8 Pa. Commw. 172 | Pa. Commw. Ct. | 1973
Opinion by
When Willie Luckey, Jr., (claimant) began working for A. P. Green Refractories Co., he first unloaded boxcars and then operated a brick crusher, both jobs being heavy, laborious, and unskilled work. Approximately three years after starting work for the company, on
Claimant later consulted his physician, Dr. Melnicoff, a general practitioner, on approximately twelve occasions over a six-week period of time. He was referred to Dr. Henry Sigmond, an orthopedic surgeon, on February 24, 1967, who ordered x-rays of the dorsal spine, low back, and right femur (the pain had extended into claimant’s right leg). On March 8, 1967, claimant was admitted to Albert Einstein Medical Center in Philadelphia where he was seen in consultation by Dr. Pedro P. Polakoff, II, a neurosurgeon. On March 14, 1967, Dr. Polakoff performed a hemilaminectomy at L-4, 5 and L-5 S-1 on the right.
On cross-examination, Dr. Polakoff related that there was evidence of disc degeneration at L-4 and L-5 noted at the time of the operation. X-ray examinations showed narrowing of the disc space between L-4 and L-5.
Dr. Martin Blaker, an orthopedic surgeon, examined claimant on September 11, 1968, and found “acute lumbosacral strain, status-post lumbar laminectomy and disc excision, findings strongly suggestive of conditions present prior to January 10, 1967 with atrophy of right lower extremity, mild, and shortening.” Dr. Blaker related that, “In my opinion the procedure which was done here, laminectomy with disc excision was directed to a condition based upon prior vulnerability or prior changes in the spine present before January 10, 1967. ... In my opinion the lifting which he is doing since it was a normal activity for him in his work frequently repeated for a long period of time, would not have produced a protrusion if the disc had been normal. If a protrusion then resulted from this normal activity, it must have been based upon prior weakness.”
Claimant, born in 1920, has had back problems before. In 1947, after attempting to lift a heavy object, he had low back pain and consulted a doctor for a few months. He wore a back brace for one or two months but continued his usual activities. Evidently between 1947 and 1967 he held jobs as a farmer, general laborer, plumber’s helper, and forklift operator. During that twenty-year period he had back pains off and on. In approximately 1963 he again had low back pain, but, after x-rays but no medical treatment, he returned to his usual activities within a few days. In January 1967 (before the lifting incident later that month) he jumped off a forklift and developed a slight ache in his low back.
The referee’s second finding of fact is therefore particularly significant: “The nature and cause of the injury were an aggravation of a pre-existing weak low back, when claimant, while reassembling a machine after cleaning same, and when in the act of replacing the heavy metal cover, while bending down and lifting the said metal cover he did violence to the bony structure of his low back so that he suffered the herniation of the intervertebral discs at the levels L4-L5 and L5-S1 on the right.” (Emphasis added.)
A timely appeal was filed with the Workmen’s Compensation (Appeal) Board which, without specifically discussing the referee’s second finding of fact, affirmed
“After a careful and independent review of the record, we are convinced that the Claimant met with an accidental injury and that he is entitled to the award. While the evidence here suggests that the Claimant had pains in his low hack during his early youth, it is also true that he was in reasonably good health, immediately prior to the lifting incident described here. In our opinion, he was a healthy workman in view of the hard, laborious work which he steadily performed for the Defendant.
“On that basis, we conclude that an unexpected and unusual pathological result occurred to the Claimant’s back while performing his regularly assigned duties. The accident here lies in the extraordinary nature of the effect, rather than in the cause of the disc protrusion, which the Claimant suffered. Claimant’s disability was immediate, sudden and obvious and is supported by the medical opinion of his physician. Under the reasoning reported in Wance vs. Gettig Eng. & Mfg. Co., Inc., 204 Super. 297 (1964), the Claimant is entitled to the award.”
We are now called upon to review that decision. Our review is limited to whether constitutional rights were violated, an error of law was committed, or any necessary finding of fact was not supported by substantial evidence. Nash v. Sandnes’ Sons, Inc., 6 Pa. Commonwealth Ct. 403, 295 A. 2d 615 (1972).
The essential issue in this case is whether or not a compensable “accident” occurred. “Disability overtaking an employe at work is not compensable unless it is the result of an accident. . . . While the Workmen’s Compensation Act should be liberally construed, its purpose is to compensate for accidental injuries and
In Hinkle v. H. J. Heinz Co., 7 Pa. Commonwealth Ct. 216, 222, 298 A. 2d 632, 635 (1972), we found that the cases disclose at least four basic categories of accidents: (1) a sudden, unexpected traumatic event such as a fall or blow; (2) unusual exertion in the course of work causing an unexpected and sudden injury; (3) an unusual pathological result of an ordinary condition of work; and (4) sudden and unexpected injury caused by the failure of an employer to furnish medical care to an employee.
As we recently stated in Collins v. U. S. Steel Cory., 7 Pa. Commonwealth Ct. 333, 336-37, 298 A. 2d 637, 638-39 (1972) :
“In this case, because it was acknowledged that the claimant, when injured, was performing his usual work in the usual manner, only the first and third classifications mentioned above could be applicable. It is our opinion, however, that the claimant has failed to carry the burden to show that his injury was caused by an ‘accident,’ as defined by either of these remaining classifications.
As we recognized in Collins, more recent decisions have developed the Unusual Pathological Result Doctrine as a liberal consequence of the strict construction accorded the definition of “accident.” The attempted distinction between “those [accidents] that are compensable and those that are not compensable [, which] are divided by a line which at times appears indistinct,” York v. State Workmen’s Ins. Fund, 131 Pa. Superior Ct. 496, 498, 200 A. 230, 231 (1938), has indeed “plunge[d] this branch of the law into a Serbonian bog.”
Essentially the third category mentioned above, the doctrine holds that where an employee sustains an injury to some part of his body not previously injured or diseased, resulting in a break of the bony structure or a tear in the soft tissue of the body, while doing his
We are faced here with a seemingly contradictory holding by the Board. On the one hand it finds that claimant had back problems “during his early youth” but was healthy enough on January 12, 1967, to qualify for an award under the Unusual Pathological Result Doctrine. On the other hand it affirms without comment the referee’s finding that the claimant’s injury resulted from “an aggravation of a pre-existing weak low back.”
The Board was in error in saying that claimant had back problems only in his early youth, and that Dr. Blaker testified that “no causal relationship existed between the lifting incident and the subsequent protru
Even with Dr. Polakoff’s testimony that “[i]t is possible that the degenerated disc and minimal herniation at L-l might have been in existence [prior to the lifting incident] and he could have worked with it but under no circumstances could that gentleman have possibly worked [prior to the lifting incident] or done any activity with the findings at L-5 ... an extruded disc which had impinged the nerve against the bone and the foramen . . .”, it is clear that there was a pre-existing condition causally related to the injury claimed. Consistent with both doctors’ testimony is the referee’s finding of fact that the claimant’s injury resulted from “an aggravation of a pre-existing weak low back.” Consequently, no reliance in this case can be placed on the Unusual Pathological Result Doctrine to establish a compensable accident within the meaning of the Workmen’s Compensation Act.
Accordingly, we find it necessary to reverse the Board’s decision and to deny claimant’s request for compensation.
Obdbb
And Now, this 22nd day of March, 1973, the order of the Workmen’s Compensation (Appeal) Board is hereby reversed.
Dr. Polakoff described the operation as follows: “The operation performed is known as a hemilaminectomy. That is taking off a small portion of the bone over the area where the nerve and disc are located, foraminotomy which is opening up the foramen where the nerve goes out to relieve any bony impression on the nerve and this is also in the lateral portion of the spine, and then removing the disc. This was performed on the 14th of March 1967 under general anesthesia at which time there was a degeneration and small herniation at the L-4 level and at the L-5 level there was an extruded piece of disc material — that is a piece of disc had actually ruptured out of the interspace and was jammed down on the fora-men between the nerve and the bone causing this gentleman’s pain. This was removed after which the disc space itself was then entered and more degenerated disc removed. So that this man had two discs, one degenerated and one actually herniated and extruded at the lower level at L-5.”
“My opinion is that the findings at surgery showed this gentleman could not possibly have been able to do any kind of work prior to the accident’because of the findings of the extruded disc which had the nerve impinged against the bone. It could not have allowed him to tolerate the pain for any. length of time- and this therefore was commensurate with the • history. of the onset of pain from the injury at work and his inability to work thereafter because of the increasing pain until the time of its removal at surgery.”
Dr. Blaker further testified: “The findings on examination certainly suggested a prior change in the right lower extremity. Also the limited motion of the hips of both sides were suggestive of a prior condition. The history also suggested that he had had prior backaches for which he had been treated.”
An additional category might include falls from a pre-existing disease as in Miller v. Schiffner & Sons, 196 Pa. Superior Ct. 84, 173 A. 2d 707 (1961), and in Allen v. Patterson-Emerson-Comstock, Inc., 180 Pa. Superior Ct. 286, 119 A. 2d 832 (1956).
See Landress v. Phoenix Mut. Life Ins. Co., 291 U.S. 491, 499 (1934) (Cardozo, J.); Comment, Pennsylvania Workmen's Compensation: An Analysis of Persistent Problems and Recent Legislative Reform, 76 Dick. L. Rev. 445, 453-59 (1972); Barbieri & Quinn, The Unusual Pathological Result Doctrine in Pennsylvania, 39 Temple L. Q. 51 (1965).