SAFECO INS. COMPANIES v. Blackmon

• Decision Date: 31 May 2002
• Citation: 851 So.2d 532
• Parties: SAFECO INSURANCE COMPANIES v. David BLACKMON.
• Court: Alabama Court of Civil Appeals

851 So.2d 532

SAFECO INSURANCE COMPANIES v. David BLACKMON.

2000452.

Court of Civil Appeals of Alabama.

May 31, 2002.

Certiorari Denied December 13, 2002.

Bennett L. Pugh, Joseph H. Driver, and Khristi Doss Flood of Carr, Allison, Pugh, Howard, Oliver & Sisson, P.C., Birmingham, for appellant.

Robert W. Lee and Wendy N. Thornton of Lee & Thornton, Birmingham, for appellee.

Alabama Supreme Court 1011731.

MURDOCK, Judge.

Safeco Insurance Companies appeals from a trial court's judgment awarding David Blackmon benefits under the Alabama Workers' Compensation Act. We reverse the trial court's judgment.

Blackmon has worked in the insurance business since graduating from college in 1973. During the almost 28 years between Blackmon's graduation and the time of trial, Blackmon worked for several insurance companies before working for Safeco. For one of these, Hartford Insurance Company, Blackmon worked for approximately 19 years. He began work for Hartford as a claims adjuster and was eventually promoted to the position of claim manager; in that position he was responsible for his entire office and all of the claims processed by that office. This managerial position entailed supervising of 10 to 15 employees, as well as overseeing the budget. After leaving Hartford, Blackmon worked for another national insurance company as a supervisor.

Blackmon went to work for Safeco in 1990 as a claims representative, a position he continued to hold at the time of trial. As a claims representative, Blackmon does not manage or supervise any other employees, and he is not responsible for the budget; he is a salaried employee. Until the summer of 1998, Blackmon's average monthly caseload with Safeco was somewhere between 100 and 130 claims, an amount Blackmon described as manageable.

For a two- to three-month period during the summer of 1998, Blackmon's caseload increased to between 150 and 200 claims per month. At the time, Safeco had acquired another insurance company and a number of employees had resigned during the transition, forcing the claims adjusters who remained with the company to absorb the workloads of those adjusters who had resigned. In addition to the increased workload during the period, Safeco was in the process of converting from a paper-based record-keeping system to a computerized system. Blackmon testified that he had no experience with computers and that he found these changes in technology to be tedious and time-consuming, causing him to fall further behind in his work. Although Safeco adjusters were required to work 37.5 hours per week, each adjuster was also required to perform the essential work on all assigned claims in a timely fashion, and it appears from the record that the 37.5-hour figure represented a minimum requirement, not a maximum requirement. Consequently, for a period of two to three months ending on September 8, 1998, Blackmon worked 70-75 hours per week.

On September 8, 1998, Blackmon came to work at about 7:00 a.m., turned on his computer, and began to read his e-mail. He testified that he was looking around his office, feeling overwhelmed by his workload, when he felt his "whole body just like started from the tip of my toes up—just like heated up, and it was like somebody was inside my chest with a sledgehammer just trying to beat their way out of my chest."

Blackmon testified that he immediately took two aspirins and told a coworker that he would be going to the emergency room because he felt like he was having a heart attack. Blackmon went to the emergency room at Brookwood Hospital in Birmingham; he was admitted to the hospital for testing. Dr. David Jackson, who became Blackmon's treating physician, testified by deposition. He stated that he had diagnosed Blackmon with unstable angina pectoris.¹ After performing a heart catheterization and coronary arteriogram, Dr. Jackson concluded that Blackmon was suffering from two-vessel coronary-artery disease.² A procedure called "rotational atherectomy"³ was performed on Blackmon. After the affected arteries were cleared by the atherectomy, Dr. Jackson placed two "stents," or tubes, inside one of the arteries to help keep it open. These procedures were successful and, according to Dr. Jackson, the affected arteries were left with "zero percent blockage," and were "completely opened up." Blackmon was discharged on September 9, 1998, the day after the procedure, and was told he could return to work on the following Monday.

When questioned at his deposition on the causation of Blackmon's illness, Dr. Jackson explained that he believed that multiple factors had combined to cause Blackmon's condition, including: Blackmon's brief history of smoking, his family history of heart disease,⁴ his high blood pressure, his high cholesterol, and stress. Dr. Jackson explained that it was impossible to separate the factors and assign a degree of significance to each one, although he did state that he did not believe that Blackmon's smoking history was very significant because he had smoked for such a brief period and had ceased smoking so long ago.

Blackmon was readmitted to the hospital with complaints of chest pain on September 14, 1998. He was evaluated by one of Dr. Jackson's partners who performed a cardiac catheterization on Blackmon, determined that there were no new blockages, and confirmed that the stents that had been surgically placed in Blackmon's arteries during his previous hospital admission were performing well. Dr. Greg Champion, a gastroenterologist, performed some tests and concluded that Blackmon suffered from gastroesophageal reflux disease, and surmised that this had caused his chest pain. Dr. Jackson saw Blackmon in his office for a follow-up visit on September 24, 1998, and noted that Blackmon had returned to work and was recuperating well.

On October 22, 1998, Dr. Jackson wrote a letter to Angela Luse, a representative of Safeco's workers'-compensation insurance carrier, to inform her that, in his opinion, stress experienced by Blackmon in connection with his work had been a contributing factor in causing Blackmon's coronary-artery disease. Dr. Jackson wrote a second letter on September 30, 1999, to Wendy Thornton, an attorney whom Blackmon had retained to assist him in the recovery of workers'-compensation benefits for injuries he claims were related to the work he performed at Safeco. In the letter he stated that Blackmon's coronary-artery disease appeared to be well under control following the performance of the 1998 surgical procedure and Blackmon's modification of his lifestyle and diet. In the letter, Dr. Jackson further stated:

"The coronary artery disease development is, therefore, in my opinion, multifactorial, and I do not believe that one can isolate one risk factor as the most important. However, I do believe that if he worked 70-75 hours a week as an insurance adjuster, that over the years that may have contributed to the development of his coronary artery disease.

"As far as I am able to determine from his current physical status he certainly is able to be gainfully employed. I would not suggest that he do heavy physical labor or seriously stressful activities, nor do I think that he should work long hours, and would recommend a normal work week of 40-45 hours or so. I do not feel that he should be particularly limited otherwise.

"I do think that it might be useful for an expert in the area of stress and its relationship to heart disease and other disorders be consulted."

On January 7, 1999, Blackmon sued Safeco, seeking reimbursement of medical expenses and disability benefits related to his coronary-artery disease. The matter proceeded to a bench trial at which Blackmon, Paul Mangum (Blackmon's supervisor), and Dr. Duane Randleman (Safeco's medical expert) each testified. As noted, the deposition testimony of Dr. Jackson also was received into evidence, as were Blackmon's medical records. Dr. Jackson testified that, in his opinion, "stress [was] a definite risk factor for coronary artery disease." Dr. Randleman, a thoracic surgeon, testified that he had reviewed Dr. Jackson's medical records and Dr. Jackson's deposition, but that he had never examined Blackmon. Although Dr. Randleman agreed with Dr. Jackson that a family history of heart disease, high blood pressure, and an elevated cholesterol level were all risk factors, he testified that stress was not a factor in causing the build-up of plaque in coronary arteries, or coronary-artery disease. He therefore disagreed with Dr. Jackson's opinion that stress had contributed to Blackmon's coronary-artery disease.

Blackmon testified that he was currently employed in the same position with Safeco that he held at the time of the September 8, 1998, incident, but that he was making a slightly higher wage due to a merit-based salary increase. He further testified that he was working fewer hours because he had consciously disciplined himself in order to reduce his workweek to 40 to 45 hours per week on the advice of his physician, Dr. Jackson.

The trial court found that Blackmon had returned to work at a slightly higher wage than he was earning before his treatment by Dr. Jackson. Nonetheless, the trial court concluded that Blackmon had a 30% physical impairment to the body as a whole.

Safeco appeals, contending that the trial court erred in ruling that Blackmon's heart condition arose out of and in the course of his employment. Safeco also contends that the trial court erred in finding that Blackmon suffered a 30% physical impairment.

We begin our analysis by noting that this case appears to involve a disease, not an "injury" as defined in Ala.Code 1975, § 25-5-1(9).⁵ Ordinarily, in such a case, whether the employee's disease would be compensable would be governed by Ala.Code 1975, § 25-5-110 et seq., dealing with occupational diseases. In his complaint, however, Blackmon did not seek recovery for an occupational disease, but for an "injury."...