Summary
In Morrison v. Burlington Industries, 304 N.C. 1, 4-5, 282 S.E.2d 458 (1981), the claimant, a textile worker, became totally disabled when she contracted byssinosis, a chronic obstructive lung condition caused by exposure to cotton dust.
Summary of this case from Deschenes v. Transco, Inc.Opinion
No. 114
Filed 6 October 1981
Master and Servant 68, 72 — total incapacity partially caused by occupational disease — compensability Where the evidence supported the Industrial Commission's conclusion that claimant was totally disabled and 55 percent of her disability was due to an occupational disease and 45 percent of her disability was due to other physical infirmities including bronchitis, phlebitis, varicose veins and diabetes, it was not error for the Industrial Commission to award claimant compensation for a 55 percent partial disability rather than for total disability. In occupational disease cases, disablement of an employee resulting from an occupational disease which arises out of and in the course of the employment, G.S. 97-52 and G.S. 97-2 (6), is compensable and claimant has the burden of proof "to show not only disability, but also its degree." The Commission does not have authority to award a claimant compensation for total disability when 40 to 50 percent of the claimant's disablement is not occupational in origin and was not aggravated or accelerated by any occupational disease.
APPEAL pursuant to G.S. 7A-30 (2) from decision of the North Carolina Court of Appeals, 47 N.C. App. 50, 266 S.E.2d 741 (1980), reversing an award of the Industrial Commission for partial disability and remanding for entry of an award for total disability. The case was argued as No. 60, Fall Term 1980 and re-argued as No. 77, Spring Term 1981.
Hassell Hudson, by Charles R. Hassell, Jr., and Robin E. Hudson, Attorneys for plaintiff appellee.
Teague, Campbell, Conely Dennis, by C. Woodrow Teague and George W. Dennis III, Attorneys for defendant appellants.
Smith, Moore, Smith, Schell Hunter, by McNeill Smith, J. Donald Cowan, Jr., and William L. Young, Attorneys for defendant appellants.
Maupin, Taylor Ellis, P.A., by Richard M. Lewis, Attorneys for National Association of Manufacturers of the United States of America, amicus curiae.
Johnson, Gamble Shearon by Samuel H. Johnson, Attorneys for North Carolina Associated Industries, North Carolina Merchants Association, North Carolina Association of Plumbing-Heating-Cooling Contractors, Incorporated, amicus curiae.
Justice EXUM dissenting.
Justice CARLTON joins in this dissent.
Claimant, Elsie Morrison, certified to her employer in her Notice of Accident and Claim filed with the Commission that she had "contracted an occupational disease, to wit: byssinosis . . . caused by exposure to cotton dust" which had resulted in "permanent, total disability."
Three hearings were held in the matter after which Commissioner Brown concluded that Mrs. Morrison was entitled to compensation for total disability pursuant to G.S. 97-29.
Defendants appealed to the Full Commission which modified Commissioner Brown's findings and award. The Full Commission found that although Mrs. Morrison suffered from "chronic obstructive lung disease, an occupational disease," she also suffered "from phlebitis, varicose veins and diabetes" and such "conditions constitute an added factor in causing her disability." The Commission then found: "Due to the occupational disease suffered by plaintiff and due to her other physical infirmities, including bronchitis, phlebitis, varicose veins and diabetes, plaintiff has no earning capacity in any employment for which she can qualify in the labor market. Fifty-five percent of such disability is due to her occupational disease and 45 percent of such disability is due to her physical infirmities not related to her employment with defendant-employer." The Commission concluded upon these findings that Mrs. Morrison was entitled under G.S. 97-30 to compensation for a 55 percent partial disability and issued its award accordingly.
Mrs. Morrison appealed, and, by a majority vote, the Court of Appeals concluded the Commission lacked authority to award claimant compensation for partial rather than total disability. That court said:
As a result of the Full Commission's amendments to Commissioner Brown's order, the Commission has found that plaintiff is totally disabled from work, that her disability was in part caused by occupational disease compensable under the law and in part caused by other noncompensable illnesses, and therefore plaintiff is only entitled to compensation for partial, not total, disability. The Commission erred in this conclusion . . . . If the worker's incapacity to work is total and if the incapacity is occasioned by a compensable injury or disease, the worker's incapacity to work cannot be apportioned to other pre-existing or latent illnesses or infirmities, nor may the entitlement to compensation be diminished for such conditions.
47 N.C. App. at 55-56, 266 S.E.2d at 744. The Court of Appeals remanded the matter to the Industrial Commission for entry of an order consistent with its opinion. Chief Judge Morris dissented on the ground that an employee should be compensated only for disability "resulting from the injury," and not for factors "totally unrelated to . . . employment."
On defendant's appeal to this Court arguments were first heard on 13 October 1980. Thereafter the Court, concluding "that the medical evidence before the Commission is not sufficiently definite on the cause of plaintiff's disability to permit effective appellate review," remanded the case to the Commission with the suggestion that the physicians more adequately address "the interrelations, if any, between the cotton dust exposure and claimant's other infirmities such as her bronchitis, upper respiratory infection, sinusitis, phlebitis, and diabetes." 301 N.C. 226, 231, 271 S.E.2d 364, 367 (1980). The Court ordered that new findings of fact be made based thereon.
The Court formulated three questions to clarify the medical evidence, to wit: (1) what percentage, if any, of plaintiff's disablement, i.e., incapacity to earn wages, results from an occupational disease; (2) what percentage, if any of plaintiff's disablement results from diseases or infirmities unrelated to plaintiff's occupation which were accelerated or aggravated by plaintiff's occupational disease; and (3) what percentage, if any, of plaintiff's disablement is due to diseases or infirmities unrelated to plaintiff's occupation which were not accelerated or aggravated by plaintiff's occupational disease. 301 N.C. at 231, 271 S.E.2d at 367 (emphasis original).
Responding to this order, further testimony was taken before Commissioner Shuford from physicians Sieker, Battigelli and Mabe, each of whom had treated and examined Mrs. Morrison and had testified at the initial hearings. After rehearing, the Commission again made findings of fact, conclusions of law and an award based on all the evidence before it, including all evidence presented prior to the remand of this Court. The Commission found the following facts which are pertinent to this appeal:
5. Dr. Sieker examined plaintiff January 18, 1977. On that date, plaintiff suffered from chronic obstructive lung disease, and, according to Dr. Sieker, was unable to engage in gainful employment because of chronic obstructive lung disease. In Dr. Sieker's opinion, fifty percent to sixty percent of plaintiff's incapacity for work resulting from chronic obstructive lung disease was caused by exposure to cotton dust during the course of her employment at Burlington Industries, while the balance (forty percent to fifty percent) of her incapacity for work resulting from chronic obstructive lung disease was due to diseases and conditions which were not caused, aggravated, or accelerated by exposure to cotton dust during the course of her employment at Burlington Industries. The plaintiff was also examined by Dr. Mario C. Battigelli, who is of the opinion that the plaintiff is only slightly incapacitated for work, if at all. In Dr. Battigelli's opinion, the plaintiff, is at most, only twenty percent incapacitated for work and that the plaintiff's exposure to cotton dust during the course of her employment at Burlington Industries could have caused, aggravated, or accelerated as little as none or as much as all of her twenty percent incapacity for work.
6. In addition to her chronic obstructive lung disease, plaintiff suffers and has suffered from time to time with phlebitis, varicose veins and diabetes. Such conditions constitute an added factor in causing her incapacity for work, and were not caused, aggravated, or accelerated by exposure to cotton dust during the course of her employment at Burlington Industries.
7. Plaintiff suffers from chronic obstructive lung disease, due, in part, to causes and conditions characteristic of and peculiar to her particular trade, occupation or employment in the textile industry. That part of her lung disease which is related to her employment is not an ordinary disease of life to which the general public is equally exposed outside of such employment.
8. Due to the chronic obstructive lung disease suffered by plaintiff, and due to her other physical infirmities, including bronchitis, phlebitis, varicose veins and diabetes, plaintiff has no earning capacity in any employment for which she can qualify in the labor market.
9. The claimant is only partially incapacitated for work as a result of conditions which were caused, aggravated, or accelerated by exposure to cotton dust during the course of her employment at Burlington Industries. Although the plaintiff is totally incapacitated for work, only fifty-five percent of her incapacity was caused, aggravated, or accelerated by exposure to cotton dust during the course of her employment at Burlington Industries. The remaining forty-five percent of the plaintiff's incapacity for work was not caused by an occupational disease, and was not caused, aggravated, or accelerated by an occupational disease or by exposure to cotton dust during the course of her employment at Burlington Industries.
10. A wage chart submitted by the defendant without plaintiff's objection and hereby made a part of the record shows plaintiff's average annual weekly wage to have been $119.77.
11. As a result of the chronic obstructive pulmonary disease caused by her exposure to cotton dust, plaintiff has only a partial incapacity for work. She has sustained a fifty-five percent loss of wage-earning capacity or ability to earn wages by reason of her cotton dust exposure. Her average weekly wage-earning capacity has been reduced by fifty-five percent of $119.77 or $65.87 per week. The balance of her wage loss was not caused by an occupational disease, and was not caused, aggravated, or accelerated by an occupational disease or exposure to cotton dust during the course of her employment at Burlington Industries.
The Commission, again, entered an award for 55 percent partial disability.
The sole question posed by this appeal is as follows: When the Industrial Commission finds as fact, supported by competent evidence, that a claimant is totally incapacitated for work and 55 percent of that incapacity is caused, accelerated or aggravated by an occupational disease and the remaining 45 percent of that incapacity for work was not caused, accelerated or aggravated by an occupational disease, must the Commission under the Workers' Compensation Act of North Carolina, award compensation for 55 percent disability or 100 percent disability? Upon such findings of fact, our Act mandates an award for 55 percent partial disability.
Except as to questions of jurisdiction, the rule is that the findings of fact made by the Commission are conclusive on appeal when supported by competent evidence. This is so even though there is evidence to support a contrary finding of fact. Morrison v. Burlington Industries, 301 N.C. 226, 271 S.E.2d 364 (1980); Inscoe v. Industries, Inc., 292 N.C. 210, 232 S.E.2d 449 (1977); Anderson v. Construction Co., 265 N.C. 431, 144 S.E.2d 272 (1965); Rice v. Chair Co., 238 N.C. 121, 76 S.E.2d 311 (1953); Henry v. Leather Co., 231 N.C. 477, 57 S.E.2d 760 (1950). The appellate court does not retry the facts. It merely determines from the proceedings before the Commission whether sufficient competent evidence exists to support its findings of fact. Moses v. Bartholomew, 238 N.C. 714, 78 S.E.2d 923 (1953).
The evidence in this case, especially the medical evidence, overwhelmingly supports the Industrial Commission's findings that 55 percent of Mrs. Morrison's inability to work and earn wages is caused by "chronic obstructive lung disease, due in part, to causes and conditions characteristic of and peculiar to her particular . . . employment in the textile industry," and the remaining 45 percent is caused independently by her other physical infirmities, including chronic obstructive lung disease not caused, aggravated or accelerated by an occupational disease, as well as bronchitis, phlebitis, varicose veins and diabetes, none of which are job related and none of which have been aggravated or accelerated by her occupational disease. This Court must accept such findings as final factual truth. The Commission has found as fact that Mrs. Morrison's infirmities other than "chronic obstructive lung disease due in part to cotton dust exposure" were disabling in and of themselves. See Findings of Fact 5, 6, 8, 9 and 11. We are bound by these findings though there is evidence to the contrary.
The following is some, but by no means all, of the evidence in the record of this appeal which supports the findings of the Commission on rehearing. It is unnecessary to recite contrary, confusing or ambiguous evidence. Finding of Fact 5: The answer of each of the three doctors to our questions on remand demonstrates support for this finding: Dr. Sieker: Q. What percentage, if any, of the plaintiff's disablement, that is, incapacity to earn wages, results from an occupational disease? A. Well, this lady, in my opinion from the information available, is disabled for all but the most sedentary types of occupation, so from a physical standpoint, except to set at a desk or sit at a job, she is totally disabled. My opinion from the history is that 50 to 60 percent of that disability can be related to her cotton dust exposure. That's a clinical judgment based on information from the history. Q. What percentage, if any, of plaintiff's disablement results from diseases or infirmities unrelated to plaintiff's occupation which were accelerated or aggravated by plaintiff's occupational disease? A. Again my testimony before was that by clinical judgment that the history of cigarette smoking as a related factor has to be assigned an etiologic contribution to her total chronic obstructive lung disease, and that assignment was 40 to 50 percent. Q. What percentage, if any, of plaintiff's disablement is due to diseases or infirmities unrelated to plaintiff's occupation which were not accelerated or aggravated by the plaintiff's occupational disease? A. Her disability is due to chronic obstructive lung disease that has several etiologic factors, so that for all intents and purposes is a hundred percent disability except for sedentary work. There is no contribution from her phlebitis or her diabetes or sinusitis or rhinitis to her disability. Now if you look at the reasons for her having chronic obstructive lung disease and make me assign percentages, I have to come back to what I did before and make the same assignments I did. Dr. Battigelli: Q. What percentage, if any, of plaintiff's disablement, that is, incapacity to earn wages, results from an occupational disease? A. And my answer would be, again, what I think I have offered beforehand; something between zero, meaning no disability, no consequence, no effect from her occupation, up to twenty percent of a whole-man assessment. Q. What percentage, if any, of plaintiff's disablement results from diseases or infirmities unrelated to plaintiff's occupation which were accelerated or aggravated by plaintiff's occupational disease? A. Namely, there was no acceleration of any significant process that I could identify and justify on medical grounds that I could shore up and buttress on the basis of the evidence that I have gathered in examining this patient and what I know of available data and information which could lead me to believe that anything has been accelerated by exposure to cotton dust. So the answer is negative to the acceleration. For the aggravation, when the patient tells me "I feel worse when dust is there," I cannot interpret that; I have to report it. I have to accept it as a fact. I can only qualify, saying that that aggravation is restored by removal from exposure, and therefore there is no clinical meaningful change in the natural course of that patient's problems, or disorder, or disease, if you wish. Q. What percentage, if any, of plaintiff's disablement is due to diseases or infirmities unrelated to plaintiff's occupation which were not accelerated or aggravated by plaintiff's occupational disease? A. And my answer is from twenty percent downward, in the sense that it may be responsible for all or part of that. Dr. Mabe: Q. Is it fair to say that you cannot give the percentages that were requested by the Supreme Court? A. Well, you know, really, by not being — I think Dr. Battigelli and Dr. Sieker or the other pulmonary specialists, if they're going to take something — you know, I'm really not sure. We do not have any — I have Dr. Sieker's letter and probably Dr. Battigelli's letter at the office. I don't have it in her file here. I'm sure they got respiratory function tests on her and know the degree. We did not get respiratory function tests on her at the time, because we didn't have the capability, then that would still require some expertise in, certainly, interpreting it. And I think the percentage certainly should be left up to Dr. Battigelli and Dr. Sieker, who both, I understand, have seen the patient and have been over the patient. Finding of Fact 6: Mrs. Morrison testified she suffers from diabetes and phlebitis. Medical reports in evidence reflect all of the infirmities found by the Commission and more including depression, sinusitis and hysterectomy. On a proof of total disability form filed 26 January 1976 with a private insurer Mrs. Morrison listed the "origin and nature of disability" as "chronic bronchitis, diabetes mellitus, early pulmonary fibrosis, phlebitis of left leg, emphysema." Mrs. Morrison was placed in a dust-free environment by her employer to alleviate her breathing problems. She left this position because the standing aggravated her phlebitis. Dr. Mabe testified: Q. Well, assuming that the record would support such a finding, that is, that when she was switched from one job to another and that job required her to stand, and that she was not able to tolerate that because of her leg problem, would you agree that in that circumstance that the leg problems would have to be considered an additive factor in maintaining that type of a job and in her disability? A. If she complained, you know, that in changing jobs, that she had one that was more walking and she complained of the leg and attributed this to her old phlebitis, then, you know, that would have to be an additive part. Q. In her disability? Or — for that particular — her ability to earn wages in that particular job? A. In that particular job. Q. So, then, your answer to my question would be, yes, with the explanation you gave? A. Well, in reading it, the first thing I see, you know, that I — in the previous testimony, "it would have to be a self-employed thing where, you know, she could work at will. In other words, she could not have been a satisfactory employee." I meant the lung disease. Now, later on down here, "she could not work this type of thing or could not stand. She had a leg problem, too," which was at that time a problem evidently. And I'd certainly have to stand by that. Yes. That would be an added disability. Again, this is only part of the evidence which supports the Commission finding. See in particular, the testimony of Dr. Battigelli as supporting finding of fact 5. Finding of Fact 7: Mrs. Morrison testified to her continuous exposure to cotton dust since 1948 until she left work in April 1975. The finding that Mrs. Morrison's chronic obstructive lung disease is "due, in part" to an occupational disease is supported by testimony by claimant and the doctors about the extent and effect of her smoking and the fact she has bronchitis. Dr. Battigelli noted in an April 1975 report in the record: "She does not present convincing cyclic disorder which would allow the diagnosis of byssinosis. However in view of her substantial chronic respiratory impairment additional exposure to lint may conceivably deteriorate her situation. I suggest to relocate this patient to a similar activity in a more sheltered environment. If impossible the patient has enough justification to apply for Social Security and I'll be happy to support her in her claim on the grounds of severe venous insufficiency, chronic obstructive lung disorder, depression, status post op. hysterectomy." Finding of Fact 8: Mrs. Morrison testified she is unable to walk up steps or any distance or lift anything without shortness of breath. All the medical testimony supports the finding that she is totally unable to earn wages "except at the most sedentary type of work." In a letter written 4 March 1976 Dr. Battigelli stated, "I have examined Mrs. Morrison on 8 April 1975 for dyspnea on light exertion and on exposure to dust and fumes. At that time, she presented severe obstructive lung disorder, documented by pronounced deficit in spirometry . . . by hypoxemia . . . and by decreased diffusion parameter . . . . She also had evidence of pulmonary shunt . . . . I conclude that she is totally disabled to gainful employment. She is therefore entitled to . . . benefits . . . under Social Security . . . . I must add that she has additional sources of physical impairment, inclusive of severe venous insufficiency of lower extremities, diabetes and borderline left ventricular enlargement, all associated to dyspnea on exertion." Finding of Fact 9: This finding is supported by the doctors' testimony. The doctors' testimony would support any finding from 0% to 60% occupational disease. The Commission was within its fact finding jurisdiction when it found within this range. Finding of Fact 10: There is no dispute about the compensation figures. Finding of Fact 11: The evidence cited under findings 6 through 10 support this as an ultimate finding of fact.
The doctors expressed varied opinions on the extent of the medical disability of Mrs. Morrison. There is a distinction between medical and legal disability. It is up to the Commission to determine the degree of legal disability under the Act. To ignore the distinction between the legal and medical concepts of disability confuses the ultimate issue and obscures the function of the fact finder. We must now determine the proper degree of legal disability for workers' compensation purposes.
In the field of workers' compensation law, the statutes control. We must follow the dictates of our legislature on what is or is not compensable.
The parties agree that the evidence is sufficient to sustain the Commission's finding that Mrs. Morrison contracted an occupational disease while employed by Burlington Industries; that she is totally incapacitated for work; and that the occupational disease caused only part of her total incapacity.
Defendants contend that the "resulting from the injury" language in both G.S. 97-29 and 97-30 means that she is entitled to compensation only to the extent of the occupational disease's contribution. Hence, she is entitled to compensation for partial disability, not total disability, because the occupational disease caused only part of the disability. Therefore G.S. 97-30, not G.S. 97-29, governs the compensation that should be paid in this case. Those statutes in pertinent part read as follows:
97-29. Compensation rates for total incapacity. — Except as hereinafter otherwise provided, where the incapacity for work resulting from the injury is total, the employer shall pay.
97-30. Partial incapacity. — Except as otherwise provided in G.S. 97-31, where the incapacity for work resulting from the injury is partial, the employer shall pay . . . . (Emphasis added.)
Mrs. Morrison contends that our Workers' Compensation Act permits no such apportionment of an award in a case of total incapacity. She argues that if an occupational disease acting together with non-job-related infirmities causes total disability the employee is entitled to compensation for total disability.
The North Carolina Workers' Compensation Act was enacted in 1929. It is not, and was never intended to be, a general accident and health insurance act. "We should not overstep the bounds of legislative intent, and make by judicial legislation our Compensation Act an Accident and Health Insurance Act." Lewter v. Enterprises, Inc., 240 N.C. 399, 403, 82 S.E.2d 410, 414 (1954); Conrad v. Foundry Co., 198 N.C. 723, 153 S.E. 266 (1930).
G.S. 97-2 (6) defines "injury" to mean "only injury by accident arising out of and in the course of the employment, and shall not include a disease in any form, except where it results naturally and unavoidably from the accident."
G.S. 97-2 (9) defines the term "disability" to mean "incapacity because of injury to earn the wages which the employee was receiving at the time of injury in the same or any other employment." Disablement resulting from all occupational diseases (except asbestosis and silicosis) is "equivalent to `disability' as defined in G.S. 97-2 (9)." G.S. 97-54.
When it became apparent that the Act should include a provision for payment of compensation to employees disabled by diseases or abnormal conditions of human beings the causative origin of which was occupational in nature, the legislature adopted in 1935 what is now codified as G.S. 97-52 and -53.
The words "arising out of" refer to the origin or cause of the accidental injury or occupational disease. Bartlett v. Duke University, 284 N.C. 230, 200 S.E.2d 193 (1973); Robbins v. Nicholson, 281 N.C. 234, 188 S.E.2d 350 (1972); Taylor v. Twin City Club, 260 N.C. 435, 132 S.E.2d 865 (1963); Guest v. Iron and Metal Co., 241 N.C. 448, 85 S.E.2d 596 (1955); Duncan v. Charlotte, 234 N.C. 86, 66 S.E.2d 22 (1951); G.S. 97-52; G.S. 97-54.
The words "in the course of" refer to the time, place and circumstances under which the injury by accident, or disablement resulting from an occupational disease, occurred. Bartlett v. Duke University, supra; Robbins v. Nicholson, supra.
The foregoing legal principles demonstrate that the inquiry here is to determine whether, and to what extent, plaintiff is incapacitated by that part of her chronic obstructive lung disease caused by her occupation to earn, in the same or any other employment, the wages she was receiving at the time she became disabled. It is overwhelmingly apparent that disability resulting from an accidental injury, or disablement resulting from an occupational disease, as the case may be, must arise out of and in the course of the employment, i. e., there must be some causal relation between the injury and the employment before the resulting disability or disablement can be said to "arise out of" the employment.
What, then, must a plaintiff show to be entitled to compensation for disablement resulting from an occupational disease covered by G.S. 97-53 (13)? The answer is: She must establish (1) that her disablement results from an occupational disease encompassed by G.S. 97-53 (13), i e., an occupational disease due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation or employment as distinguished from an ordinary disease of life to which the general public is equally exposed outside of the employment; and (2) the extent of the disablement resulting from said occupational disease, i.e., whether she is totally or partially disabled as a result of the disease. If the disablement resulting from the occupational disease is total, the claimant is entitled to compensation as provided in G.S. 97-29 for total disability. If the disablement resulting from the occupational disease is partial, the claimant is entitled to compensation as provided in G.S. 97-30 for partial disability. To be compensable under the Workers' Compensation Act, an injury must result from an accident arising out of and in the course of the employment. G.S. 97-2 (6). Claimant has the burden of showing such injury. Henry u Leather Co., supra. That means, in occupational disease cases, that disablement of an employee resulting from an occupational disease which arises out of and in the course of the employment, G.S. 97-52 and G.S. 97-2 (6), is compensable and claimant has the burden of proof "to show not only . . . disability, but also its degree." Hall v. Chevrolet Co., 263 N.C. 569, 575, 139 S.E.2d 857, 861 (1965).
When the statutory law of North Carolina is applied to the evidence in this case, the conclusion is inescapable that claimant's disablement resulting from the occupational disease does not exceed 50 to 60 percent and that the remaining 40 to 50 percent of her disability results from bronchitis, phlebitis, varicose veins, diabetes, and that part of her chronic lung disease not caused by her occupation. These ailments were in no way caused, aggravated or accelerated by the occupational disease. The Industrial Commission so found, with overwhelming evidence to support the findings. The Commission did precisely what the law of this State required it to do. It had no legal authority to award the claimant compensation for total disability when 40 to 50 percent of her disablement was not occupational in origin and was not aggravated or accelerated by any occupational disease.
To be compensable, any incapacity to earn wages, resulting either from an injury by accident arising out of and in the course of the employment or from an occupational disease, must spring from the employment. "This rule of causal relation is the very sheet anchor of the Workmen's Compensation Act. It has kept the Act within the limits of its intended scope, — that of providing compensation benefits for industrial injuries, rather than branching out into the field of general health insurance benefits." Duncan v. Charlotte, 234 N.C. 86, 91, 66 S.E.2d 22, 25 (1951).
When the General Assembly, by the amendment in 1935, extended the scope of the Act to include a specified list of occupational diseases which are the usual and natural incidents of particular types of employment, the amendment "in nowise relaxed the fundamental principle which requires proof of causal relation between injury and employment. And nonetheless, since the adoption of the amendment, may an award for an occupational disease be sanctioned unless it be shown that the disease was incident to or the result of the particular employment in which the workman was engaged." Duncan v. Charlotte, supra, 234 N.C. at 91, 66 S.E.2d at 25; accord, Blassingame v. Asbestos Co., 217 N.C. 223, 7 S.E.2d 478 (1940); Tindall v. Furniture Co., 216 N.C. 306, 4 S.E.2d 894 (1939). Proof of causation required to establish a compensable claim under G.S. 97-53 (13) is a limitation "which protects our Workmen's Compensation Act from being converted into a general health and insurance benefit act." Booker v. Medical Center, 297 N.C. 458, 475, 256 S.E.2d 189, 200 (1979). Additionally, to be compensable under G.S. 97-53 (13), an occupational disease must be "proven to be due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation or employment," and it cannot be "ordinary diseases of life to which the general public is equally exposed outside of the employment." These requirements are specified by the statute itself. Accord, Booker v. Medical Center, supra.
The findings of the Commission are supported by competent evidence and are therefore conclusive. They establish the necessary causal relationship of only 55 percent of Mrs. Morrison's inability to work and earn wages. This was the extent of her disability resulting from an occupational disease. The incapacity for work resulting from the occupational disease is therefore partial and compensation should be awarded pursuant to G.S. 97-30. The remaining 45 percent of her incapacity is not the responsibility of nor a compensation obligation of her employer under our Workers' Compensation Act which compels industry "to take care of its own wreckage." Barber v. Minges, 223 N.C. 213, 216, 25 S.E.2d 837, 839 (1943). Mrs. Morrison's chronic obstructive lung disease not due to cotton dust exposure is not "industry's wreckage." Neither is her phlebitis, varicose veins nor diabetes.
Alternate sources of benefits exist for those infirmities which are totally unrelated to employment. An employer or employee or both together may obtain private long- or short-term disability insurance programs to cover these illnesses not caused, aggravated or accelerated by occupational conditions. Such terms are standard in group life and accident insurance policies. Also, disability benefits are available under the Social Security System. The record indicates application by Mrs. Morrison for benefits from both of these sources. The Social Security disability benefits which Mrs. Morrison receives would be substantially reduced by a workers' compensation award. The Social Security Act requires an offset of Social Security benefits for workers' compensation benefits received. 42 U.S.C. § 424a (1976), 20 C.F.R. 404-408. A reduction in Mrs. Morrison's Social Security benefits must be made for any month before she attains age 62 to fully or partially offset a periodic workers' compensation benefit received for the same month. The amount of the reduction is the amount by which the total Social Security benefits plus the workers' compensation exceeds the higher of two limits: 80 percent of "average current earning" as defined for Social Security purposes, or the family's total Social Security benefits. See McCormick, Social Security Claims and Procedures 403 (1978). The offset applies even where the benefits under Social Security and workers' compensation are paid for different disabilities. Kananen v. Matthews, 555 F.2d 667 (8th Cir.), cert. den., 434 U.S. 939, 54 L.Ed.2d 298, 98 S.Ct. 429 (1977). Social Security disability is supposed to provide compensation for disabilities not caused, aggravated or accelerated by the work environment. Workers' compensation benefits are not so designed.
The law we apply today departs from neither statute nor case precedent. Anderson v. Motor Co., 233 N.C. 372, 64 S.E.2d 265 (1951), first adopted for North Carolina the principle of compensation for aggravation and acceleration of a pre-existing infirmity. It mandates a causal connection between the injury or disease and the employment. In Anderson, we held:
While there seems to be no case on the specific point in this State, courts in other jurisdictions hold with virtual uniformity that when an employee afflicted with a pre-existing disease or infirmity suffers a personal injury by accident arising out of and in the course of his employment, and such injury materially accelerates or aggravates the pre-existing disease or infirmity and thus proximately contributes to the death or disability of the employee, the injury is compensable, even though it would not have caused death or disability to a normal person.
233 N.C. at 374, 64 S.E.2d at 267. In Anderson, the employee slipped and fell under compensable conditions wrenching his back. The employee suffered from a congenital infirmity of the spine which impaired his back's normal functioning and subjected it to injury more easily. The employee's physician was of the opinion that he had a "permanent physical disability" of 10 percent and that his disability "could be the result of the last injury received [on the job] or could have arisen before that time." The Commission denied the employee any award on the basis that he had not suffered a compensable injury by accident. On appeal the employee contended that the Commission improperly rejected his argument that if his back injury accelerated or aggravated his pre-existing spinal infirmity in such a way that proximately contributed to his permanent partial disability he would be entitled to compensation. This Court recognized the validity of the employee's argument. It concluded, however, that the Commission did not reject the argument but simply found that plaintiff had not sustained a compensable injury. In the present case, Mrs. Morrison's argument that the work environment caused her lung disease was accepted in part by the Commission. The Commission did not accept her contention that it caused all of her lung disease or that her occupation in any way affected her other infirmities. In fact, the Commission specifically found that her occupation did not cause, aggravate or accelerate her other diseases and infirmities which cause 45 percent of her incapacity to work and earn wages.
To like effect is Little v. Food Service, 295 N.C. 527, 246 S.E.2d 743 (1978). In that case we said:
The relevant inquiry under G.S. 97-29 is not whether all or some persons with plaintiff's degree of injury are capable of working and earning wages, but whether plaintiff herself has such capacity. In Anderson v. Motor Co., 233 N.C. 372, 64 S.E.2d 265 (1951), Justice Ervin, writing for the Court, noted: "While there seems to be no case on the specific point in this State, courts in other jurisdictions hold with virtual uniformity that when an employee afflicted with a pre-existing disease or infirmity suffers a personal injury by accident arising out of and in the course of his employment, and such injury materially accelerates or aggravates the pre-existing disease or infirmity and thus proximately contributes to the death or disability of the employee, the injury is compensable, even though it would not have caused death or disability to a normal person." Similarly, if other pre-existing conditions such as an employee's age, education and work experience are such that an injury causes him a greater degree of incapacity for work than the same injury would cause some other person, the employee must be compensated for the incapacity which he or she suffers, and not for the degree of disability which would be suffered by someone with superior education or work experience or who is younger or in better health.
295 N.C. at 531-32, 246 S.E.2d at 746.
In Little, the evidence shows that plaintiff, an over-fifty, obese, uneducated woman, tripped over a mop and fell in a sitting position, resulting in injury to her spinal cord. One doctor rated her physical disability at 50 percent and was of the opinion that she was wholly incapable of resuming her former employment as a laborer. A second doctor was of the opinion that she had suffered an injury to her spinal cord in the neck area; that she had a pre-existing arthritic condition in her neck which was activated by her fall; and that she had suffered a 40 percent disability to the neurological system. The medical evidence further indicated that the injury to Mrs. Little's spinal cord had resulted in weakness "in all of her extremities" and numbness or loss of sensation "throughout her body"; that she had suffered diminished mobility and had difficulty recognizing objects by feeling of them.
The Industrial Commission found that Mrs. Little had suffered "a permanent partial disability of 45 percent . . . loss of use of her back" and awarded compensation for 135 weeks pursuant to G.S. 97-31 (23). The Court of Appeals affirmed. We reversed, holding that the Commission could not limit plaintiff to an award under G.S. 97-31 (23) because the fall had apparently caused some unspecified loss of use of both arms and both legs and possibly disabling impairments compensable under other sections of the Act. We remanded for further proceedings saying: "The injured employee is entitled to an award which encompasses all injuries received in the accident." 295 N.C. at 531, 246 S.E.2d at 746.
The Little decision mandates the payment of compensation for all disability caused by the work-related accident. Our holding in Little is sound and does not support claimant's contention in this case. Mrs. Little had no pre-existing, nonoccupational diseases or infirmities that caused any percentage of her incapacity for work. We know that all of Mrs. Little's incapacity for work, whether total or partial, was caused by the fall. With respect to Mrs. Morrison, we know that 45 percent of her incapacity for work was not caused, aggravated, or accelerated by an occupational disease or by her exposure to cotton dust during the course of her employment because the Commission so found upon overwhelming evidence to that effect.
It would serve no useful purpose to engage in a detailed discussion of many confusing and conflicting decisions from other jurisdictions because, for the most part, they are based on statutes and interpretations thereof quite different from our own. It suffices to say that we are not bound by the law of other states. "The decisions from other jurisdictions, while helpful in construing the provisions of our statute, are not controlling; neither is the interpretation placed upon a statute similar to ours, binding on this Court." Stanley v. Hyman-Michaels Co., 222 N.C. 257, 266, 22 S.E.2d 570, 576 (1942). The result we reach is consistent with the principle that our Workers' Compensation Act is not, and was never intended to be, a general accident and health insurance law. Such was not the legislative intent and we should not, by judicial legislation, convert our compensation law into a system of compulsory general health insurance.
In summary: (1) an employer takes the employee as he finds her with all her pre-existing infirmities and weaknesses. (2) When a pre-existing, nondisabling, non-job-related condition is aggravated or accelerated by an accidental injury arising out of and in the course of employment or by an occupational disease so that disability results, then the employer must compensate the employee for the entire resulting disability even though it would not have disabled a normal person to that extent. (3) On the other hand, when a pre-existing, nondisabling, non-job-related disease or infirmity eventually causes an incapacity for work without any aggravation or acceleration of it by a compensable accident or by an occupational disease, the resulting incapacity so caused is not compensable. (4) When a claimant becomes incapacitated for work and part of that incapacity is caused, accelerated or aggravated by an occupational disease and the remainder of that incapacity for work is not caused, accelerated or aggravated by an occupational disease, the Workers' Compensation Act of North Carolina requires compensation only for that portion of the disability caused, accelerated or aggravated by the occupational disease.
Our Workers' Compensation Act, as enacted by the legislature and interpreted and applied by this Court, will not support a recovery by Mrs. Morrison for total disability. It is our duty to interpret the Act as it exists. This Court is not philosophically opposed to the result sought by Mrs. Morrison, but expansion of the law to permit such recovery is the legislature's prerogative, not ours.
For the reasons stated the decision of the Court of Appeals is reversed. The case is remanded to that court for further remand to the Industrial Commission for reinstatement of its award based on its findings and conclusions following our remand order dated 23 October 1980 and appearing in 301 N.C. 226, 271 S.E.2d 364 (1980).
Reversed and remanded.