On certification to Superior Court, Appellate Division, whose opinion is reported at 270 N.J. Super. 520 (1994).
The opinion of the Court was delivered by Pollock, J. Chief Justice Wilentz and Justices Handler, O'Hern, Garibaldi, and Stein join in Justice Pollock's opinion. Justice Coleman did not participate.
The opinion of the court was delivered by: Pollock
(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the interests of brevity, portions of any opinion may not have been summarized).
JOHN FIORE V. CONSOLIDATED FREIGHTWAYS (A-46-94)
Argued November 7, 1994 -- Decided June 1, 1995
POLLOCK, J., writing for a unanimous Court.
In this appeal, the Court determines the standard of proof required to establish an occupational heart-disease claim under the Workers' Compensation Act (the Act).
On August 8, 1986, John Fiore, a truck driver employed by Consolidated Freightways, suffered an angina attack while delivering freight. At the time of his attack, Fiore was thirty-nine years old and was obese. In addition, he had smoked two packs of cigarettes per day for twenty years and had a family history of heart disease. Fiore claims that while loading and unloading at Consolidated terminals, he was exposed to toxic fumes, including carbon monoxide.
Fiore filed two workers' compensation claims: the first petition alleged that his occupational exposure to "deleterious substances" had resulted in neurological, neuropsychiatric, and pulmonary injuries; the second petition alleged that he had suffered a heart attack at work that resulted in neurological, neuropsychiatric, and heart injuries. The Workers' Compensation Judge dismissed Fiore's heart-attack claim for failure to sustain the required burden of proof and dismissed the pulmonary-disability claim because Fiore's own expert had classified the disability as mild. Nonetheless, the Judge did award thirty-three and one-third percent of partial-total permanent disability, finding that the occupational exposure to carbon monoxide had caused Fiore's angina and coronary-artery disease and, therefore, his claim fell under the section 7.2 (or the heart section) of the Act. The Judge awarded Fiore 200 weeks of compensation at the rate of $133 per week for a total of $26,000.
On appeal, the Appellate Division remanded for dismissal of the petition, finding that Fiore's claim fell under section 7.2 but that he had not met that section's burden of proof. Although the court acknowledged that section 7.2 is not designed for an occupational heart disease claim, it found that to accord with legislative intent, the standard for such a claim must be as stringent as that set forth in section 7.2. The court concluded that when exposure is related to toxic fumes, the petitioner must prove that the exposure was in excess of that normally encountered in every day living; that it arose out of the course of employment; and that it was due in a material degree to causes peculiar to the particular employment.
Fiore petitioned the Supreme Court for certification, asserting that an occupational heart-disease claim should be analyzed under section 31 of the Act pertaining to occupational diseases, not section 7.2. The Court granted the petition.
HELD: An employee claiming an occupational heart disease must show that the disease is due in a material degree to causes or conditions that characterize the employee's occupation and that substantially contribute to the development of the disease.
1. Dual causation is any occupational-disease causation problem in which a personal element combines with an employment element to produce a disease or disability. A difficult question to answer is whether the legal cause of the disease results from exposure to substances at work or to personal-risk factors, such as smoking or family history of the disease. Because no specific provision of the Act addresses the specific standard to apply in dual causation cases, the Court looks to the Act as a whole to determine legislative intent. (pp. 4-12)
2. Because an occupational heart-disease claim could come under section 7.2 or section 31, both sections should be construed in light of each other. Sections 31 and 7.2 are limited to work-related injuries. Although section 7.2 is limited to heart attacks caused by excessive work effort or strain, and section 31 to occupational disease, both sections require that causation occur in the workplace. Fiore's claim, which relates to occupational exposure to carbon monoxide arising out, and in the course of, his employment, focuses on his working conditions. Thus, section 31 more readily fits Fiore's claim. (pp. 12-19)
3. The Legislature did not address specifically the issue of a dual-causation occupational-disease that gives rise to a cardiovascular disability. Because the statute is silent, the legislative intent must be discerned from the terms of the Act and its structure, history and purpose. The Legislature enacted section 7.2 based on its understanding that heart attacks are usually caused by natural or non-occupational causes; under that section, employment must contribute something substantial to offset the causal contribution of the personal risk factors. The Legislature could not have intended that a more relaxed standard apply under section 31 to coronary disease resulting from occupational exposure than applies under section 7.2 to cardiovascular injury caused by the work effort. (pp. 19-22)
4. To best effectuate legislative intent, the Court holds that a petitioner claiming an occupational heart disease must show causes or conditions characteristic to the occupation or place of employment that substantially contributed in a material way to the disease. To satisfy that standard, the petitioner must meet three requirements: 1) that the disease is due in a material degree to causes arising out of the workplace that are or were characteristic of or peculiar to a particular trade, occupation, process or place of employment; 2) prove, by suitable medical evidence, that the employment exposure caused or contributed to the disease by demonstrating that the work exposure exceeds the exposure caused by the petitioner's personal-risk factors; and 3) that the employment exposure substantially contributes to the development of coronary-artery disease when the exposure is so significant that, without exposure, the disease would not have developed to the extent that it caused the disability. (pp. 22-27)
5. A petitioner must provide sufficient credible evidence to support a claim for compensation. On remand, the parties should provide more reliable evidence than the record now reflects. (pp.27-30)
6. The workers' compensation Judge did not address the issue of apportionment and the record does not provide a suitable basis to analyze the issue. To the extent that the issue is relevant on remand, it is noted that the burden of proof is on the employer. (pp. 30-32)
Judgment of the Appellate Division is REVERSED and the matter is REMANDED to the Division of Workers' Compensation.
CHIEF JUSTICE WILENTZ and JUSTICES HANDLER, O'HERN, GARIBALDI and STEIN join in JUSTICE POLLOCK'S opinion. JUSTICE COLEMAN did not participate.
We granted certification, 137 N.J. 165 (1994), to determine the standard of proof required to establish an occupational heart-disease claim under N.J.S.A. 34:15-1 to -128, the Workers' Compensation Act (the Act). We conclude generally that an employee claiming an occupational heart disease must show that the disease is due in a material degree to causes or conditions that characterize the employee's occupation and that substantially contribute to the development of the disease. That Conclusion leads to a remand to the Division of Workers' Compensation (Division) to determine whether the work of petitioner, John Fiore, substantially contributed to his angina attack and coronary-artery disease. Complicating that determination are Fiore's personal-risk factors, including the facts that he had smoked two packs of cigarettes a day for twenty years, was fifty-sixty pounds overweight, and had a family history of heart disease. Thus, the case presents a question of dual causation concerning an occupational disease.
On August 8, 1986, Fiore suffered an angina attack while delivering freight. He filed two workers' compensation claims. The first petition alleged that Fiore's occupational exposure to "deleterious substances" had resulted in neurological, neuropsychiatric, and pulmonary injuries. The second alleged that he had suffered a heart attack at work that had resulted in neurological, neuropsychiatric, and heart injuries. The Workers' Compensation Judge dismissed both claims. He dismissed the heart-attack claim for "failure to sustain burden of proof . . . as to any specific incident," and the pulmonary-disability claim because Fiore's own expert had classified the disability as "mild."
Finding that the occupational exposure to carbon monoxide had caused Fiore's angina and coronary-artery disease, however, the Judge awarded Fiore thirty-three and one-third percent of partial-total permanent disability. Pursuant to the requirements of N.J.S.A. 34:15-7.2 (subsequently described as "section 7.2" or the "heart section" of the Act), the Judge concluded that Fiore had
proven by a fair preponderance of the credible evidence that the angina incident of August 8th, 1986 was produced by the work effort or strain involving a substantial condition, event or happening in excess of the wear and tear of the petitioner's daily living and in reasonable, medical probability caused in a material degree, the angina and coronary artery disease resulting therefrom.
The Judge thereby awarded Fiore 200 weeks of compensation at the rate of $133 per week for a total of $26,000.
The Appellate Division reversed and remanded for dismissal of the petition. 270 N.J. Super. 520 (1994). Although the Appellate Division agreed with the compensation Judge's determination that Fiore's claim fell under section 7.2, the court held that Fiore had not met that section's burden of proof. The court acknowledged that section 7.2 is not designed for an occupational heart-disease claim, but concluded that to "be true to the Legislature's intent," the standard for such a claim "must be at least as stringent as those set forth in section 7.2 . . . ." Id. at 542. The Appellate Division posited the following test:
Where the exposure is related to toxic fumes, the test called for would translate to requiring proof that the exposure was in excess of that ordinarily encountered in every day living; that it arose out of and in the course of employment, and that it was due in material degree to causes peculiar to the particular employment.
Fiore petitioned for certification asserting that an occupational heart-disease claim should be analyzed under section 31, not section 7.2. Although we agree with petitioner that section 31, which pertains to occupational diseases, provides a more suitable framework for analyzing occupational heart-disease claims, a fair reading of the Act leads to the Conclusion, as the Appellate Division recognized, that the analysis should proceed in light of the more stringent requirements of section 7.2. In reaching that Conclusion, we acknowledge that we have gleaned the legislative intent, as did the Appellate Division, by reading sections 7.2 and 31 together. Thus, whether the analysis proceeds under section 31, as we deem appropriate, or under section 7.2, as the Appellate Division decided, the result remains that the compensability of occupational heart diseases depends on satisfying the requirements of both sections. Our Conclusion leads to a reversal of the Appellate's Division's judgment and a remand to the Division.
At the time of his heart attack, Fiore was thirty-nine years old and obese. Before the attack, he had smoked two packs of cigarettes a day for twenty years. His father, moreover, had died of a heart attack at age ...