermatitis Concerns Spark Industry Study, Florist, Jan. 1988, at 95 ("Hoogasian I"); Cindy Hoogasian, Dermatitis Concerns Continue, Florist, March 1990, at 75 ("Hoogasian II"); Robert M. Adams, M.D. et al., Alstroemeria: The Cause of a New and Potent Allergen for Florists (manuscript of article eventually published in Dermatology Clinics, Jan. 1990). These articles state that allergens contained in plants have long been recognized as a source of dermatitis and that the condition became particularly prevalent among florists in the 1980s. See Adams, supra, at 1; Hoogasian I, supra, at 95-96, Hoogasian II, supra, at 75. Allergic contact dermatitis "is a skin irritation caused by contact with an allergen." Hoogasian I, supra, at 96. The condition "involves a reaction of the body's immune system to the substance to which that person is sensitive...." Hoogasian II, supra, at 77. Alstroemeria, tulips and other flowers contain chemicals that "cause allergic skin reactions in some people with skin sensitivities." Hoogasian I, supra, at 96, 99; see also Hoogasian II, supra, at 76, 77, Adams, supra, at 1, 4. Increased exposure to these allergens "sensitize[s] some people to the extent that an allergic reaction takes place upon contact with the chemical." Hoogasian I, supra, at 96. However, one article states that "[t]here is little or no fear" the public will develop allergic sensitivity to the allergen in alstroemeria because "their actual involvement with the flower is limited." Hoogasian I, supra, at 98. According to Dr. Alan Moshell, an occupational dermatologist in Washington, D.C., the general public has little chance of becoming sensitized to floral allergens and that "[o]nly in cases where there is constant contact with the juice of the alstroemeria, such as a designer or a sales employee would have, is there cause for concern." Id. at 96, 98. Once an individual develops an allergy to the chemicals in a particular flower, it is generally "a lifelong sensitivity." Hoogasian II, supra, at 76, 77.

Claimant filed a claim for benefits contending that her allergic contact dermatitis was a compensable occupational disease. Appellant defended against the claim on the sole ground that allergic contact dermatitis is not a compensable disease under the Act. Following a hearing, a deputy commissioner concluded that claimant's allergic contact dermatitis was a compensable occupational disease under Code § 65.2-400 and awarded benefits to claimant.

Appellant appealed, and the commission affirmed. Quoting The Stenrich Group v. Jemmott, 251 Va. 186, 199, 467 S.E.2d 795, 802 (1996), the commission stated that "job-related impairments resulting from cumulative trauma caused by repetitive motion, however labeled or however defined, are, as a matter of law, not compensable under the present provisions of the Act." The commission then found that "[t]he evidence does not establish that cumulative traumatic insults resulting from repetitive motion caused the claimant's condition." The commission also found that allergic contact dermatitis is caused by "exposure over time to a particular causative agent resulting in an adverse reaction in the form of contact dermatitis." The commission reasoned that claimant's allergic contact dermatitis was not barred from compensation under Jemmott because it did not result from a cumulative trauma caused by repetitive motion. The commission concluded that allergic contact dermatitis was a compensable occupational disease.

II.

"FLORIST'S ALLERGIC CONTACT DERMATITIS" AS A COMPENSABLE DISEASE UNDER THE ACT

Appellant contends the commission erred as a matter of law when it concluded that claimant's allergic contact dermatitis was a compensable disease. It argues that allergic contact dermatitis is a "cumulative trauma" condition and cannot be compensated under the Act. We disagree.

Although a condition caused by "cumulative trauma" cannot be a "disease" under the Act as that term has been construed by our Supreme Court, see Jemmott, 251 Va. at 199, 467 S.E.2d at 802; Merillat Indus., Inc. v. Parks, 246 Va. 429, 433, 436 S.E.2d 600, 602 (1993) (citing Morris v. Morris, 238 Va. 578, 586, 385 S.E.2d 858, 863 (1989)); see also Allied Fibers v. Rhodes, 23 Va.App. 101, 104, 474 S.E.2d 829, 830 (1996), the record in this case established that claimant's allergic contact dermatitis, although incurred over time, was not caused by the process of "trauma." Thus, we first hold that allergic contact dermatitis is not excluded per se from coverage as a disease under the Act. Turning to the legal aspect of the mixed question presented by this case, we hold as a matter of law that "florist's allergic contact dermatitis" qualifies as a disease under the Act.

A.

This case compels us to revisit an issue of some uncertainty in Virginia Workers' Compensation jurisprudence: the General Assembly's intended meaning of the word "disease" in the Act. As has often been stated, the Act currently provides coverage for impairments arising out of and in the course of employment that fall into one of two categories: (1) "injury by accident" or (2) "occupational disease." Code § 65.2-101; see Jemmott, 251 Va. at 192-93, 467 S.E.2d at 798-99; Merillat, 246 Va. at 431, 436 S.E.2d at 600-01; Holly Farms/Federal Co. v. Yancey, 228 Va. 337, 340, 321 S.E.2d 298, 299 (1984). Although used repeatedly in the text of the Act, the word "disease" was not defined by the General Assembly.

The Supreme Court has set forth some basic parameters for determining whether a particular impairment or condition was intended by the General Assembly to be compensated as a "disease" under the Act. First, the Court has stated that when the General Assembly added "occupational diseases" to those impairments covered by the Act in 1944, it intended this coverage to be "carefully limited." Morris, 238 Va. at 584, 385 S.E.2d at 862. In addition, in order for a condition to be compensable as an occupational disease, it "must first qualify as a disease." Merillat, 246 Va. at 432, 436 S.E.2d at 601. As such, whether an impairment or condition is a compensable "disease" is a mixed question of law and fact that is reviewable on appeal. See Jemmott, 251 Va. at 192, 467 S.E.2d at 798. The "factual part" of the mixed question includes both the nature and causation of a claimant's ailment. See id. The "legal part" of the mixed question involves deciding "whether these impairments ... constitute diseases within the contemplation of the Act." Id. (also stating that "the crucial inquiry is whether the Commission correctly applied the law to the established facts"). Medical evidence that a particular condition is considered a disease, standing alone, is not dispositive of whether the condition is covered under the Act as a disease. See id. at 198, 467 S.E.2d at 801 (stating that "just because a doctor opines that a particular impairment is a disease does not necessarily make it so").

Regarding the substantive meaning of the word "disease" under the Act, the Supreme Court has eschewed the approach of setting forth a "bright line" definition of disease. Instead, the Supreme Court has only defined disease in the negative, stating what the term "disease" does not mean. According to the Supreme Court, the General Assembly's intended meaning of "disease" is not so broad as to "encompass any bodily ailment of whatever origin," Yancey, 228 Va. at 340, 321...