{ "id": 1884308, "name": "NASHVILLE LIVESTOCK COMMISSION and U.S. Insurance Group v. John Paul COX", "name_abbreviation": "Nashville Livestock Commission v. Cox", "decision_date": "1990-04-16", "docket_number": "89-178", "first_page": "69", "last_page": "77", "citations": [ { "type": "official", "cite": "302 Ark. 69" }, { "type": "parallel", "cite": "787 S.W.2d 664" } ], "court": { "name_abbreviation": "Ark.", "id": 8808, "name": "Arkansas Supreme Court" }, "jurisdiction": { "id": 34, "name_long": "Arkansas", "name": "Ark." }, "cites_to": [ { "cite": "243 Ark. 483", "category": "reporters:state", "reporter": "Ark.", "case_ids": [ 8721477 ], "weight": 2, "year": 1967, "opinion_index": 0, "case_paths": [ "/ark/243/0483-01" ] }, { "cite": "255 Ark. 431", "category": "reporters:state", "reporter": "Ark.", "case_ids": [ 8721325 ], "weight": 2, "year": 1973, "opinion_index": 0, "case_paths": [ "/ark/255/0431-01" ] }, { "cite": "41 Ark. L. Rev. 89", "category": "journals:journal", "reporter": "Ark. L. Rev.", "year": 1988, "opinion_index": 0 }, { "cite": "215 Ark. 305", "category": "reporters:state", "reporter": "Ark.", "case_ids": [ 1464491 ], "weight": 2, "year": 1949, "opinion_index": 0, "case_paths": [ "/ark/215/0305-01" ] }, { "cite": "206 Ark. 921", "category": "reporters:state", "reporter": "Ark.", "case_ids": [ 1484981 ], "weight": 3, "year": 1943, "opinion_index": 0, "case_paths": [ "/ark/206/0921-01" ] }, { "cite": "494 N.Y.S.2d 169", "category": "reporters:state", "reporter": "N.Y.S.2d", "year": 1985, "opinion_index": 0 }, { "cite": "33 U.S.C. \u00a7 902", "category": "laws:leg_statute", "reporter": "U.S.C.", "pin_cites": [ { "page": "(2)" } ], "opinion_index": 0 }, { "cite": "738 F.2d 474", "category": "reporters:federal", "reporter": "F.2d", "case_ids": [ 3801165, 661813 ], "weight": 2, "year": 1984, "pin_cites": [ { "page": "478" } ], "opinion_index": 0, "case_paths": [ "/us-app-dc/238/0080-01", "/f2d/738/0474-01" ] }, { "cite": "253 S.E.2d 213", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1979, "opinion_index": 0 }, { "cite": "148 Ga. App. 810", "category": "reporters:state", "reporter": "Ga. App.", "case_ids": [ 797385 ], "year": 1979, "opinion_index": 0, "case_paths": [ "/ga-app/148/0810-01" ] }, { "cite": "253 La. 1115", "category": "reporters:state", "reporter": "La.", "case_ids": [ 3238049, 9825258 ], "weight": 2, "year": 1968, "opinion_index": 0, "case_paths": [ "/la/253/1115-01", "/so2d/221/0816-01" ] }, { "cite": "347 A.2d 605", "category": "reporters:state_regional", "reporter": "A.2d", "case_ids": [ 8068145 ], "year": 1975, "opinion_index": 0, "case_paths": [ "/a2d/347/0605-01" ] }, { "cite": "600 P.2d 738", "category": "reporters:state_regional", "reporter": "P.2d", "case_ids": [ 11959266 ], "year": 1979, "opinion_index": 0, "case_paths": [ "/p2d/600/0738-01" ] }, { "cite": "579 S.W.2d 380", "category": "reporters:state_regional", "reporter": "S.W.2d", "case_ids": [ 9939583 ], "year": 1979, "opinion_index": 0, "case_paths": [ "/sw2d/579/0380-01" ] }, { "cite": "Ark. Code Ann. \u00a7 11-9-102", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "weight": 2, "pin_cites": [ { "page": "(4)" }, { "page": "(5)" } ], "opinion_index": 0 }, { "cite": "Ark. Code Ann. \u00a7 11", "category": "laws:leg_statute", "reporter": "Ark. Code Ann.", "opinion_index": 0 }, { "cite": "646 S.W.2d 31", "category": "reporters:state_regional", "reporter": "S.W.2d", "case_ids": [ 6139774 ], "year": 1983, "opinion_index": 0, "case_paths": [ "/ark-app/7/0181-01" ] }, { "cite": "1 Ark. App. 181", "category": "reporters:state", "reporter": "Ark. App.", "year": 1983, "opinion_index": 0 }, { "cite": "6 Ark. App. 370", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6142997 ], "weight": 2, "year": 1982, "opinion_index": 0, "case_paths": [ "/ark-app/6/0370-01" ] }, { "cite": "274 N.W.2d 411", "category": "reporters:state_regional", "reporter": "N.W.2d", "year": 1979, "opinion_index": 1 }, { "cite": "405 Mich. 105", "category": "reporters:state", "reporter": "Mich.", "case_ids": [ 1957161 ], "year": 1979, "opinion_index": 1, "case_paths": [ "/mich/405/0105-01" ] }, { "cite": "603 P.2d 1191", "category": "reporters:state_regional", "reporter": "P.2d", "case_ids": [ 8692343 ], "year": 1979, "opinion_index": 1, "case_paths": [ "/or-app/43/0493-01" ] }, { "cite": "43 Or. App. 505", "category": "reporters:state", "reporter": "Or. App.", "case_ids": [ 8692666 ], "year": 1979, "opinion_index": 1, "case_paths": [ "/or-app/43/0505-01" ] }, { "cite": "646 S.W.2d 31", "category": "reporters:state_regional", "reporter": "S.W.2d", "case_ids": [ 6139774 ], "weight": 2, "year": 1983, "opinion_index": 1, "case_paths": [ "/ark-app/7/0181-01" ] }, { "cite": "6 Ark. App. 370", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6142997 ], "weight": 2, "year": 1982, "pin_cites": [ { "page": "375", "parenthetical": "Glaze, J., concurring" }, { "page": "341", "parenthetical": "Glaze, J., concurring" } ], "opinion_index": 1, "case_paths": [ "/ark-app/6/0370-01" ] }, { "cite": "646 S.W.2d 31", "category": "reporters:state_regional", "reporter": "S.W.2d", "case_ids": [ 6139774 ], "weight": 2, "year": 1983, "opinion_index": 2, "case_paths": [ "/ark-app/7/0181-01" ] }, { "cite": "6 Ark. App. 370", "category": "reporters:state", "reporter": "Ark. App.", "case_ids": [ 6142997 ], "weight": 4, "year": 1982, "opinion_index": 2, "case_paths": [ "/ark-app/6/0370-01" ] } ], "analysis": { "cardinality": 857, "char_count": 18357, "ocr_confidence": 0.882, "pagerank": { "raw": 2.0570401881208652e-07, "percentile": 0.756061067652979 }, "sha256": "19369daaaa8bf1f7f2eebb0dd7a7031caa09797f8860f510b64d8a71c81446c5", "simhash": "1:06aee851ee6a147e", "word_count": 2945 }, "last_updated": "2023-07-14T14:34:09.444418+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "Hays and Turner, JJ., dissent.", "Glaze, J., concurs.", "Hays, J., joins in this dissent." ], "parties": [ "NASHVILLE LIVESTOCK COMMISSION and U.S. Insurance Group v. John Paul COX" ], "opinions": [ { "text": "David Newbern, Justice.\nThe Arkansas Workers\u2019 Compensation Commission refused compensation to the respondent, John Paul Cox. Due to unusual circumstances, Cox was required by his employer, Nashville Livestock Commission (NLC), to work extra hours over a three-day period. He suffered chest pain and was disabled and hospitalized. The workers\u2019 compensation commission\u2019s decision was based upon language found in Black v. Riverside Furniture Co., 6 Ark. App. 370, 642 S.W.2d 338 (1982) and Kempner\u2019s & Dodson Ins. Co. v. Hall, 1 Ark. App. 181, 646 S.W.2d 31 (1983). We granted review of the court of appeals plurality decision which remanded the case to the commission. The court of appeals held that the statements in those two cases which the commission considered to be governing, were obiter dicta, and thus the workers\u2019 compensation commission should not have regarded them as controlling of this case. While we agree with that conclusion, we also conclude that the court of appeals should have decided the fundamental question whether a disabling symptom of an underlying disease may be the basis of compensation if it is brought on by exertion in the course of employment. We hold that the work-related occurrence of a disabling symptom of underlying heart disease is compensable. The court of appeals decision is thus reversed and remanded.\nThe references in the Black and Kempner\u2019s opinions to symptomology aggravation being noncompensable were clearly unnecessary to the decisions of those cases. In the Black case, the issue was solely whether there was sufficient evidence to support the workers\u2019 compensation commission\u2019s conclusion that a claim for death benefits should be denied. The claimant had an underlying heart condition which had not been shown to have been aggravated by employment. Nor had it been shown that the claimant\u2019s employment was the reason for surgery resulting in death. The claim was a death claim and not one for benefits for disability resulting from an angina attack. In the Kempner\u2019s case, the holding was simply that the testimony of a physician was sufficient to support the commission\u2019s decision that an infarction which had occurred was work related. There was discussion of the language in the Black case, and even a statement that the Black case \u201cholding\u201d was that a disability resulting from a symptom such as angina was not compensable. That discussion, however, clearly was not necessary to the decision and thus was an obiter dictum. W.S. Kirkpatrick & Co., Inc. v. Environmental Tectonics Corp., International, No. 87-2066, slip op. (U.S., January 17, 1990).\nThe workers\u2019 compensation commission\u2019s opinion in the case before us now contained the following:\nThe claimant testified that he previously had heart problems in 1977. During a six month time period the claimant experienced weakness, shortness of breath and tightness in his chest. The claimant was hospitalized three or four times and was diagnosed as having minor heart blockage. Claimant attempted to refute that diagnosis by testifying that he later was rediagnosed as having a nervous condition from being around groups of people.\nAt the time of his alleged injury, the claimant was the manager of the Nashville Livestock Commission. As manager he participated in soliciting business, gathering cattle, and getting cattle ready for weekly sales. On November 19, 1986, cattle sales were scheduled for 1:00 p.m. and 7:00 p.m. Claimant testified that he began getting ready for the Wednesday sales on Sunday and that he had been working from 5:00 or 6:00 a.m. until 12:00 to 2:00 each night from Sunday through Wednesday. Shortly after the beginning of the 7:00 sale, claimant experienced pain in this chest and left arm and felt sick at his stomach. The claimant took some medicine and continued working until 2:30 or 3:00 a.m. Later that night, claimant awoke with severe chest pains and was taken to Nashville Hospital.\nClaimant was examined by Dr. Pye, a general practitioner in Nashville, and was later referred to Dr. Hutchins, a cardiologist at the U of A Medical Center in Little Rock. Dr. Hutchins diagnosed claimant as having a pre-existing heart condition; namely single vessel coronary artery disease, and stated that claimant\u2019s working conditions aggravated angina, a symptom of this pre-existing condition. Claimant then filed a workers\u2019 compensation claim alleging that the chest pains arose out of and during the course and scope of his employment causing him to incur hospital and medical bills.\nThe commission concluded that \u201cclaimant\u2019s working conditions merely aggravated angina, a symptom of claimant\u2019s preexisting condition, and is not compensable.\u201d\nUnder our workers\u2019 compensation law, an employer pays compensation to an employee for \u201cdisability or death from injury arising out of and in the course of employment without regard to fault as a cause of the injury.\u201d Ark. Code Ann. \u00a7 11 -9-401(a)(1) (1987). The employer must also promptly provide such medical services to any injured employee as are reasonably necessary. Arkansas Code Ann. \u00a7 11-9-508(a) (1987).\u201c \u2018Injury\u2019 means only accidental injury arising out of and in the course of employment, including occupational diseases . . . and occupational infections arising out of and in the course of employment.\u201d Ark. Code Ann. \u00a7 11-9-102(4). \u201c \u2018Disability\u2019 means incapacity because of injury to earn, in the same or other employment, the wages which the employee was receiving at the time of the injury.\u201d Ark. Code Ann. \u00a7 11-9-102(5) (1987).\nThere is no question that Cox\u2019s condition was disabling. The argument here centers on whether Cox suffered an \u201cinjury.\u201d Cox argues an incident of angina which arises out of and in the course of employment is an \u201cinjury.\u201d NLC argues such an incident cannot constitute an injury unless there is a change, such as an infarction which damages heart tissue, in the physical condition of the claimant. Other than the obiter dicta in the Black and Kempner\u2019s cases, the only authority cited for that statement by NLC is Sowders v. Mason & Dixon Lines, Inc., 579 S.W.2d 380 (Ky. App. 1979), which, as Cox points out, was based upon a Kentucky statute which specifically defined \u201cinjury\u201d as \u201cwork related harmful change in the human organism.\u201d\nCox cites a number of cases from other jurisdictions which have allowed recovery for angina pectoris attacks resulting in disability absent a showing of an aggravation, in the sense of making an underlying arteriosclerosis or septal effect worse, of the underlying heart condition which caused the pain. Jones v. Alaska Workers\u2019 Compensation Board, 600 P.2d 738 (Alaska 1979); Canning v. State Department of Transportation, 347 A.2d 605 (Me. 1975); Bertrand v. Cole Operator\u2019s Casualty Company, 253 La. 1115, 221 So. 2d 816 (1968); and H.V. & T.G. Thompson Lumber Co. v. Bates, 148 Ga. App. 810, 253 S.E.2d 213 (1979).\nIn addition to those cases, we have studied Crum v. General Adjustment Bureau, 738 F.2d 474 (D.C. Cir. 1984), which arose under the Longshoreman\u2019s and Harbor Workers Compensation Act which, at 33 U.S.C. \u00a7 902(2), defines \u201cinjury\u201d much the same as our statute quoted above. The employer made exactly the same argument as that made by NLC here. The employer argued that no compensable injury had been suffered because angina is not a disease but merely a symptom, and as the employment did not cause the underlying disease, there could be no recovery under the act. The court held that the disabling onset of angina was an \u201cinjury\u201d within the meaning of the act and cited other cases where compensation had been allowed despite the fact that the underlying disease or condition had not been caused by the employment, such as back pain in a person suffering spina bifida, pain resulting from varicose veins which prevented the claimant from standing for long periods, and aggravation of underlying psoriasis. 738 F.2d at 478. See also Perrin v. Baldwinsville VF Co., 494 N.Y.S.2d 169 (1985).\nIn workers\u2019 compensation law the employer \u201ctakes the employee as he finds him\u201d and employment circumstances which aggravate pre-existing conditions are compensable. See McGregor & Pickett v. Arrington, 206 Ark. 921, 175 S.W.2d 210 (1943); Green v. Lion Oil Co., 215 Ark. 305, 220 S.W.2d 409 (1949). 1 A. Larson, The Law of Workmens\u2019 Compensation, \u00a7 12.20 (1985). We see no reason to hold that a person who is disabled from pain causally related to his or her employment and resulting from an underlying physical condition should be any less entitled to workers\u2019 compensation benefits just because there is no change in that underlying condition. For years this court has labeled myocardial infarctions, \u201cheart attacks,\u201d as \u201cinjuries\u201d in the parlance of the workers\u2019 compensation act. R. B Leflar, Compensation for Work-Related Illness in Arkansas, 41 Ark. L. Rev. 89 (1988), citing as examples, Hoerner Waldorf Corp. v. Alford, 255 Ark. 431, 500 S.W.2d 758 (1973); Reynolds Metals Co. v. Cain, 243 Ark. 483, 420 S.W.2d 872 (1967); and McGregor & Pickett v. Arrington, supra. When there is a work-related disabling angina attack, the disability, although temporary as in this case, is no less a disability. The expense of hospitalization and related medical treatment may be less in the case of an angina attack resulting purely from underlying heart disease than with respect to an angina attack which symptomizes an accompanying infarction or other tissue change, but we can think of no reason why there should be compensation for one but not the other if both are brought on by employment. Our holding here is that an attack of angina pectoris which results in disability as defined in the workers\u2019 compensation act may constitute an injury giving rise to compensation under the act if it arises out of and occurs in the course of employment.\nCox\u2019s reply brief suggests .that the commission has not decided whether the angina was caused by his employment. Our reading of the commission\u2019s opinion quoted in part above is that a finding of a relationship between the angina and the employment was made and is clearly shown in the commission\u2019s statement that the angina was aggravated by the employment. The case will nonetheless have to be remanded to the commission to determine the amount of compensation to which Cox is entitled.\nReversed and remanded.\nHays and Turner, JJ., dissent.\nGlaze, J., concurs.", "type": "majority", "author": "David Newbern, Justice." }, { "text": "Tom Glaze, Justice,\nconcurring. I agree with the majority and write only to renew my concurring view in Black v. Riverside Furniture Co., 6 Ark. App. 370, 375, 642 S.W.2d 338, 341 (1982) (Glaze, J., concurring). Black involved a non-work related death case, not a disabling angina case. If the evidence in Black had shown Black\u2019s angina pains had hastened his death, I believe the court would have held the claim compensable. Nonetheless, the medical evidence in Black was lacking in this respect, and the widow\u2019s claim was properly denied.\nHere, appellant also relies upon Kempner\u2019s v. Hall, 7 Ark. App. 181, 646 S.W.2d 31 (1983), but that case involved a heart attack, which the Workers\u2019 Compensation Commission found work-related and compensable and the court of appeals affirmed. Again, disabling angina was not the issue there, but I point out that the court of appeals upheld Hall\u2019s heart attack as compensable because the medical evidenc\u00e9 showed his work-related angina pains precipitated his myocardial infarction.\nThe present case is the first one where an employee\u2019s claim was based upon disabling angina. While there are dicta in Black (and mentioned in Kempner\u2019s) that indicate angina pectoris is not compensable, the cases cited and relied on in Black do not support such a view. In fact, the Black decision cites Duffy v. State Accident Insurance Fund, 43 Or. App. 505, 603 P.2d 1191 (1979), but that case specifically notes that the Fund accepted angina attacks as compensable. In fact, the Workers\u2019 Compensation referee and Board made a permanent partial disability award for the claimant\u2019s angina condition and the Fund never challenged that award. Instead, the only issue raised by the Fund was its denial that it was responsible for the claimant\u2019s underlying heart ailment.\nThe Black opinion also relied upon Kostamo v. Marquette Iron Mining Co., 405 Mich. 105, 274 N.W.2d 411 (1979), which, in my opinion, is no authority for disallowing disabling angina. Kostamo involved five cases where the claimants suffered from arteriosclerotic heart disease. The Michigan Supreme Court simply affirmed the Workers\u2019 Compensation Appeal Board in each case, four where the Board concluded the claimant failed to show a relationship between his heart attack or death and his employment and one where the Board held the claimant had met his burden of proof. None of the five cases in Kostamo involved the issue we have before us now, viz., whether disabling angina is compensable.\nAlmost appellant\u2019s entire argument is based upon Black and Kempner\u2019s, which, for the reasons above, are neither controlling nor persuasive on the angina issue presented here. The majority opinion, on the other hand, sets forth sound logic and legal authority why angina, if shown to be work-related, should be compensable. The Commission found the claimant\u2019s disabling angina related to his work conditions. Therefore, I agree with this court\u2019s remand of the case to the Commission to determine the amount of benefits due the claimant.", "type": "concurrence", "author": "Tom Glaze, Justice," }, { "text": "Otis H. Turner, Justice,\ndissenting. The majority of this court has now traversed the final hurdle and has effectively made any claim arising from a heart condition a compensable claim under the Arkansas Workers\u2019 Compensation Law. Stated another way, workers\u2019 compensation insurance has now clearly become health insurance as far as the law relates to heart cases. The only requirement appears to be that the claimant be gainfully employed by an employer covered by the Workers\u2019 Compensation Act.\nVolumes have been written on both sides of the question on whether heart conditions are job-related. There is no longer any room for debate that under our holdings a disabling heart condition is compensable if it can somehow be related to the claimant\u2019s employment. However, this court has never implied, before today\u2019s holding, that medical expenses arising from underlying symptomology are reimbursable through workers\u2019 compensation, even if the underlying condition in and of itself does not give rise to a compensable claim.\nThe majority chooses to distinguish the only previous Arkansas cases on the subject of aggravation of symptoms, Black v. Riverside Furniture Co., 6 Ark. App. 370, 642 S.W.2d 338 (1982), and Kempner\u2019s v. Hall, 7 Ark. App. 181, 646 S.W.2d 31 (1983) , by finding that the language there relating to compensability of symptomology was \u201cobiter dicta.\u201d Obiter dicta is defined by Black\u2019s Law Dictionary (5th ed. 1979) as \u201cWords of an opinion entirely unnecessary for the decision of the case. . . . A remark made, or opinion expressed, by a judge, in his decision upon a cause, \u2018by the way,\u2019 that is, incidentally or collaterally, and not directly upon the question before him, or upon a point not necessarily involved in the determination of the cause, or introduced by way of illustration, or analogy or argument. Such are not binding as precedent.\u201d\nIn Black, the decedent became ill at work and was off for five days while being treated by a physician. He again became ill at work, and the doctor diagnosed the ongoing problems as arteriosclerosis and atrial septal defect and prescribed by-pass surgery. The worker ultimately died from complications of the operation.\nThere were obvious medical expenses in Black, but in affirming the Workers\u2019 Compensation Commission\u2019s decision and denying compensability, Judge Cloninger said:\nWe have a situation in this case which has not been specifically addressed before in this jurisdiction; namely, whether or not aggravation of the symptoms of a preexisting condition is compensable. It is not controverted that Mr. Black had two pre-existing heart conditions. His work aggravated the symptoms of those conditions, consisting of chest pains which is called angina pectoris. Mr. Black\u2019s injury, his death, was the result of bypass .surgery which was conducted to correct the pre-existing heart condition.\nI do not consider that language to be incidental, collateral, or \u201centirely unnecessary.\u201d\nNor do I believe the language of the Court of Appeals in Kempner\u2019s to be incidental, collateral, or \u201centirely unnecessary.\u201d In Kempner\u2019s, the employee had several separate episodes of angina while performing his employment duties. The pain became so great that he eventually went to a hospital and thereafter submitted to by-pass surgery. The issue was whether the surgery was elective, undertaken to alleviate pain caused by arteriosclerosis pre-existing the employment. In Kempner\u2019s the Court of Appeals, though finding the heart condition was job-related and compensable, said:\nIn order to understand the argument and the issue of this appeal two medical terms must be defined and the action our courts have previously taken with respect to this type case should be reviewed. These definitions are generally accepted and are supported by the medical testimony in the record before us. \u201cAngina\u201d is defined not as a disease but a symptom of the underlying disease. The angina is the pain resulting from the underlying disease. In appellee\u2019s case, it was a symptom of his arteriosclerosis or hardening of the arteries. We have recently held that aggravation of the symptoms of a pre-existing condition are not compensable. In Black v. Riverside Furniture Co., 6 Ark. App. 370, 642 S.W.2d 338 (1982), we held that where working conditions merely aggravated the angina, the symptoms of the pre-existing, underlying arteriosclerosis, the employer was not liable for medical expenses or other consequences.\nObiter dicta, like beauty, is in the eyes of the beholder. In my opinion we are overruling Black and Kempner\u2019s and expanding the application of the workers\u2019 compensation law.\nI respectfully dissent.\nHays, J., joins in this dissent.", "type": "dissent", "author": "Otis H. Turner, Justice," } ], "attorneys": [ "Barber, McCaskill, Amsler, Jones & Hale, P.A., for appellants.", "Wright, Chaney & Berry, P.A., for appellee." ], "corrections": "", "head_matter": "NASHVILLE LIVESTOCK COMMISSION and U.S. Insurance Group v. John Paul COX\n89-178\n787 S.W.2d 664\nSupreme Court of Arkansas\nOpinion delivered April 16, 1990\nBarber, McCaskill, Amsler, Jones & Hale, P.A., for appellants.\nWright, Chaney & Berry, P.A., for appellee." }, "file_name": "0069-01", "first_page_order": 95, "last_page_order": 103 }