delivered the opinion of the Court.
This appeal raises the question whether, in a Workmen’s Compensation case, the trial court properly permitted the jury to determine, on the basis of subjective lay testimony, that the employee was 100 per cent disabled when all the expert medical testimony in the case was to the contrary. From a judgment entered on the jury’s verdict of 100 per cent disability, the employer appeals.
The facts are undisputed. Appellee, Josephine Blamble, was employed as a door to door saleslady by the appellant, Jewel Tea Company, Inc. While making a call in the village of Eckhart Mines on August 7, 1959, she fell down three steps of a residence and suffered a broken left ankle and a sprained right ankle. She was taken immediately to a hospital in Cumberland where her left ankle was set and a cast applied. After four days of complete bed rest she was taken to the physical therapy department for instruction in crutch ambulation and while being fitted for crutches she suffered a heart attack. She remained in the hospital two months before being sent home for ah additional period of convalescence.
At a hearing before the Workmen’s Compensation Commission to determine the extent of Mrs. Blamble’s disability
Both parties appealed from this determination to the Circuit Court for Allegany County, where the case was tried before a jury. Dr. Himmelwright’s testimony before the Commission was read into evidence. He also appeared as a witness, as did Dr. Samuel M. Jacobson, a cardiologist, both called by the appellant. At the close of the case the employer offered a prayer requesting the court to instruct the jury that from the uncontradicted evidence it could not find that Mrs. Blamble was 100 per cent disabled, which was denied and the denial excepted to. The jury returned a finding on issues that Mrs. Blamble was permanently totally disabled, 100 per cent of which was due to the accident and none due to a pre-existing disease, and the decision of the Commission was so modified. In its appeal from the resulting judgment the employer cites as error the refusal of the trial court to instruct the jury as requested in its prayer.
The leading Maryland case establishing the test of what constitutes “total disability” within § 36 of Art. 101, Code (1959 Cum. Supp.) is
Congoleum Nairn v. Brown,
The general rule in Workmen’s Compensation cases is that where there is
any
evidence from which a rational conclusion may be drawn, as opposed to the theory of a prayer for a directed verdict, the trial court must leave to the jury all considerations as to the weight and value of such evidence.
Superior Builders, Inc. v. Brown,
The evidence produced on behalf of Mrs. Blamble’s' claim does not, in our opinion, meet the test of legal sufficiency under the authorities cited. Rather, the evidence as a whole leads to the conclusion that Mrs. Blamble was not in fact totally disabled as that term is defined in our Compensation act.
Examining first the evidence supporting Mrs. Blamble’s claim, we find the testimony of the appellee herself to the effect that she did not feel she could go back to work, that she could not climb steps and had certain feelings of heaviness in her heart and down her arm. She bases her conclusion not upon any attempt she has made to work but only on
Dr. Jacobson, the cardiologist, stated that on the basis of his personal examination of Mrs. Blamble and a study of an electrocardiogram, taken as part of his examination, he could find no evidence of heart disease, though this did not absolutely rule out the possibility of such disease. In his opinion Mrs. Blamble very likely did not suffer a coronary occlusion with a myocardial infarction, as diagnosed by Dr. Himmelwright. He felt it more probable that she had had an episode of paroxysmal tachycardia, which is described as “a condition marked by attacks of excessively rapid heart action which come on abruptly and terminate just as abruptly.” Dorland,
Medical
Dictionary, (23rd ed.) p. 1359. Dr. Jacobson was of the
Thus, countering the lay testimony of Mrs. Blamble and her landlady that she could not work, was the testimony of her attending physician that she could do sedentary work and that of a heart specialist that she could engage in employment and possibly even return to her former position. It is to be noted that we are dealing here with a disability that to the inexperienced and inexpert witness must remain purely subjective in nature. Appellant cites authority to the effect that in disabilities of a subjective nature, evidence sufficient to warrant submission of the issue of disability to a jury must be supported by expert testimony, since it should be judicially noted that common experience does not enable lay witnesses to make objective findings upon which a verdict can rationally be based. Annotation,
“Prediction from present conditions of the conditions which will exist in the future may in some instances be made by a jury without the aid of opinions of experts in such matters. Common knowledge would tell them that a lost member is permanently lost (Congoleum Nairn v. Brown,158 Md. 285 , 289,148 A. 220 ), and there may be conditions which, while less obviously permanent in their nature, may still, according to common knowledge, be probably so, with such a degree of probability that an adjudication of permanency as a fact may be permissible without expert opinions. Washington, B. & A. Electric R. Co. v. Cross,142 Md. 500 , 510,121 A. 374 ; United Laundries Co. v. Bradford,133 Md. 363 , 367,105 A. 303 . There must, however, be a reliable basisfor the adjudication of it as a fact, something beyond mere conjecture, or possibility; and the burden is upon the plaintiff to establish the fact by evidence sufficient to support the finding, if he intends to include permanent injury as an item in the ground of his recovery.”
The injury involved in that case was a fractured finger and this Court concluded that the misshapen condition of the finger was sufficient objective evidence to allow a jury to infer a permanent injury.
It is obvious that in cases such as the one before us the experience and information secured by medical experts concerning the type, degree, extent and duration of disability attendant upon the disease involved here, and the superimposing of their findings upon the general physical and mental condition of the patient, are invaluable. In the instant case such expert testimony was in fact, in our opinion, determinative, in contradistinction to the testimony of the lay witnesses, which, from the nature of this case, could only be conjectural.
It has been held that reliance on lay testimony alone is not justified when the medical question involved is a complicated one, involving fact finding which properly falls within the province of medical experts.
Travelers Ins. Co. v. Blazier,
Judgment reversed; case remanded for a new trial; appellee to pay costs.
