|
IN THE SUPREME COURT OF THE STATE OF KANSAS
No. 89,091
WAYNE MUDD, ERICA MUDD, and CONNOR MUDD,
Surviving Spouse and Dependent Children of
DEBRA SUE MUDD, Deceased,
Claimants/Appellees,
v.
NEOSHO MEMORIAL REGIONAL MEDICAL CENTER,
Respondent/Appellant,
and
KANSAS HOSPITAL ASSOCIATION
WORKER COMPENSATION FUND, INC.,
Insurance Carrier/Appellant.
SYLLABUS BY THE COURT
1. The legislative intent in enacting the so-called heart amendment to K.S.A. 44-501 was to
limit
compensability for heart and stroke cases and reverse a long line of Supreme Court decisions
in which compensation was awarded even though preexisting heart or vascular conditions
may have been a predisposing factor.
2. The heart amendment applies to those cases where the exertion of claimant's work is the
agency necessary to precipitate the disability.
3. What is usual exertion, usual work, and regular employment, as those terms are used in
the
heart amendment, are facts to be determined by an administrative law judge and the Workers
Compensation Board, which will be upheld on appeal where supported by substantial
competent evidence.
4. Where the worker's disability is the product of some external force, and not of the exertion
of the claimant's work, the heart amendment has no applicability. The usual versus unusual
exertion test of the heart amendment is irrelevant.
5. To support a finding that claimant's cardiac or vascular injury is the product of some
extreme
external force, the claimant must prove (1) the presence of a substantial external force in the
working environment and (2) there must be expert medical testimony that the external force
was a substantial causative factor in producing the injury.
6. Whether an external force or agency caused a worker's disability is a question of fact
which
an appellate court reviews for sufficiency of the supporting evidence. Whether stress qualifies
as an external force, however, is an issue of law, and our review is unlimited.
7. The heart amendment is constitutional. The legislature had a legitimate goal in passing the
amendment and the means chosen by the legislature bear a rational relationship to that goal.
Appeal from the Workers Compensation Board. Opinion filed January 24, 2003. Reversed.
Nancy S. Anstaett, of Rowe & Anstaett, L. L. C. of Overland Park, argued the
cause, and Wade A. Dorothy, of Dorothy
& Henoch, L.L.C., of Lenexa, was with her on the briefs for appellants.
Timothy A. Short, of Spigarelli, McLane & Short, of Pittsburg, argued
the cause and was on the brief for
appellees.
The opinion of the court was delivered by
NUSS, J.: This is an appeal from an award of benefits by the Workers Compensation
Board
(Board). Mary Sue Mudd was a nurse at the Neosho Memorial Regional Medical Center
(Neosho)
who died after suffering a rupture of a cerebral aneurysm (stroke) at work. An administrative law
judge (ALJ) denied the claim for benefits filed by her surviving spouse and dependent children.
The
Board reversed, and Neosho appealed. We granted the motion to transfer from the Court of
Appeals
under K.S.A. 20-3017.
The parties present three issues on appeal. First, does the record contain substantial
competent evidence to support the Board's finding that Mudd's stroke met the "unusual exertion"
requirement of the heart amendment of the Workers Compensation Act: K.S.A. 44-501(e)?
Second,
does "stress" qualify as an external factor which makes the heart amendment irrelevant to Mudd's
claim? Third, is the heart amendment unconstitutional?
We hold there is not substantial competent evidence to support the unusual exertion
finding,
that stress does not qualify as an external factor, and that the heart amendment is constitutional.
We
therefore reverse.
FACTS
Mudd was a 47-year-old registered nurse employed for more than 10 years by Neosho.
She
worked in the intensive care unit and the emergency room. While at Neosho, Mudd was called
upon
to respond to "code blues," which required her to stop what she was doing and run to help
resuscitate
a dying patient.
During the 6 months prior to September 13, 1999, 19 code blues had occurred at Neosho.
Mudd was involved in responding to seven of them. Her husband, Wayne, testified that she was
required to run to code blues and afterward she would be upset, stressed, and unable to sleep,
sometimes for days after the event.
On September 13, 1999, Mudd became ill while responding to a code blue and passed out.
She was initially treated at Neosho by Dr. Gehrt who performed a spinal tap and found blood in
her
spinal fluid. Mudd was transferred to Via Christi Regional Medical Center in Wichita. There, Dr.
Schwertfeger concluded that she had suffered a cerebrovascular stroke. She died on September
23,
1999.
Dr. Schwertfeger testified that Mudd's stroke was likely the result of a preexisting
aneurysm,
which is a weakening of a blood vessel wall. According to him, the weak area develops a bulge
and
eventually ruptures, typically following some sort of exertion or stress which causes an elevation
in
blood pressure. He stated that running to respond to a code blue would potentially cause an
increase
in blood pressure and that responding to a code blue was within the normal scope of the duties of
an
ICU nurse. Dr. Schwertfeger testified regarding his conclusions as follows:
"Q. Do you have an opinion within a reasonable degree of medical
certainty, which means more
likely than not, whether her activity and stress of running to respond to a code blue precipitated
her stroke?
"A. It would be conditions that would be conducive to a
subarachnoid hemorrhage in a patient
predisposed to that.
. . . .
"Q. So you would say that it is more likely than not that the exertion of this lady
running
to respond to a code blue was a factor in precipitating her stroke?
"A. It would be a factor I believe, yes."
Mudd's surviving spouse and dependent children sought survivors' benefits under the
Workers
Compensation Act. The ALJ denied their claim, finding that they had not met their burden of
proving
an unusual exertion caused her aneurysm to fail. He therefore concluded "[t]hat the claimant was
acting within the course of her 'usual work' and her 'regular employment' when she suffered her
cerebrovascular stroke."
After the claimants appealed, the Board reversed and entered an award for them. It found
that
the exertion from running to respond to a code blue was something that occurred on average only
once a month while Mudd was on duty. In addition, the Board found that running was an unusual
activity for Mudd and that the running constituted unusual exertion within the meaning of K.S.A.
44-501(e). It further found that she suffered "heightened stress when responding to a code blue,"
and
that "[t]his unusual stress . . . contributed to the unusual level of exertion and, in addition,
constituted
an external force within the meaning of the heart amendment." Finally, the Board found that the
stress, combined with the running, elevated decedent's blood pressure and, more likely than not,
precipitated the rupture of the aneurysm while Mudd was responding to the code blue. Neosho
and
its insurance carrier appealed.
DISCUSSION
Issue 1: Does the record contain substantial competent evidence to support the Board's
finding that
Mudd's stroke met the "unusual exertion" requirement of the heart amendment?
The Board found that the claim based upon Mudd's stroke was
compensable under K.S.A.
44-501. Specifically, the Board found claimants met the requirements of subsection (e), the
so-called
heart amendment, which states:
"Compensation shall not be paid in case of coronary or coronary artery disease or
cerebrovascular injury unless it is shown that the exertion of the work necessary to
precipitate the
disability was more than the employee's usual work in the course of the employee's
regular
employment."
The legislature passed this amendment in 1967. L. 1967, ch. 280, § 1. Its general
purpose
was to limit compensability for heart and stroke cases and reverse a long line of Supreme Court
decisions in which compensation was awarded even though preexisting heart or vascular
conditions
may have been a predisposing factor. See Dial v. C.V. Dome Co., 213 Kan. 262,
266-267, 515 P.2d
1046 (1973); Nichols v. State Highway Commission, 211 Kan. 919, 923,
508 P.2d 856 (1973). In
Nichols we noted one legal commentator's opinion that by passing the amendment,
perhaps the
legislature felt that awards were sometimes allowed where the disability or death should have
been
regarded as the end result of the natural progress of disease, rather than as arising out of
employment.
211 Kan. at 923, citing Kelly, The Unusual-Exertion Requirement and
Employment-Connected Heart
Attacks, 16 Kan. L. Rev. 411, 416 (1968).
Accordingly, claimants since 1967 have borne the burden of proof to demonstrate injuries
in
this category arose out of something more than the exertion required of their usual work in the
course
of their regular employment. 211 Kan. at 924. See K.S.A. 44-501(a). Kansas is therefore
included
in a "substantial minority of jurisdictions" which require a showing that the exertion was in some
way
unusual. 2 Larson's Workers' Compensation Law § 43.03[1][b] (2002).
In the case at hand, the Board found that the exertion from running to respond to a code
blue
was something that occurred on average only once a month while Mudd was on duty. In
addition,
the Board found that running was an unusual activity for Mudd and that the running constituted
unusual exertion. Finally, it found that Mudd suffered "heightened stress when responding to a
code
blue," and that "[t]his unusual stress . . . contributed to the unusual level of exertion." These
determinations are questions of fact. See Suhm v. Volks Homes, Inc., 219 Kan. 800,
805, 549 P.2d
944 (1976).
Our review of questions of fact is limited to determining whether they are supported by
substantial competent evidence. 219 Kan. at 805. This determination, however, is a question of
law.
Griffin v. Dale Willey Pontiac-Cadillac-GMC Truck, Inc., 268 Kan. 33, 34-35, 991
P.2d 406 (1999).
In workers compensation cases, substantial evidence is evidence possessing
something of substance
and relevant consequence and carrying with it fitness to induce conviction that the award is
proper,
or furnishing a substantiating basis of fact from which the issue tendered can be reasonably
resolved.
We view the evidence in the light most favorable to the prevailing party and do not reweigh the
evidence or determine the credibility of the witnesses. 268 Kan. at 34.
Despite this deferential standard of review, we hold as a matter of law that the record does
not contain substantial competent evidence to support several of the Board's key findings: that
running was an unusual activity for Mudd, that the running constituted unusual exertion, that
Mudd
suffered "heightened" stress when responding to a code blue, and that this "unusual stress"
contributed to the unusual level of exertion. As mentioned, the law requires the claimant to show
"'that the exertion of the work necessary to precipitate the disability was more than the
[employee's]
usual work in the course of [the employee's] regular employment.'" (Emphasis added.)
211 Kan. at
923. Consequently, the standard for determining what is usual exertion is the work history of the
individual involved. Chapman v. Wilkenson Co., 222 Kan. 722, 726, 567 P.2d 888
(1977).
The record is devoid of any evidence, however, of Nurse Mudd's work history which
would
demonstrate her usual work or the level of exertion required to perform these usual duties.
The
record simply reveals that on the day in question, for the seventh time in 6 months she ran an
unknown distance to a code blue, that she had previously found this activity stressful, and that the
running and stress contributed to her stroke. Without a baseline of what is usual for her, there
can
be no determination of what is unusual for her, particularly when "[u]nusualness may
be a matter of
degree and may appear in the duration, strenuousness, distance or other circumstances involved in
the work." 222 Kan. at 728, citing 1A Larson, The Law of Workmen's Compensation §
38.64(a)
(1973).
Claimants simply failed to meet their burden of proof as defined in K.S.A. 44-508(g): "to
persuade the trier of facts by a preponderance of the credible evidence that such party's position
on
an issue is more probably true than not true on the basis of the whole record." Likewise, in
Calvert
v. Darby Corporation, 207 Kan. 198, 201, 483 P.2d 491 (1971), we held that "claimant did
not
sustain the burden of proof that the decedent did anything more than the usual amount of work in
the
course of his regular employment on the day he suffered his fatal heart attack." Similarly, in
Suhm,
219 Kan. at 806-07, we observed that after claimant described his usual workday, he
admitted that
he was no stranger to long work days, road trips, or daily work-related stress. Accordingly, we
upheld the district court's conclusion that his exertion on the day in question was no more than
that
required of his usual work. See also Woods v. Peerless Plastics, Inc., 220 Kan. 786,
788, 556 P.2d
455 (1976) ("We examine first the question of Mr. Woods' usual work which he performed as
part
of his regular employment.").
Additionally, even if claimants had established through Mudd's work history the requisite
baseline for her work and exertion, we question whether they would have been able to meet their
burden of proof to establish that the code blue and its accompanying stress on September 13,
1999,
sufficiently exceeded this baseline to qualify as unusual. For example, Mudd's own physician, Dr.
Schwertfeger, testified that responding to a code blue was within the normal scope of the duties
of
an ICU nurse, i.e., part of Mudd's usual job. Moreover, since K.S.A. 44-501(e) does
not require a
certain task to be done daily for it to fit the definition of "usual work," Mudd's husband's
testimony
that she was required to run to code blues, coupled with the stipulation that she had responded to
seven code blues during the 6 months before her stroke, strongly suggests this activity was not
unusual.
Issue 2: Does "stress" qualify as an external factor which makes the heart amendment
irrelevant to
claimants' claim?
Six years after the legislature's passage of the heart amendment, we held it did not apply
unless the exertion of the work was the precipitating cause of the disability. Dial v. C.V.
Dome Co.,
213 Kan. 262. We ruled that when exertion was not an issue, the stroke/heart attack
claimant could
prevail by instead showing an "external force" was the precipitating cause of her disability. See
Dial,
213 Kan. at 266; Woods, 220 Kan. at 788. In this case, the Board
found that Mudd's
heightened/unusual stress in running to the code blue constituted an external force.
Whether an external force or agency produced a worker's disability is a question of
fact.
Suhm, 219 Kan. 800, Syl. ¶ 4 . Whether stress qualifies as an external force,
however, is an issue of
first impression necessarily involving an interpretation and application of the law. See Kindel
v. Ferco
Rental, Inc., 258 Kan. 272, 277, 899 P.2d 1058 (1995). See Kuhn v. Sandoz
Pharmaceuticals Corp.,
270 Kan. 443, 456, 14 P.3d 1170 (2000). Our review of questions of law is unlimited.
Lindsey v.
Miami County National Bank, 267 Kan. 685, 689-90, 984 P.2d 719 (1999).
We begin our analysis by identifying the required elements for external force described in
Makalous v. Kansas State Highway Commission, 222 Kan. 477, 484-85, 565 P.2d
254 (1977):
"To support a finding that claimant's cardiac or vascular injury is the product of some
extreme
external force, [1] the presence of a substantial external force in the working environment must be
established and [2] there must be expert medical testimony that the external force was a
substantial
causative factor in producing the injury and resulting disability."
In the case at hand, Dr. Schwertfeger's testimony establishes the element of causation:
"[H]er
activity and stress of running to respond to a code blue . . . would be conditions that would be
conducive to a subarachnoid hemorrhage." His testimony, though contradicted by defendants'
physician, Dr. Pfuetze, was found more persuasive by the Board and is therefore binding on this
court
since we do not reweigh evidence or determine credibility of witnesses. Griffin, 268
Kan. at 34.
For the Board's determination of the other element, the presence of an external force, it
relied
upon two cases. It first observed, "[i]n dicta, the Kansas Supreme Court in Dial v. C.V.
Dome Co.,
213 Kan. 262, 515 P.2d 1046 (1973), indicated that anxiety and stress could constitute
external force
and an exception to the heart amendment contained in K.S.A. 44-501." Second, the Board noted
our
finding 3 years later in Suhm v. Volks Homes, Inc., 219 Kan. 800, that the medical
testimony failed
to establish stress was the external force which precipitated claimant's heart attack and also noted
that
we had not expressly rejected stress as an external force. The Board therefore concluded
Suhm
implied that stress could constitute external force.
In addition to our examining Suhm's implications and Dial's
acknowledged dicta, however,
we must also look to other Kansas law for guidance. The bedrock of our examination is our
oft-stated acknowledgment of the legislative purpose of the 1967 heart amendment: to limit
compensability for heart and stroke cases and reverse a long line of decisions in which
compensation
was awarded even though preexisting heart or vascular conditions may have been a predisposing
factor. See Makalous v. Kansas State Highway Commission, 222 Kan. at 481;
Suhm, 219 Kan. at
804-05; Dial, 213 Kan. at 266; Nichols v. Kansas State Highway, 211
Kan. at 923.
Our examination continues with a recognition of similarly limiting legislative action taken
in
1987: the addition of subsection "g" to K.S.A. 44-501. L. 1987, ch. 187, § 1. It states in
relevant
part: "The provisions of the workers compensation act shall be applied impartially to both
employers
and employees in cases arising hereunder." The addition changed the course of case law which
had
required courts to tilt somewhat in favor of the employee: to "liberally construe the workers
compensation statutes to award compensation to the worker where it was reasonably possible to
do
so." Nguyen v. IBP, Inc., 266 Kan. 580, 582, 972 P.2d 747
(1999). See Miner v. M. Bruenger &
Co., 17 Kan. App.2d 185, 193-94, 836 P.2d 19 (1992). Just as we are required to give
effect to the
intention of the legislature as expressed and not determine what the law should or should not be
when
we review a statute that is plain and unambiguous, so are we prohibited from developing case law
inconsistent with the legislature's purpose. See In re Marriage of Killman, 264 Kan.
33, 42-43, 955
P.2d 1228 (1998).
Our continuing review reveals not only the acknowledged dicta in Dial
relied upon by the
Board, but also our additional statements made there, e.g., an external force is
"wholly independent
of the workman's exertion." 213 Kan. at 266. As a result, "[w]here the disability is the product
of
some external force or agency, and not of the exertion of the claimant's work, the
heart amendment
has no applicability." (Emphasis added.) 213 Kan. at 268. Three years later we confirmed these
statements with our analysis of Dial in Woods v. Peerless Plastics, Inc.,
220 Kan. at 790. "In Dial
the heat was an external force, wholly independent of the workman's exertion." Similarly, 1
year later
we again described our analysis in Dial by stating in Makalous, 222 Kan.
at 483: "[T]he exertion of
the work had little if any appreciable effect in producing the heatstroke in Dial."
Consistent with these prior conclusions and reaffirmations, to date we have decided that
only
"oppressive heat" and "freezing cold and windy weather" qualify as external forces,
i.e., external to
the claimant's work exertion. See Dial; Makalous. Moreover, the example cited by
the Dial court
is similarly external to the workers' exertion: After a worker is confronted by an armed assailant
bent
on robbery, he suffers a heart attack because of the natural fear and anxiety. 213 Kan. at 267-68.
The Dial court also discussed another example where a falling beam struck the
claimant on the head
and caused a cerebrovascular injury; we held the heart amendment would not apply there because
"the
agency which 'precipitated' the disability was not the exertion of his work but the external force of
the blow." 213 Kan. at 267.
In the case at hand, Mudd's own physician testified that the stress was not external to her
exertion, but actually combined with it. We therefore hold that stress cannot, as a matter of law,
be
an external factor under these facts. Any suggestion or implication to the contrary in our prior
decisions is overruled. To hold otherwise would be to eviscerate the heart amendment. For
example,
a stroke or heart attack claimant who has unsuccessfully tried to prove the statutory requirement
of
unusual exertion could nevertheless prevail by instead showing the cause of the injury was merely
the
usual (though "substantial" per Makalous) stress of her work at the time.
While stress does not qualify under these circumstances as an external factor, claimants
are
not totally without recourse. They may still demonstrate that the stress was caused by factors
external to Mudd's exertion, e.g., the armed assailant or the falling beam in
Dial's examples. In
addition, they may still show unusual work or unusual exertion which was a causative factor of
the
unusual stress. Similarly, although not emphasized by the parties as a separate basis for
compensation, the Board found that Mudd suffered heightened/unusual stress while responding to
the code blue and that it contributed to her unusual level of exertion. We hold, however, that this
Board finding of "unusual stress" is not supported by substantial competent evidence. As
mentioned
earlier regarding the absence of a baseline to establish unusual work/exertion, the record is also
devoid of any baseline to establish that the stress on the day of the stroke was "unusual,"
i.e., more
than what Mudd experienced at other times. For this additional reason, the claim should be
denied.
Issue 3: Is the heart amendment unconstitutional?
Finally, claimants argue the heart amendment violates the Equal Protection Clause of the
United States Constitution. Although this issue was not decided below, the parties agree it was
properly preserved and that the rational basis test is the appropriate standard.
As the party asserting a statute's unconstitutionality, claimants' burden is a "weighty one."
Barrett v. U.S.D. 259, 272 Kan. 250, 255, 32 P.3d 1156 (2001). "This is as it should be
for the
enacted statute is adopted through the legislative process ultimately expressing the will of the
electorate in a democratic society." 272 Kan. at 255. Consequently, while the determination of
whether a statute violates the constitution is a question of law over which we have unlimited de
novo
review, we have often held:
"'A statute is presumed constitutional, and all doubts must be resolved in favor of its
validity. If there
is any reasonable way to construe a statute as constitutionally valid, the court must do so. A
statute
must clearly violate the constitution before it may be struck down. [Citations omitted.]. "This
court
not only has the authority, but also the duty, to construe a statute in such a manner that it is
constitutional if the same can be done within the apparent intent of the legislature in passing the
statute." State v. Durrant, 244 Kan. 522, 534, 769 P.2d 1174, cert. denied
492 U.S. 923 (1989).'
[Citation omitted.]" Injured Workers of Kansas v. Franklin, 262 Kan. 840, 844, 942
P.2d 591
(1997).
Claimants argue the heart amendment violates the Equal Protection Clause because it
discriminates between workers. According to claimants, a worker who suffers a heart attack or
stroke caused by the exertion of a particular task which that worker regularly performs will be
denied
any medical or disability compensation, while another worker who suffers an identical heart attack
or stroke caused by the same level of exertion performing the exact same task will be awarded full
compensation merely because the other worker rarely performed the particular task.
We affirm that the concept of equal protection of the law is one which "'emphasizes
disparity
in treatment by a State between classes of individuals whose situations are arguably
indistinguishable.'" Barrett, 272 Kan. at 256. However, under the rational basis test,
"a law is
constitutional, despite some unequal classification of citizens, if the 'classification bears some
reasonable relationship to a valid legislative objective.'" Injured Workers of Kansas,
262 Kan. at 847
(citing Farley v. Engelken, 241 Kan. 663, Syl. ¶ 3, 740 P.2d 1058 [1987]).
For a statute to pass constitutional muster under the rational basis standard, it therefore
must
meet a two-part test: (1) It must implicate legitimate goals, and (2) the means chosen by the
legislature must bear a rational relationship to those goals. Barrett v. U.S.D. 259,
272 Kan. at 256
(citing State v. Mueller, 271 Kan. 897, Syl. ¶ 8, 27 P.3d 884 [2001]). We have
previously described
it as "a very lenient standard" because, among other things,
"'[t]he "reasonable basis" test is violated only if the statutory classification rests on
grounds
wholly irrelevant to the achievement of the State's legitimate objective. The state legislature is
presumed to have acted within its constitutional power even if the statute results in some
inequality.
Under the reasonable basis test, a statutory discrimination will not be set aside if any state of facts
reasonably may be conceived to justify it.'" Injured Workers of Kansas, 262 Kan. at
847.
Accordingly, "[a] [party] asserting the unconstitutionality of a statute under the rational basis
standard
has the burden to negate every conceivable basis which might support the classification."
Peden v.
Kansas Dept. of Revenue, 261 Kan. 239, Syl. ¶ 6, 930 P.2d 1 (1996), cert.
denied 520 U.S. 1229
(1997).
As we apply the two parts of the rational basis test, we first recognize that in 1911 the Kansas
Legislature abolished the employees' common-law right to sue employers for injuries and provided
the employees with an adequate substitute remedy for the right abolishedthe Workers
Compensation
Act. 262 Kan. at 855. The Act allowed employees to quickly receive a smaller, set
amount of money
for injuries received at work, whether they were caused by employer negligence or not. 262 Kan.
at
855. The Act's goal was to make a more equitable adjustment of loss under a system
which was
intended largely to eliminate controversies and litigation and place the burden of accidental
injuries
incident to employment upon the industries themselves or rather upon the consumers of the
products
of such industries. McRoberts v. Zinc Co., 93 Kan. 364, 366-367, 144 Pac. 247
(1914). The
legitimacy of this goal was confirmed many years ago when the Act survived a number of
constitutional challenges. See Shade v. Cement Co., 93 Kan. 257, 144 Pac. 249
(1914); Hovis v.
Refining Co., 95 Kan. 505, 148 Pac. 626 (1915).
To further advance this clear goal the legislature, in enacting the heart amendment, has
chosen to distinguish cases of "coronary or coronary artery disease or cerebrovascular injury"
from
other cases of "personal injury by accident arising out of and in the course of employment."
K.S.A.
44-501(a) and (e). For the last 35 years, compensability has been based on whether the injured
worker's exertion which precipitates the disability is more than the exertion of the injured worker's
usual work. In Nichols we acknowledged that the legislature had passed the heart
amendment
because it was concerned that workers compensation awards were allowed where disability or
death
were merely the result of the natural progress of disease, rather than arising out of employment.
Indeed, the legislature created the heart amendment after we noted in McIver v. State
Highway
Commission, 198 Kan. 678, 683, 426 P.2d 118 (1967), that any change to our 48 years of
case law
holding that compensable injuries included aggravation of heart ailments during the
exertion of
ordinary labor would have to come from the legislature.
Claimants' challenge to the legislative goal of the heart amendment appears to be based
primarily upon our decision in Stephenson v. Sugar Creek Packing, 250 Kan. 768,
830 P.2d 41
(1992). In Stephenson we ruled that the legislature's distinctions for injured
workers, based solely
on whether the injury resulted from "repetitive" rather than a "single" trauma, violated the rational
basis test because the scheme was simply to further the alleged goal of reducing workers
compensation insurance premiums for industry. 250 Kan. 780.
The goal of the heart amendment, by contrast, is legitimate. It is not to deny
compensation
to claimants who suffer injury on the job, but rather to avoid requiring the employer to act as an
absolute insurer of claimants whose death or disability was merely the result of the natural
progress
of disease and which coincidentally occurred at the workplace. This specific goal was generally
affirmed by the legislature's later addition of subsection "g" to K.S.A. 44-501 to end the
compensation tilt in favor of the employee by now requiring impartial application of the workers
compensation act to employees and employers alike. While the legislature's demarcation based on
"unusual exertion" is not scientifically exact, the rational basis test does not require such
precision.
Injured Workers of Kansas, 262 Kan. at 848 (citing Peden v. Kansas Dept. of
Revenue, 261 Kan.
239, 258-59, 930 P.2d 1 [1966]), cert. denied 520 U.S. 1229 (1997) (The rational
basis test does not
require mathematical precision in establishing classifications.). We therefore hold that the
statute's
purpose implicates a legitimate goal and the means chosen by the legislature bear a rational
relationship to that goal. K.S.A. 44-501(e) is constitutional.
While not dispositive of the issue, we are additionally persuaded by the recognition that
one
third of other jurisdictions also require unusual exertions. Moreover, several of them have found
similar statutes constitutional, e.g., not violative of equal protection under the rational
basis test.
DeSchaaf v. Indus. Com'n of Ariz., 141 Ariz. App. 318, 320, 686 P.2d 1288 (1984)
(Arizona statute
did not violate equal protection when it provided that heart-related or perivascular injury was not
a
personal injury by accident arising out of and in the course of employment unless "'some injury,
stress
or exertion related to the employment was a substantial contributing cause of the heart-related or
perivascular injury, illness or death'"); Claimants in Matter of Kohler v. Indus. Com'n,
671 P.2d
1002, 1006 (Colo. App. 1983) (The legislature "could have reasonably concluded that because of
the
inherent difficulty in ascribing the cause of many heart attacks to particular events or
circumstances,
a claimant, in order to receive benefits, should be required to show the presence of unusual
exertion
in the performance of his employment duties, and that such exertion is causally related to the heart
attack."); Benoit v. Maco Mfg., 633 So. 2d 1301, 1305 (La. App. 1994) (Rational
basis existed for
statute requiring a higher burden of proof in heart-related or perivascular injury cases "because
heart
attacks and strokes are ordinarily the result of natural physiological causes, rather than trauma or
particular effort, which is more easily discernible as a work-related injury."); Cosse' v.
Orleans
Material and Equipment, 626 So. 2d 440, 442 (La. App. 1993) (The Louisiana statute
"satisfies the
legitimate state interest of compensating only those employees who suffer heart attacks as a result
of factors related to their work.").
We reverse the Board and affirm the decision of the administrative law judge denying the
claim for benefits.
|