Zemke v. Workmen's Compensation Appeals Bd.

CourtUnited States State Supreme Court (California)
Writing for the CourtTOBRINER; TRAYNOR
Citation441 P.2d 928,68 Cal.2d 794,69 Cal.Rptr. 88
Parties, 441 P.2d 928 Ernest J. ZEMKE, Petitioner, v. WORKMEN'S COMPENSATION APPEALS BOARD, W. S. Shamban and Company, et al., Respondents. L.A. 29533.
Decision Date28 June 1968

Levy, DeRoy, Geffner & Van Bourg, Jack P. Koszdin and Ernest Stroloff, Van Nuys, for petitioner.

Everett A. Corten, San Francisco, Edward A. Sarkisian, Nathan Mudge, Herbert H. Hiestand, Jr., and James P. Cudahy, Los Angeles, for respondents.

TOBRINER, Justice.

Petitioner seeks review of the appeals board's opinion and order denying reconsideration of its prior decision after reconsideration in which the appeals board found that 50 percent of petitioner's permanent disability was attributable to his preexisting asymptomatic arthritic condition. Since the apportionment is not supported by substantial evidence and is based on an error of law we must annul the order.

The petitioner, Ernest J. Zemke, worked as a maintenance mechanic for W. S. Shamban and Company in Newberry Park, California, prior to December 18, 1965. On that date he injured his back while picking up a barrel of scrap. The parties agree that petitioner's injury arose 'out of and in the course of the employment.' (Lab.Code, § 3600.) The only issue concerns the propriety of the apportionment under Labor Code section 4663.

Section 4663 provides that, 'In case of aggravation of any disease existing prior to a compensable injury, compensation shall be allowed only for the proportion of the disability due to the aggravation of such prior disease which is reasonably attributed to the injury.' This 'section must be read in light of the rule that an employer takes the employee as he finds him at the time of employment and when subsequent injury lightens up or aggravates a previously existing condition rendering it disabling, liability for the full disability without proration is imposed upon the employer.' (Colonial Ins. Co. v. Industrial Acc. Com. (1946) 29 Cal.2d 79, 83--84, 172 P.2d 884, 887.)

Since the employer must compensate not only for the disability caused solely by the industrial injury, but also for that resulting from an aggravation or 'lighting up' of a non-disabling disease preexisting the industrial injury, the appeals board may apportion the disability under section 4663 only in those cases in which part of the disability would have resulted, in the absence of the industrial injury, from the 'normal progress' of the preexisting disease. (Reynolds Elec. etc., Co. v. Workmen's Comp. App. Bd. (1966) 65 Cal.2d 438, 443, 55 Cal.Rptr. 254, 421 P.2d 102; Tanenbaum v. Industrial Acc. Com. (1935) 4 Cal.2d 615, 617--618, 52 P.2d 215; Industrial Indem. Co. v. Ind. Acc. Com. (1949) 95 Cal.App.2d 443, 450, 213 P.2d 11; 2 Hanna, California Law of Employee Injuries and Workmen's Compensation (2d ed. 1967) § 14.03(3)(b), at pp. 14--21---14--23.)

'Whether a disability results in whole or in part from 'the normal progress of a preexisting disease' (Industrial Indemn. Co. v. Industrial Acc. Comm. (supra), 95 Cal.App.2d 443, 450, 213 P.2d 11, 15) or represents a fully compensable lighting up or aggravation of a pre-existing condition is a question for the (appeals board) to determine, and its award will not be annulled if there is substantial evidence to support it. (Citations.)' (Argonaut Ins. Co. v. Industrial Acc. Com. (1962) 57 Cal.2d 589, 593, 21 Cal.Rptr. 545, 547, 371 P.2d 281, 283.) We therefore review the record to determine whether substantial evidence supports the board's finding that 50 percent of petitioner's disability was attributable to his preexisting arthritic condition.

The record contains medical reports from three doctors and the testimony of one doctor. All three doctors agree that petitioner's arthritic condition was totally asymptomatic prior to his industrial injury.

Dr. Nippell, an orthopedic surgeon, examined petitioner for the first time on February 15, 1966. 1 Dr. Nippell diagnosed his condition as: 'Acute low back strain superimposed on pre-existing osteoarthritic changes.' His second report, dated March 16, diagnosed petitioner's condition as '(1) probable low back strain with persistence of symptoms due to preexisting osteoarthritic changes; (2) Possible osteoarthritis involving the right hip.' In a letter dated September 9, 1966, in response to an inquiry by the compensation carrier as to apportionment, Dr. Nippell stated: 'I would think that a fair division would be fifty per cent due to pre-existing problems, and fifty per cent due to the aggravating incident.' Dr. Nippell does not mention any facts upon which he based this opinion. And he does not indicate in any of his medical reports that part of petitioner's disability would have resulted from the normal progress of his osteoarthritic condition even if he had not sustained the industrial injury.

Dr. Cozen, a specialist in orthopedics and fractures who examined petitioner on August 9, 1966, stated in his report of August 10 that petitioner's 'present condition is caused by the accident * * * superimposed on previously existing non-symptomatic degenerative disc diseases.' He does not mention the apportionment issue and nowhere states any facts which would support an apportionment finding.

The independent medical examiner, Dr. Schoneberg, an orthopedic surgeon, examined petitioner on January 3, 1967. In his report of January 5 he stated that petitioner suffered from a 'Chronic lumbar sprain superimposed on degenerative disc disease, * * * as well as osteoarthritic changes, * * *.' He further reported: 'I feel that the patient's persistent low back complaints, as stated by previous examiners, both Doctor Nippell and Doctor Cozen, are due to the pre-existing degenerative changes. * * * In view of the length of time since his initial injury, I feel that patient can be rated as having a permanent and stationary disability. * * * In arriving at a permanent disability rating I feel there should be an apportionment from his pre-existing degenerative changes of 50% And his industrial injury of 50%.'

Dr. Schoneberg testified at the hearing of April 26, 1967. In response to the question, 'Could you state if ever, but for the accident, the applicant would have had symptoms?' Dr. Schoneberg answered: 'Well, at the time of the accident he was 65, approximately, and if he had gone that length of time, I mean, it would be an educated guess, he may just have an occasional--I would say would be unusual didn't have occasional backaches with his x-ray findings. You can have that without any arthritic problem, too. As to when you had it, He may have never had it, he may have had it. * * * It would be a matter of speculation.' (Italics added.) Dr. Schoneberg replied affirmatively to the question, 'And it was the impact on this asymptomatic pathology by this injury which brings on this total picture; is that a fair way of stating it?' Finally, answering the question whether he still had the same opinion respecting apportionment as he stated in his report, Dr. Schoneberg said: 'The percentage I think is fair in view of the fact that he does have considerable change. One would assume he had a simple sprain. One would hope or anticipate he would be over it in a reasonable period of time, but this combination, I think, is the only way I could apportion it with any fairness.'

Although the board must rely on expert medical opinion in resolving the issue of apportionment, an expert's opinion which does not rest upon relevant facts or which assumes an incorrect legal theory cannot constitute substantial evidence upon which the board may base an apportionment finding. (Owings v. Industrial Acc. Com. (1948) 31 Cal.2d 689, 692--693, 192 P.2d 1; West v. Industrial Acc. Com. (1947) 79 Cal.App.2d 711, 716--720, 180 P.2d 972; cf. Jones v. Workmen's Comp. App. Bd. (1968) 68 A.C. 490, 493--494, 67 Cal.Rptr. 544, 439 P.2d 648.)

Dr. Nippell's opinion that a 50 percent apportionment would be 'fair' poses a mere legal conclusion. The question whether the disability is partially due to the normal progress of the disease presents an issue of fact which the board must resolve on the basis of expert medical opinion. Dr. Nippell's report, however, nowhere discloses either facts or opinion on the relationship between applicant's disability and what would have been the normal progress of his preexisting condition in the absence of his industrial injury. Instead, the report states an opinion on a legal matter: the proper...

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