On appeal from Division of Workers' Compensation.
Botter, King and McElroy. The opinion of the court was delivered by McElroy, J.A.D.
[178 NJSuper Page 573] This is a workers' compensation case. Petitioner was employed by appellant primarily as a packer of telephones on an assembly line and as a bench worker in telephone repair. Two petitions were filed in this matter, neither of which mentioned assembly line work stress nor work quota stress of any sort. The first, filed on November 14, 1972, alleged that while "working for respondent, petitioner was exposed to chemicals and fumes causing occupational disease." This paper alleged "disability to nervous system, internal organs, and complications arising therefrom." The second petition, filed November 28, 1972, asserted that petitioner "contracted an occupational disease," omitted reference to chemicals and fumes, and alleged "disability to chest, lungs, nose, throat, hearing and complications arising therefrom." By means of the alchemistic process [178 NJSuper Page 574] peculiar to the workers' compensation matters, these 1972 allegations were transmuted by 1975, when the first of 21 hearings began, into a claim primarily centered upon allegations that the exposure of petitioner to the stresses of assembly line work aggravated a preexisting and underlying schizophrenia, thereby giving that mental illness the character of an occupational disease under N.J.S.A. 34:15-31.*fn1 The judge of compensation, by oral opinion rendered November 3, 1978, adopted this view of the matter and awarded petitioner permanent total disability benefits. The ensuing order for judgment recited that such disability was occasioned because petitioner "was exposed to adverse environment, noise, stress, and tension resulting in an occupational exposure which resulted in occupational diseases in the nature of chronic bronchitis, binaural hearing loss, and schizophrenia with symptomatic alcoholism and anxiety as a result of his occupational exposure to stress and strain of attaining quotas and keeping up with the assembly line, his exposure to lacquer thinners, to fumes, dust, welding fumes and noise . . . ." The employer does not appeal from this entire cluster of alleged exposure and ills, but rather from the major aspect of the award which concerns the question, novel to this State, as to whether mental illness exacerbated by alleged repetitive mental stress or stimuli is compensable. Necessarily, if the answer to this question be, yes, the accompanying inquiry is whether this case meets the applicable standards of proof. We have examined the opinion below and the record presented. Such consideration, guided by the principles which govern our power of review, obliges us to reverse the decision of the judge of compensation. Close v. Kordulak Bros. , 44 N.J. 589, 598 (1965).
This case involves application of N.J.S.A. 34:15-31 to its facts. That statute, as it existed in the time frame applicable to this case,*fn2 provided:
34:15-31. 'Compensable occupational disease' defined
For the purposes of this article the phrase 'compensable occupational disease' shall include all diseases arising out of and in the course of employment, which are due to causes and, conditions which are or were characteristic of or peculiar to a particular trade, occupation, process or employment, or which diseases are due to the exposure of any employee to a cause thereof arising out of and in the course of his employment.
Precedent to a recitation of the facts adduced below and a consideration of applicable legal principles we will recount some of the medical evidence which describes the nature of petitioner's schizophrenia. We do so because we feel that in order to obtain the substance and true form of this case and to gauge whether work stress was here, in realistic sense and material degree, an aggravating factor of petitioner's mental disease, one must view the evidence ever conscious that we are dealing with the reactions of a schizophrenic to normal job conditions. In short, if what we have is a man who, because he is a schizophrenic, has a purely subjective reaction to his job (as indeed, he
may react to all other aspects of life), we have a case of a diseased mind reacting to normal work demands. In such connotation this case is similar to Walck v. Johns-Manville Products Corp. , 56 N.J. 533 (1970), where Justice Francis, speaking of a hypochondriac's subjective concern about loss of employment, said:
In other words, if the nature of an employee is such that he is a worrier, the mere fact that he becomes unnecessarily tense and nervous as to whether he is going to keep or lose his job, without more, would not make a heart attack compensable, even if the attack did result from that worry. That kind of anxiety or tension cannot be considered a risk arising out of the employer's work. If worry, about job security alone, which produces a heart seizure would establish compensability, the employer would become an insurer against such attacks. [at 557]
The psychiatric experts here agreed that plaintiff's schizophrenia preexisted the alleged employment exposure and was idiopathic in nature. Plaintiff's expert, Dr. Robert T. Latimer, defined schizophrenia as a mental disorder "which produces pronounced disorganization of the personality with defects in the areas of associated thinking . . . ." Of importance to what we have just said in relation to the Walck case, Dr. Latimer stated that this disease "produces something called autism, which is the tendency to look at the world through one's own pathological conceptualization of it." The doctor suggested that we approach petitioner's reactions to reality with caution: "The man says many things. He is totally unreliable."
Appellant's expert, Dr. David Flicker, presented much the same view.
People irritate him. People on the job, people off the job. Of course, everybody irritated him, he was a schizophrenic. And he was a decompensating schizophrenic. Therefore, he blamed everything on the job and off the job. But particular [ sic ] on the job. The only thing that any lay mind can do is attribute his difficulties to the situation in which he is in. He therefore attributes it to his family, his friends, his job. Never to other factors such as possibly the use of alcohol, which he was using undoubtedly as a tranquilizer, was aggravating and had produced a vicious cycle in that the more he used alcohol, the less compensation he had. He attributes it to those things around him. Those are not the true etiology, those are the rationalization of a psychotic mind . . . The only place a man can be is on his job or off, and he carried his schizophrenia with him on the job and off the job. But it didn't mean that the job contributed in any way to that schizophrenic process.
Compensation awards based upon physical injuries caused by psychic or emotional trauma have been granted in this State. Examples are Geltman v. Reliable Linen & Supply Co. , 128 N.J.L. 443 (E. & A. 1942), and Hall v. Doremus , 114 N.J.L. 47 (Sup.Ct.1934). In Geltman the decedent, a salesman, became embroiled with another automobile driver in an abusive and heated argument concerning decedent's operation of his vehicle. The emotional and nervous shock produced what was deemed a compensable heart attack. The Hall case involved a farmhand who witnessed the gory breech delivery of a calf. This produced an emotional reaction which caused him to faint and fall to the floor, suffering injury. Our courts have also awarded compensation for purely psychic injury caused by psychic shock emanating from a single frightening event. Simon v. R.H.H. Steel Laundry Inc. , 25 N.J. Super. 50 (Cty.Ct.1953), aff'd, 26 N.J. Super. 598 (App.Div.1953), certif. den. 13 N.J. 392 (1953). Simon involved a workman who was in a boiler room when a "violent and terrifying" explosion of a high pressure steam pipe occurred. Simon was rendered unconscious and awoke to a room filled with steam. His terror induced a psychoneurotic disability found to be compensable.
Simon , like Hall and Geltman , are examples of statutory accidents compensable under N.J.S.A. 34:15-17. Heretofore no case has been presented to our courts where mental illness allegedly induced by repetitive work stress was deemed to be an occupational disease as defined in N.J.S.A. 34:15-31. For cases in other jurisdictions treating the issue either as an occupational disease or an accident, see Annotation, "Mental Disorders As Compensable Under Workmen's Compensation Act," 97 A.L.R. 3d 161 (1980). See also, the discussion of the subject in 1B Larson, The Law of Workmen's Compensation , § 42.23(b) (1979). The parties in their briefs have exhaustively discussed cases from other jurisdictions, but we see no good purpose served by our undertaking any such venture. The cases range from absolute denial of compensation for apparently strict policy reasons or the absence of an "external event" type of accident, to awards
on liberal policy grounds or because of particular statutory language defining injury arising out of and in the course of employment. Whether the cases fall into either camp, they are distinguishable by reason of their facts or the adopted legal approach to those facts.
In our State the principles which in general govern the grant or denial of an award do not differ merely because a case can be labeled as an "accident" or an "occupational disease" matter. Giambattista v. Thomas A. Edison , 32 N.J. Super. 103, 111-112 (App.Div.1954). In that case this court, in speaking of the occupational diseases sections as they appeared before the 1979 revision, observed:
In view of the definition in our statute, the proof of a causal connection between working conditions and the harm should be the focal point of the inquiry . . . Our current occupational disease sections, by reason of their historical development and the fact they are clearly an integrated part of the system of compensation law, must be interpreted and construed in the light of the ...