Reid v. Gamb, Inc.

• Decision Date: 22 June 1987
• Docket Number: No. 87-C-0110,87-C-0110
• Citation: 509 So.2d 995
• Parties: Tilmon W. REID v. GAMB, INC. d/b/a Stark's Family Restaurant.
• Court: Louisiana Supreme Court

Page 995

509 So.2d 995

Tilmon W. REID v. GAMB, INC. d/b/a Stark's Family Restaurant.

No. 87-C-0110.

Supreme Court of Louisiana.

June 22, 1987.

Rehearing Denied Sept. 3, 1987.

Chris J. Roy, Robert Herrington, Alexandria, for applicant.

John T. Bennett, Bennett, Bennett & Bennett, Marksville, Henry B. Bruser, III, Gold, Simon, Weems, Bruser, Sharp, Sues & Rundell, Alexandria, for respondent.

DENNIS, Justice.

This is a worker's compensation case involving a claim for benefits as a result of an employee's cerebral vascular accident, or stroke, allegedly caused by his employment. The trial and intermediate appellate courts denied recovery. Reid v. Gamb, Inc., 499 So.2d 644 (La.App. 3rd Cir.1986). We affirm although we do not agree totally with the reasons assigned below.

The plaintiff employee, Tilmon W. Reid, was employed as the district manager of five Stark's Family Restaurants in Pineville, Port Allen, Bunkie, Donaldsonville and Marksville. In this capacity, which he held for about one year, he was required to visit the stores, monitor operations, interview applicants, review financial reports and perform other managerial duties. On January 3, 1984 Reid spent the day working with other employees to prepare the Donaldsonville store for its initial opening. At 6:00 p.m., after helping stock the storeroom, he picked up a snack at a convenience store and checked into a motel room which he shared with the Stark's equipment manager. Between 9:00 p.m. and 10:00 p.m. he noticed a numbness in his right arm and hand but went to sleep disregarding the symptoms. When Reid awoke the next morning, however, he could not lift his right arm and his mouth was drawn. Later that day his doctor determined that he had suffered a cerebral vascular accident and hospitalized him for three days. Afterwards he was discharged but continued to be treated by a physician. The employer paid worker's compensation but discontinued benefits on March 24, 1984. Disputes as to whether Reid was disabled and whether his stroke was employment-related led to this litigation.

1. Worker's Compensation Law

The Louisiana Worker's Compensation Act provides that if an employee receives personal injury by accident arising out of and in the course of his employment, the employer shall pay compensation. La.R.S. 23:1031.

As the court of appeal correctly observed, it is well settled that the occurrence of a cerebral vascular accident, or stroke, is a "personal injury by accident" within the ambit of La.R.S. 23:1031. Leleux v. Lumbermen's Mutual Insurance Company, 318 So.2d 15 (La.1975); Lonzo v. Town of Marksville, 430 So.2d 1088 (La.App. 3rd Cir.1983); writ denied 438 So.2d 576 (La.1983). Reid v. Gamb, Inc., 499 So.2d at 646.

The court of appeal also concluded correctly that, because Reid was required to stay overnight in Donaldsonville away from his home in pursuit of his employer's business, namely the opening of a new restaurant the next day, and was not there pursuing his own interests, he was "in the course of his employment" under La.R.S. 23:1031 when he suffered the stroke in his motel room. An accident occurs in the course of employment when it happens during the time of employment and at a place contemplated by the employment. Michaleski v. Western Preferred Cas. Co., 472 So.2d 18 (La.1985); Guidry v. Sline Industrial Painters, Inc., 418 So.2d 626 (La.1982); Lisonbee v. Chicago Mill & Lbr. Co., 278 So.2d 5 (La.1973); Kern v. Southport Mill Ltd., 174 La. 432, 141 So. 19 (1932).

The function of the "arising out of" requirement of La.R.S. 23:1031 is to assure that compensation will be awarded only for personal injury causally related to the employment and fairly part of the employer's cost of business. Nix v. City of Houma, 488 So.2d 184 (La.1986); Adams v. New Orleans Public Service, Inc., 418 So.2d 485 (La.1982); Guidry v. Sline, supra; Leleux v. Lumbermen's Mutual Ins. Co., 318 So.2d 15 (La.1975); Roussel v. Colonial Sugars, 318 So.2d 37 (La.1975); Prim v. City of Shreveport, 297 So.2d 421 (La.1974) and, generally, Larson, Workmen's Compensation Law (1985) Vol. 1B, § 38.81 and W. Malone & H. Johnson, 13 Louisiana Civil Law Treatise--Workers' Compensation Law and Practice § 191 (2d Ed.1980). In heart disease and related cases many courts have established special rules for proof of causation because death or injury from heart disease may ordinarily be the result of natural physiological causes rather than trauma or particular effort and because of the fear that heart cases and related types of injury and death will get out of control unless some kind of arbitrary boundaries are set up. 1B A. Larson § 38.81.

This court in Guidry v. Sline Industrial Painters, Inc., 418 So.2d 626, 633 (La.1982) drew upon the rules suggested by Professor Larson, see 1B A. Larson, Workmen's Compensation Law § 38.83 (1980), to formulate precepts to govern proof that a worker's heart accident arises out of the employment: (1) If the employee has a previously weakened or diseased heart the employment exertion, stress or strain, acting on the preexisting condition, must be a degree greater than that generated in everyday non-employment life and must be a cause in fact of the employee's personal injury or death; (2) if there is no prior weakness or disease, the employment exertion, stress or strain must be simply a cause in fact of the worker's personal injury or death; (3) to be a cause in fact in either situation the employment exertion, stress or strain must precipitate, accelerate, aggravate, or otherwise cause or contribute to the worker's personal injury or death. 1B Larson § 38.83(h); see also Leleux, supra; and Roussel, supra.

In Guidry this court made clear that there is no presumption that a vascular accident occurring on the job is caused by the employment. The plaintiff must prove the causal link between the employment and the accident by a preponderance of the evidence. Guidry v. Sline, supra; see Prim v. City of Shreveport, 297 So.2d 421 (La.1974).

These precepts are compatible with many preexisting jurisprudential rules. Accordingly, it is not necessary for the claimant to prove that the work was the sole cause of the heart injury, so long as it is shown to be a contributing, accelerating or aggravating factor. Guidry v. Sline, supra; Parks v. Insurance Company of North America, 340 So.2d 276 (La.1976); and Roussel, supra. The presence of a history of arteriosclerosis or even the fact a heart attack was "inevitable", does not necessarily rule out an award. Guidry v. Sline, supra; Guillory v. United States Fidelity & Guaranty, 420 So.2d 119 (La.1982); Guidry v. Serigny, 378 So.2d 938 (La.1979); Cadiere v. West Gibson Products Co., 364 So.2d 998 (La.1978); and Roussel, supra. Lay testimony may be relied on to support a causal connection, even when there is positive medical testimony to the contrary. In view of medical experts' understandable tendency to assess causation of disease in the context of the patient's whole history, rather than as it relates specifically to employment, their testimony as to job-injury relationships should be evaluated carefully: for example, cautious medical testimony couched in terms of "might have" and "possibly" may be used in conjunction with lay testimony to find a probability, and positive conclusory statements about causation by doctors should not be uncritically adopted. Beaty v. Thiokol, 414 So.2d 1292 (La.App.2d Cir.1982); see, Walton v. Normandy Village Homes Assoc., Inc., 475 So.2d 320 (La.1985); Lucas v. Insurance Co. of N. America, 342 So.2d 591 (La.1977); Malone & Johnson, supra, § 256; and see, generally, Kostamo v. Marquette Iron Mining Co., 274 N.W.2d 411 (Mich.1979).

This case raises the question of whether the Guidry formula for proof of a causal link between job and accident, which was adopted in a heart attack case involving physical stress, should also apply in a cerebral vascular accident case, and, if so, whether the formula applies even when the employment contribution to the accident consists solely of mental or emotional stress. In Guidry this court was not required to answer these questions and specifically noted that a different standard for mental and emotional stress cases had been enunciated in McDonald v. International Paper Co., 406 So.2d 582 (La.1981). Guidry v. Sline Indus. Painters, Inc., 418 So.2d at p. 631, n. 11, p. 633, n. 17. No reason may be surmised from the court's opinion for reserving judgment on these questions, however, other than traditional judicial reluctance to decide an issue not presented.

Confronting the questions squarely in the present case, we conclude that the formula adopted by this court in Guidry for heart cases should also be applied in cerebral vascular accident cases. It is well settled that a worker may recover compensation for a stroke if his employment contributed to the accident and that he carries the burden of proving this causal link by a preponderance of the evidence. Leleux v. Lumbermen's Mutual Ins. Co., supra; Lonzo v. Town of Marksville, supra. As this court observed with respect to heart attacks, if the physical exertion, stress or strain on the job, and preceding the infarction, is no more than the worker would likely have experienced in a non-work situation, the attack may be a result of the natural progression of a preexisting disease rather than the result of the employment activity. Guidry v. Sline, supra; see 1B A. Larson, Workmen's Compensation Law § 38.83, (1980); and Malone & Johnson, supra, § 261 (1987 Supp.). In order to avoid unfairly charging the employer with the cost of strokes not causally related in some way with the employment, if the employee has a preexisting weakness or condition that predisposes him to a cerebral vascular accident, the claimant should be required to prove that the employment acting on the preexisting condition was a degree greater than that generated in everyday non-employment life. Malone & Johnson, ...