COUCH v. ARKANSAS STATE POLICE, 1998 AWCC 227

CLAIM NO. E500890

BILL COUCH, EMPLOYEE, CLAIMANT v. ARKANSAS STATE POLICE, EMPLOYER, RESPONDENT and PUBLIC EMPLOYEE CLAIMS DIVISION, CARRIER, RESPONDENT

Before the Arkansas Workers’ Compensation Commission
OPINION FILED JUNE 18, 1998

Upon review before the FULL COMMISSION, Little Rock, Pulaski County, Arkansas.

Claimant represented by JASON WATSON, Attorney at Law, Fayetteville, Arkansas.

Respondent represented by RICHARD SMITH, Attorney at Law, Little Rock, Arkansas.

[1] OPINION AND ORDER
[2] This case comes on for review before the Full Commission on remand from the Court of Appeals. In its decision rendered March 18, 1998, the Court stated:

. . . Nowhere in the Commission’s findings does there appear medical evidence to the effect that in relation to appellee’s coronary artery disease, the accident appellee experienced was the major cause of the physical harm.

[3] The Court remanded this claim so the Commission could make additional findings concerning major cause. [4] While the legislature did not limit the acceptable evidence that could be considered in determining whether the major cause requirement has been met, as we interpret the Court’s comments in the present case, we must address the medical evidence with regard to major cause since in this particular case there is medical evidence of a pre-existing underlying coronary artery disease which has, in at least one medical report, been linked to the cause of claimant’s myocardial infarction. While we are not limited to only medical evidence, we must address the medical evidence especially when the medical evidence indicates that the cause may be something other than the accident and may in fact be a pre-existing underlying condition. We are in agreement that in some cases a major cause finding does not have to be predicated on medical evidence since the legislature did not limit our consideration of major cause to medical evidence; however, when the medical evidence indicates that there are other causes, namely a pre-existing underlying condition, it is our impression that the Court in the present case requires that we look at all the evidence, particularly the medical evidence, when addressing the major cause element. [5] The medical evidence, in this case, clearly indicates that claimant suffered from arteriosclerotic heart disease at the time he experienced his myocardial infarction on October 29, 1994. Claimant’s treating cardiologist, Dr. James A.S. Haisten noted in his October 23, 1995, report:

I do feel that the stress involved in the emotionally charged chase over narrow crooked roads was a definite aggravating factor that would play a causal connection in the precipitation of the acute anterior myocardial infarction that Mr. Couch suffered on December 29, 1994.

[6] In addition, in a cardiology report dated December 27, 1994, Dr. Ronald Revard noted that claimant suffers from coronary artery disease. [7] Accordingly, when we consider the medical evidence in addition to the close temporal relationship between claimant’s high speed pursuit and subsequent myocardial infarction, we find that the stress involved in the emotionally charged chase only aggravated claimant’s coronary artery disease to the point which eventually resulted in a myocardial infarction. If not for claimant’s coronary artery disease and the stress from the chase, it is unlikely that claimant would have experienced his myocardial infarction on October 29, 1994. There is no evidence in the record that claimant’s physical exertion or physical activity
involved in the chase was anything more than a causative factor. A causative factor is not the equivalent of the major cause of claimant’s heart attack. It is but one factor among many. In our opinion, all evidence points to the emotional stress and claimant’s pre-existing coronary artery disease as the major cause of claimant’s myocardial infarction. When we are faced with medical evidence clearly linking claimant’s heart attack to claimant’s emotional stress and coronary artery disease, we cannot find that the accident or high speed chase was, in fact, the major cause of claimant’s physical harm. In our opinion, the preponderance of the evidence reveals that claimant’s underlying arteriosclerotic heart disease, not the high speed chase, was more than 50% the cause of claimant’s myocardial infarction. Accordingly, we find that pursuant to Ark. Code Ann. §11-9-114(b)(2) claimant has failed to prove the compensability of his myocardial infarction. [8] IT IS SO ORDERED.

ELDON F. COFFMAN, Chairman MIKE WILSON, Commissioner

[9] Commissioner Humphrey dissents. [10] DISSENTING OPINION
[11] I must respectfully dissent from the opinion of the majority finding that claimant failed to prove by a preponderance of the evidence that he is entitled to compensation benefits for a heart attack suffered while on the job. [12] In my opinion, claimant has proven that the accident was the result of extraordinary or unusual physical exertion. Further, the greater weight of the evidence indicates that claimant would not have suffered the heart attack in October 1994 had he not been involved in the high-speed chase. Therefore, I find that although claimant’s coronary artery disease was obviously a factor, the high-speed chase was the major cause (at least 51%) of the physical harm claimant suffered in the form of a myocardial infarction. [13] Preexisting coronary artery disease will be a factor in many, if not most, heart attack cases that come before this Commission. Without such disease, the physical exertion by a claimant will rarely result in a heart attack. The Commission is signaling that without an unequivocal opinion by a physician, the Commission’s finding will be that the preexisting condition and the employment, taken together, were the major cause of the heart attack. In my opinion, the fact that claimant’s heart attack would not have occurred had it not been for the physical exertion during the high-speed chase is sufficient to satisfy the major cause requirement. [14] For the foregoing reasons, I dissent. [15] PAT WEST HUMPHREY, Commissioner