On appeal from the Division of Workers' Compensation.
O'Brien, Simpson and Scalera. The opinion of the court was delivered by Scalera, J.s.c. (temporarily assigned).
The employer appeals from a judgment entered in the Division of Workers' Compensation that determined the petitioner to be 25% partially permanently disabled, 20% as a result of a myocardial infarction, and 5% for traumatic anxiety and cardiophobia. We address here the recent statutory amendment relating to coronary and cardiovascular injuries and more particularly the so-called "wear and tear" requirement contained in the statute.
The evidence produced at the hearing established that petitioner was 53 years old and had worked at Branch Motor Express for 30 years. In October 1981 he operated a hi-lo forklift machine as a platform man, loading and unloading trucks. On October 28, 1981 he worked the midnight to 9 a.m. shift as he had done for ten or fifteen years. He arrived at work just before midnight feeling fine. When he started his shift, he was told by his foreman to quickly unload specific cargo in the trailer assigned to him. That freight (tools) was in the front of the trailer, farthest from the doors, and had to be carried by him over the boxes and crates in the middle of the trailer. Access to the boxes in the front of the trailer was blocked by a seven-foot by ten-foot crate that could be moved only by using a crane, after removing the canvas trailer roof.
The trailer was 40 or 45 feet long and was full. Prusecki asked the foreman for a helper at the beginning of the shift and several other times during the shift "because of the way the truck was loaded"; he had to maneuver the boxes by hand, which ranged in weight from very light to about 200 pounds, over the freight in his way instead of using his hi-lo machine in the usual manner. He received no help until near the end of his shift and they did not help him with the difficult task of maneuvering boxes to the rear of the trailer to be unloaded; rather, they waited for him to get the boxes to the rear of the trailer, where they placed the boxes on their carts and wheeled
them away. He manually unloaded 20 to 25 boxes during his shift.
Shortly before his "dinner" break at 6 a.m. Prusecki began sweating heavily. He took his dinner break from 6 to 7 a.m. and ate some of the soup and a sandwich which he had brought. He felt sick and lay down for a half-hour during his break. At that time, he was sweating heavily and his heart was pounding. He began to feel pain in his elbows, his heart continued to pound and he felt dizzy. Nonetheless, he resumed working at 7 a.m. and was joined by a co-worker, Satnowski, who began to push petitioner playfully. Prusecki asked him to stop because he had gas pains and felt sick. Satnowski offered to do the heavy work, and directed Prusecki to use a cart to perform the less strenuous task of carting the boxes away, but the symptoms persisted.
They worked until about 8:45 a.m. and then went to the locker room to wash up. Prusecki began turning grey and told Satnowski that his chest and left arm hurt. Also his speech was "getting funny." Satnowski and another co-worker drove Prusecki to the emergency room at St. James Hospital in Newark where he was admitted and stayed in the hospital until November 10.
Prusecki said that he had had no prior problem with his heart. Rush jobs, like the one on which he was working when his heart attack occurred, were fairly common; on occasion he had been required to climb over boxes to get at items, as he was doing on the day of his attack. He admitted to smoking between a pack and a pack and a half of cigarettes per day at the time. In mid-February 1982 he returned to the same job as he had although now he works slower and is given lighter cargo to load and unload.
He no longer mows his lawn or does much of the work around the house, such as home improvements, and his sex life has suffered. He fears having another heart attack and he does not go out as much or stay out as late.
Hubert Silberner, M.D., testified as an expert for petitioner and opined that Prusecki "suffered an acute myocardial infarction on October 28, 1981 during the course of his employment at Branch Motors Express." He gave as reasons for this conclusion:
He was admitted to the hospital and kept in the intensive care unit for the investigation. During the course of the investigation, he was noted to have elevation of the cardiac enzymes. That is the SPK, the SGOT and the LDH. The changes of the electrocardiogram were not marked. It was necessary to take a special procedure to move the electrodes into a higher location at which time they found evidence of Q waves. He stayed in the hospital for a period of approximately two weeks and subsequent investigation in the form of a coronary angiography confirmed that he did have coronary arteries disease. There were certain pre-existing factors that should be mentioned here. He was a heavy cigarette smoker. He had high blood pressure. He had diabetes, and there was a family history. His father died at an early age and also his uncle. So, considering all these factors, an individual with multiple risk factors, doing heavy employment, subsequently found to have organic disease of the coronary arteries, develops severe chest pain associated with palpitation, rapid heart beat and sweating, with elevation of all three cardiac enzymes, it is my opinion that he suffered an acute myocardial infarction. It is my opinion that the location of the infarct was away from the usual anatomical location, so that the routine electrocardiography at the time of his hospitalization did not show much in the way of change, did not show anything in the way of changes.
Likewise, subsequent electrocardiography performed in my office showed a normal cardiogram. However, cardiac enzymes are very sensitive tests, and in view of the fact that he had significant elevation of the CPK plus the history plus the subsequent demonstration of organic coronary artery disease, it is in my opinion that he suffered a myocardial infarction in the course of the employment on October 28, 1981.
The doctor thought that the strongest indication that Prusecki had a heart attack was the 787 CPK reading taken at St. James shortly after his admission. A CPK reading of greater than 225 indicates that there has been muscle damage somewhere in the body, causing a release of the enzyme that produces the reading. Prusecki's elevated CPK reading indicated that there had been heart damage.
Dr. Silberner noted further that on November 30, 1981 Prusecki went to Beth Israel Hospital in Newark where he underwent cardiac catheterization. He said that the test showed a 60 to 80% ...