RUMSEY v CARDINAL PETROLEUM

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No. 12699 I N THE SUPREME COURT OF THE STATE OF M N A A OTN CECIL Claimant and Respondent, CARDINAL PETROLEUM, Employer and GLACIER GENERAL ASSURANCE COMPANY, Respondent and Appellant. Appeal from: District Court o f t h e T h i r t e e n t h J u d i c i a l D i s t r i c t , Honorable Robert Wilson, Judge p r e s i d i n g . Counsel o f Record : For Appellant : Crowley, Kilbourne, Haughey, Hanson and G a l l a g h e r , B i l l i n g s , Montana Bruce R. Toole, argued, B i l l i n g s , Montana For Respondent: Michael J. Whalen argued, B i l l i n g s , Montana Submitted: November 13, 1974 Decided: JAN g w 5 M r . J u s t i c e John Conway H a r r i s o n d e l i v e r e d t h e Opinion of t h e Court . T h i s i s a n a p p e a l from a judgment of t h e d i s t r i c t c o u r t , Yellowstone County, which r e v e r s e d a n o r d e r of t h e Workmen's Compensation D i v i s i o n and h e l d i n f a v o r o f t h e c l a i m a n t , C e c i l J . Rumsey . On J a n u a r y 1 0 , 1970, C e c i l Rumsey, a n employee of C a r - d i n a l P e t r o l e u m Company, s u f f e r e d a n i n j u r y w h i l e working a s a "roughneck" on a n o i l w e l l . The a c c i d e n t o c c u r r e d when a d r i l l e r s t a r t e d a winch w h i l e c l a i m a n t w a s a t t e m p t i n g t o c o n n e c t a s e t of t o n g s t o t h e d r i l l stem of a n o i l w e l l . Claimant was j e r k e d a c r o s s t h e p l a t f o r m o f t h e o i l r i g and s u s t a i n e d i n j u r i e s t o h i s r i g h t a r m , s h o u l d e r and c h e s t . C l a i m a n t ' s h o s p i t a l and s u r g e r y c o s t s i n t h e amount of $6,413.70 were p a i d by a p p e l l a n t . Weekly compensation b e n e f i t s were p a i d from J a n u a r y 1 7 , 1970 t h r o u g h F e b r u a r y 4 , 1970 and from F e b r u a r y 2 , 1971 t h r o u g h October 1 4 , 1971, f o r a t o t a l of 39-1/7 weeks, i n t h e amount of $1,695.71. A f t e r a s h o r t p e r i o d of r e c u p e r a t i o n , c l a i m a n t q u i t h i s j o b a t C a r d i n a l P e t r o l e u m Company and went t o Wyoming where h e worked a s a p l a s t e r e r . During t h i s p e r i o d of t i m e , h e complained of a n e x t e n s i v e a c h e i n h i s r i g h t s i d e and a r m , a l o n g w i t h c h i l l s and f e v e r . H e a l s o found i t d i f f i c u l t t o b r e a t h e and e x p e r i e n c e d a s h a r p p a i n i n h i s c h e s t when he o v e r e x e r t e d h i m s e l f . On October 7 , 1970, c l a i m a n t w a s a d m i t t e d t o t h e i n t e n s i v e c a r e u n i t of a Wyoming h o s p i t a l a f t e r h a v i n g s u f f e r e d s e v e r e chest pains. C l a i m a n t ' s i l l n e s s was d i a g n o s e d a s m y o c a r d i a l i s c h e m i a , a c o n d i t i o n t h a t h a s c a u s e d c l a i m a n t t o become permanentl y disabled. Ischemia i s a c o n d i t i o n where t h e r e i s a n o b s t r u c t i o n o f t h e blood f l o w t h r o u g h t h e c o r o n a r y a r t e r i e s r e s u l t i n g i n t h e l a c k of an a d e q u a t e blood s u p p l y t o t h e h e a r t muscle. If the condition i s extensive, angina p e c t o r i s o r an oppressive pain under t h e b r e a s t b o n e r e s u l t s . On March 1 9 , 1971, c l a i m a n t underwent s u r g e r y t o r e s t o r e t h e c a p a c i t y of h i s r i g h t l u n g which had become s e v e r e l y compromised a s a r e s u l t of t h e i n d u s t r i a l a c c i d e n t . The m e d i c a l t e s t - imony p r e s e n t e d t o t h e Workmen's Compensation D i v i s i o n d i s c l o s e d t h a t t h e i n d u s t r i a l a c c i d e n t had c a u s e d t h e c l a i m a n t t o s u f f e r i n t e r n a l b l e e d i n g which had c a u s e d h i s r i g h t c h e s t c a v i t y t o become f i l l e d w i t h b l o o d . The blood e v e n t u a l l y formed a r e s t r i c - t i v e c a s i n g around t h e r i g h t l u n g and p r e v e n t e d i t from f u n c t i o n ing properly. The o p e r a t i o n removed t h i s t h i c k c a s i n g of blood o r p l e u r a and t h e r i g h t l u n g w a s expanded. O September 29, 1971, c l a i m a n t p e t i t i o n e d t h e Workmen's n Compensation D i v i s i o n t o be d e c l a r e d permanently d i s a b l e d and t o be awarded a lump-sum s e t t l e m e n t . The c r u c i a l i s s u e p r e s e n t e d t o t h e Workmen's Compensat i o n D i v i s i o n was whether t h e i n d u s t r i a l a c c i d e n t c o u p l e d w i t h t h e compromised r i g h t l u n g and t h e r e s u l t a n t p h y s i c a l and emot i o n a l stress, had a c c e l e r a t e d o r a g g r a v a t e d t h e c l a i m a n t ' s p r e e x i s t i n g c o n d i t i o n of myocardial i s c h e m i a . During t h e h e a r i n g t h e d e p o s i t i o n s of two p h y s i c i a n s , Doctor Movius and Doctor R o u s s a l i s were i n t r o d u c e d . Doctor Movius t e s t i f i e d : "Q. Now, b a c k i n g up a l i t t l e , and h a v i n g i n mind t h e c o n d i t i o n of t h i s l u n g d u r i n g t h e 1 4 months bef o r e s u r g e r y , would t h e c o n d i t i o n t h a t e x i s t e d t h e r e d u r i n g t h a t p e r i o d of t i m e impose any l i m i t a t i o n upon t h e oxygen s u p p l y t h a t would be f u r n i s h e d t o t h e h e a r t ? A. Y e s , s i r . "Q. A. And what would be t h e n a t u r e of t h a t l i m i t a t i o n ? W e l l , a s I mentioned e a r l i e r , i t would be m y o p i n i o n t h a t t h e p a t i e n t would a c t u a l l y be f u n c t i o n i n g w i t h less t h a n one l u n g inasmuch a s t h e r i g h t o n e w a s c o m p l e t e l y c o n s t r i c t e d and v e r y p r o b a b l y pushed somewhat t o t h e l e f t and l i m i t i n g t h e f u n c t i o n of t h e uninjured lung, so t h a t s o f a r a s t h e t o t a l o x y g e n a t i o n i s concerned under s t r e s s , he p r o b a b l y had less t h a n 5 0 % o x y g e n a t i o n t o h i s body t h a n was p o s s i b l e under maximum c o n d i t i o n s b e f o r e t h e i n j u r y . "Q. And d u r i n g t h i s p e r i o d o f t i m e when he was a t t e m p t i n g t o work he was under s t r e s s , i s t h a t c o r r e c t ? A. I d o n ' t t h i n k t h e r e i s any d o u b t a b o u t it. And w i t h t h a t l i m i t a t i o n and s t r e s s , would t h a t p u t any s t r e s s upon o t h e r v i t a l o r g a n s of t h e body? A. I think so. "Q. "Q. And which one? A. Primarily the heart. "Q. Now, c o u l d you t e l l u s , p l e a s e , whether o r n o t a f t e r t h e performance of t h i s s u r g e r y t h e r e would now be any l i m i t a t i o n of t h e oxygen s u p p l y t o t h e h e a r t b e c a u s e of t h i s c o n d i t i o n , a s d i s t i n g u i s h e d from what i t would have been p r i o r t o t h e t i m e of i n j u r y ? A . Yes, t h e r e i s some l i m i t a t i o n , b u t n o t n e a r l y s o g r e a t a s b e f o r e . According t o t h e t e s t s , we f i n d t h a t , a c c o r d i n g t o t h e a v e r a g e i n d i v i d u a l , h e h a s 8 5 % a s much a s a normal i n d i v i d u a l s i n c e t h e o p e r a t i o n . But p r i o r t o t h e o p e r a t i o n , I would e s t i m a t e t h a t it w a s somewhere i n t h e r e g i o n of 40 t o 45%. "Q. And what would c a u s e t h e c o n t i n u e d l i m i t a t i o n of oxygen t o t h e h e a r t a f t e r t h e s u r g e r y h a s been completed, t h e h e a l i n g p e r i o d p a s t ? A. Well, I t h i n k t h a t any stress phenomenon t h a t any i n d i v i d u a l endures--and a t t h i s p e r i o d of l i f e we a l l know t h a t t h e r e i s a narrowing of your blood v e s s e l s and many p e o p l e d o n ' t l i v e t o be a t t h e a g e of many of u s a r e . And i f I may go i n t o h i s h i s t o r y , t h e f a c t t h a t he had a c o r o n a r y problem i n October of 1970, I t h i n k t h e r e i s no q u e s t i o n t h a t t h e f a c t t h a t he worked f o r a p p r o x i m a t e l y n i n e months w i t h l e s s t h a n one l u n g g r e a t l y a g g r a v a t e d h i s p r o b a b l e p r e s e n t e x i s t i n g c o r o n a r y narrowing and was l a r g e l y r e s p o n s i b l e f o r t h e o c c u r r e n c e of h i s c o r o n a r y a t t h a t t i m e b e c a u s e of t h e c o n t i n u e d v i g o r o u s work which he d i d w i t h a markedly compromised-oxygen s u p p l y . " Doctor R o u s s a l i s testified: Then, D o c t o r , you e x p l a i n e d i n your o p i n i o n , your w r i t t e n o p i n i o n which i s now a t t a c h e d t o Doctor Movius' d e p o s i t i o n , and I w i l l q u o t e , 'EKG r e v e a l e d t h e p a t i e n t t o have m y o c a r d i a l i s c h e m i a which i s n o t r e l a t e d t o t h i s i n j u r y and which w i l l be of permanent n a t u r e ' . I w i l l j u s t s i m p l y a s you ( s i c ) , a r e you s t i l l of t h a t o p i n i o n , and t h a t i s , t h e i s c h e m i a i s n o t r e l a t e d t o t h e i n j u r y which h a s been d e s c r i b e d i n your h i s t o r y and f o r which t h i s That i s c o r r e c t . c l a i m i s made? A. "Q. "Q. And i t i s y o u r o p i n i o n , t h e n , i f I u n d e r s t a n d you, t h i s i s a d e v e l o p m e n t a l d i s e a s e of a g i n g of Correct." o u r s o c i e t y ? A. When t h e h e a r i n g s examiner was c o n f r o n t e d w i t h t h e conf l i c t i n g m e d i c a l t e s t i m o n y , he d e c i d e d t o send p e r t i n e n t p o r t i o n s of t h e f i l e t o an i n d e p e n d e n t p h y s i c i a n , Doctor Goulding, f o r h i s opinion. Doctor G o u l d i n g ' s two page r e p o r t w a s s e n t by t h e h e a r i n g s examiner t o r e s p e c t i v e c o u n s e l a l o n g w i t h a l e t t e r s t a t i n g t h e r e p o r t would be u t i l i z e d i n r e a c h i n g a d e c i s i o n . Doctor G o u l d i n g ' s r e p o r t s t a t e d , i n t e r a l i a , t h a t l u n g d i s e a s e and e m o t i o n a l trauma were n o t f a c t o r s i n a c c e l e r a t i n g m y c a r d i a l ischemia. Upon r e c e i p t of t h i s r e p o r t , c l a i m a n t ' s c o u n s e l w r o t e t o t h e h e a r i n g s examiner o b j e c t i n g t o t h e u s e of e v i d e n c e o u t s i d e of t h e r e c o r d and r e q u e s t i n g t h e o p p o r t u n i t y t o cross-examine Doctor Goulding and t o o b t a i n a d d i t i o n a l m e d i c a l t e s t i m o n y t o rebut h i s findings. On October 30, 1972, t h e h e a r i n g s examiner d e n i e d cornp e n s a t i o n t o c l a i m a n t w i t h o u t a f f o r d i n g him t h e o p p o r t u n i t y t o cross-examine Doctor Goulding and t o r e b u t h i s f i n d i n g s . Thereupon, c l a i m a n t a p p e a l e d t o t h e d i s t r i c t c o u r t which h e a r d a d d i t i o n a l t e s t i m o n y from Doctor Movius and r e v e r s e d t h e f i n d i n g s of t h e D i v i s i o n . The employer and i t s i n s u r a n c e company appealed. The i s s u e s a r e : 1. Did t h e D i v i s i o n e r r i n d e n y i n g c l a i m a n t a n oppor- t u n i t y t o cross-examine Doctor Goulding and t o r e b u t h i s f i n d i n g s ? 2. Did t h e d i s t r i c t c o u r t e r r i n r e v e r s i n g t h e f i n d i n g s of t h e D i v i s i o n ? I s s u e 1. W n o t e t h e r u l e s of e v i d e n c e a r e more r e l a x e d e i n a n a d m i n i s t r a t i v e p r o c e e d i n g t h a n i n a c o u r t of law. 92-812, R.C.M. Section 1947; Ross v . I n d u s t r i a l A c c i d e n t Board, 106 Mont. 486, 80 P.2d 362; Bergan v. G a l l a t i n V a l l e y Mlg. Co., 27, 353 P.2d 320. 138 Mont. However, t h e s e r u l e s w i l l n o t be r e l a x e d t o t h e p o i n t where due p r o c e s s of law and t h e fundamental r i g h t s o f t h e i n j u r e d workmen a r e d i s r e g a r d e d . In Mulholland v. Butte & Superior Min. Co., 87 Mont. 561, 289 P. 574, two referee physicians were selected by the Industrial Accident Board to render an opinion after the board was unable to reach a decision because of conflicting medical testimony. A written report favoring the claimant was submitted. Accordingly, the board found the claimant was totally disabled and awarded him compensation. Thereupon, the defendant company perfected an appeal to the district court which upheld the decision of the board after additional evidence was heard. This Court conceded the board had erred in depriving defendants of their right to cross-examine the physicians. However, the dis- trict court was not held in error because it was presumed that it had considered only competent testimony and had ignored the reports. 3 Larson, Workmen's Compensation Law, B 79.63, states: "Under the increasingly common practice of referral of claimant to an official medical examiner or an independent physician chosen by the commission, it is particularly important that commissions not lose sight of the elementary requirement that the parties be given an opportunity to see such a doctor's report, cross-examine him, and if necessary provide rebuttal testimony." In Massachusetts Bond. 74 C.A.2d & Ins. Co. v. Industrial Acc. Com'n, 911, 170 P.2d 36,37, the California Industrial Accident Commission referred a case to two independent physicians because of conflicting medical testimony. Upon appeal, the petitioner contended he had been denied due process of law when his request for an opportunity to cross-examine the physicians and to produce rebuttal testimony had been denied. The court agreed with his contention and stated: " * * * Even if regarded as a purely administrative agency, however, in exercising adjudicatory functions the commission is bound by the due process clause of the fourteenth amendment to the United States Constitution to give the parties before it a fair and open hearing. 'The right to such a hearing is one of "the rudiments of fair play" (citation) assured to every litigant by the Fourteenth Amendment as a minimal requirement.' [Cases cited] . "The reasonable opportunity to meet and rebut the evidence produced by his opponent is generally recognized as one of the essentials of these minimal requirements [Cases cited] and the right of cross-examination has frequently been referred to as another [Cases cited]." For similar holdings see: Beeler v. Central Foundry Division, 32 Mich.App. 661, 189 N.W.2d 64; Hegglin v. Workmen's Compensa- tion Appeals Board, 93 Cal.Rptr. 15, 480 P.2d 967; Chavez v. Industrial Commission, 5 Ariz.App. 294, 425 P.2d 864; North West Trailer Sales v. McCann, (Fla. 1968) 217 So.2d 310; Armes v. Pierce Governor Co., 121 1nd.App. 566, 101 N.E.2d 199; Puncec v. City and County of Denver, 28 Col.App. 542, 475 P.2d 359; Annotation, 109 ALR 598. The Division erred in basing its decision upon an independent medical report made by a physician appointed by the Division, accompanied by denial of the right to cross-examine and rebut. Issue 2. Section 92-834, R.C.M. 1947, provides the dis- trict court may consider additional evidence that was not before the Division. If this additional evidence is substantial, the district court may reverse the division even though the evidence before the Division preponderates in favor of the Division. Young v. Liberty Nat. Ins. Co., 138 Mont. 458, 357 P.2d 886; OINeil v. Industrial Accident Board, 107 Mont. 176, 81 P.2d 688; wee die v. Industrial Accident Board, 101 Mont. 256, 53 P.2d 1145. Further- more, every presumption is in favor of the correctness of the district court's decision when additional evidence has been presented. Murphy v. Industrial Accident Board, 93 Mont. 1, 16 P.2d 705; O'Neil, supra; Mulholland, supra. With these principles in mind, we review the additional evidence presented. Doctor Movius t e s t i f i e d a s t o t h e l a c k of s i g n i f i c a n c e a t t r i b u t a b l e t o t h e f a c t t h a t c l a i m a n t had no enzyme change i n s o f a r a s h i s d i a g n o s i s was c o n c e r n e d . He a l s o t e s t i f i e d c l a i m a n t was n o t s u f f e r i n g from c h r o n i c l u n g d i s e a s e , a f a c t o r r e l i e d upon by Doctor Goulding. A t t h e t i m e t h i s m a t t e r came before t h e d i s t r i c t c o u r t , counsel f o r a p p e l l a n t s i n d i c a t e d t o the court: * * * But I would l i k e t o i n d i c a t e "MR. TOOLE: a t t h i s t i m e t h a t I may have a r e b u t t a l w i t n e s s who i s n o t h e r e and t h a t would be D r . Goulding who p a r t i c i p a t e d i n t h i s p r o c e e d i n g e a r l i e r a s a c o n s u l t a n t t o t h e I n d u s t r i a l A c c i d e n t Board, and I t o l d M r . Whalen t h a t I would t r y t o have him h e r e t h i s morning and t o be h o n e s t a b o u t i t I f o r g o t t o c a l l D r . Goulding and I am n o t r e a l l y s u r e t h a t I am g o i n g t o need him i n any c a s e , s o p e r h a p s i t ' s j u s t a s w e l l n o t t o have him s i t t i n g h e r e . Now w i t h t h a t r e s e r v a t i o n and w i t h t h e r e a l i z a t i o n t h a t I may make a r e q u e s t l a t e r , i f n e c e s s a r y , t o g e t some e v i d e n c e from D r . Gouldi n g , we a r e r e a d y . "THE COURT: Thank you. M r . Whalen? "MR. WHALEN: For t h e r e c o r d , Your Honor, and w h i l e I have i t i n mind i t i s n o t m purpose t o y l i m i t t h e e v i d e n c e b e f o r e t h e C o u r t , b u t when I t a l k e d t o M r . Toole on May 11, 1973 I t o l d him a t t h a t t i m e I i n t e n d e d t o c a l l D r . Movius f o r a d d i t i o n a l t e s t i m o n y and i f o t h e r m e d i c a l w i t n e s s e s y were g o i n g t o be c a l l e d it was m d e s i r e t h a t i t be c o r r e l a t e d a t t h e t i m e of the h e a r i n g s o t h a t t h e o p p o r t u n i t y would e x i s t t o maybe p u t on a m e d i c a l w i t n e s s t h a t I had f o r r e b u t t a l i n t h e event t h a t it appeared necessary a f t e r t h e testimony of D r . Goulding. I n t h e e v e n t t h a t M r . Toole t h r o u g h h i s c l i e n t i s w i l l i n g t o pay f o r any a d d i t i o n a l c h a r g e s t h a t may be made t o make D r . Movius a v a i l a b l e a t t h e t i m e t h e t e s t i m o n y may be t a k e n from D r . Goulding, i f i t i s g o i n g t o be t a k e n a t some e a r l y d a t e I would n o t r e s i s t i t ; on t h e o t h e r hand i f Claimant i s g o i n g t o be e x p e c t e d t o pay f o r making a d d i t i o n a l m e d i c a l w i t n e s s a v a i l a b l e a t t h a t t i m e I would r e s i s t t h e r e q u e s t t h a t i s anticipated i n M r . Toole's statement. "MR. TOOLE: I w i l l commit now t h a t i f we do t h i s and i f M r . Whalen wants D r . Movius p r e s e n t a t t h a t time, o r t o t a k e D r . Moviusls t i m e f o r s u b s e q u e n t d e p o s i t i o n , we w i l l u n d e r t a k e t o pay t h e c o s t of t h a t . "THE COURT: "MR. TOOLE: Very w e l l . Not o n l y h i s t i m e b u t t h e c o s t of the deposition as well. "MR. WHALEN: With that, Your Hono,, and the understanding that there will not be prolonged delay, I have no objection to it.'' At the end of the hearing, counsel for appellants informed the court he did not want to call Dr. Goulding and no further effort was made for another hearing. Dr. Movius also developed the significance of the lack of oxygen experienced by claimant as an influence upon the development of myocardial ischemia and stated that this factor can cause coronary damage whether there was a preexisting coronary disease or not. The testimony also pointed out the importance of physical and emotional stress in connection with the development of myocardial ischemia. We find such testimony to be both substantial and convincing. We realize that in dealing with elusive diseases and in the effect of a traumatic injury in aggravating a preexisting disease, learned medical authorities often differ. It is our duty, however, to construe the Workmen's Compensation Act liberally so that the humane purposes of the Act can be carried out. tion 92-838, R.C.M. 1947. Sec- When there is a doubt, the doubt should be resolved in favor of the injured workman. Gaffney v. Industrial Accident Board, 129 Mont. 394, 287 P.2d 256. Appellants throughout argument stressed that this Court should return the matter to the Division, citing Johnson v. Industrial Accident Board, 157 14ont. 221, 483 P.2d 918. In Johnson this Court returned the matter to the Division when it determined that medical evidence was admitted for the first time at the district court hearing. Such is not the fact situation here for Dr. Goulding's findings were considered by the Division's hearing examiner. He, not the district judge, brought the material into evidence, and the problems arose at the court hearing because Dr. Goulding was not available for cross-examination. Three recent cases are of import to our consideration here. McAndrews v. Schwartz, Mont. , 523 P.2d 1379, 31 St.Rep. 517; Bagley v. Florence Hotel Co., Mont. , 526 P.2d 1372, 31 St.Rep. 766; Rasmussen v. Gibson Products Co., Mont. , 527 P.2d 563, 565, 567, 31 St.Rep. 860. In McAndrews, after being denied compensation by the Board, claimant appealed to the district court which, upon hearing testimony of the claimant and Cr. Sims, who had not testified at the Board hearing, reversed the Board. Factwise the medical testimony involved was not sufficient to move this Court to hold that it was substantial. The district court's judgment was set aside and the order of the Division affirmed. In Bagley, a latent injury case, the Division found that the employer was estopped to deny a claim after over a year had run. The district court overruled the Division and this Court upheld its ruling, noting that the trial court had properly found the evidence before the Division did not support the finding of equitable estoppel. In Rasmussen, this Court upheld the district court's reversal of a denial of the claimant's petition. Speaking for this Court Chief Justice James T. Harrison noted: " * * * Respondent's testimony was more orderly than that heard by the Division, but in substance contained nothing new except for the fact she had undergone surgery for a herniated disc after the Division proceedings closed." The Court further noted that such testimony as a whole was beyond the scope of "additional evidence" as the term is used by the statute but that the testimony of other witnesses, including her previous employers and the doctor who did the surgery, was admissible. The Court said: "Obviously this testimony lends independent support t o D r . Humberger's o p i n i o n t h a t a c a u s a l r e l a t i o n s h i p e x i s t e d between r e s p o n d e n t ' s back t r o u b l e i n 1972 and h e r i n j u r y a t Gibsons i n 1969. I n s h o r t , t h e t e s t i m o n y t o o k on a d d i t i o n a l r e l e v a n c e i n l i g h t of what D r . Humberger had t o s a y a t t h e d i s t r i c t c o u r t h e a r i n g . Respondent c o u l d n o t r e a s o n a b l y have f o r e s e e n t h i s a t t h e t i m e t h e D i v i s i o n conducted i t s p r o c e e d i n g s ; a c c o r d i n g l y , a p p e l l a n t s ' o b j e c t i o n on t h i s p o i n t i s n o t w e l l t a k e n . "We t h i n k t h e d i s t r i c t c o u r t c o u l d f i n d a p r e ponderance of c r e d i b l e e v i d e n c e t o s u s t a i n responde n t ' s c l a i m , b o t h from t h e a d d i t i o n a l e v i d e n c e p r e s e n t e d a t t h e d i s t r i c t c o u r t h e a r i n g and t h e r e c o r d of t h e D i v i s i o n . " T h a t same argument c a n be made i n t h e i n s t a n t c a s e f o r t h e f i n d i n g s of t h e d i s t r i c t c o u r t . L i k e w i s e , w e have r e c o g n i z e d t h e d o c t r i n e t h a t a n employee s u f f e r i n g from a p r e e x i s t i n g c o n d i t i o n i s n o t d e n i e d compensation i f t h e d i s a b i l i t y w a s a g g r a v a t e d o r a c c e l e r a t e d by i n d u s t r i a l injury. I n B i r n i e v. U.S. Gypsum Co., 134 Mont. 39, 328 P.2d 1 3 3 , we a f f i r m e d an award where trauma had a c c e l e r a t e d a p r e e x i s t ing a r t h r i t i c condition. I n Young, w e a f f i r m e d a n award where s h o c k , a n x i e t y and e x c e s s i v e e x e r t i o n under t r y i n g c i r c u m s t a n c e s aggravated an a r t e r i o s c l e r o t i c condition. Weakley v . Cook, 126 Mont. 332, 249 P.2d Furthermore, i n 926, w e a f f i r m e d a n award where a workman s u f f e r i n g from a r t e r i o s c l e r o s i s had s u s t a i n e d a f a l l and had d i e d from c o r o n a r y t h r o m b o s i s . W b e l i e v e t h e same e principle applies t o t h e i n s t a n t case. The judgment o f t h e d i s t r i c t c o u r t i s a f f i r m e d . Justice We c o n c u r : i - I . ----Justices - 1 1 - Mr. Justice Wesley Castles dissenting: I dissent. I would reverse the judgment and order the matter returned to the Workmen's Compensation Division for findings on the medical testimony. Dr. Goulding, the independent medical expert relied on by the Division, testified the arteriosclerosis could not have been aggravated by the injury and resultant stress. Dr. P4ovius, at the hearing before the district court, did not, in my view, testify to any materially different or new matters. He merely disputed the other two doctors. Dr. Goulding was not the defendants', appellants here, witness. He was the Division's witness. If the district court considered that Dr. Goulding's report was improperly received and therefore prejudicial, it should have remanded the matter to the Division so that claimant might have the opportunity of cross-examining Dr. Goulding. That is what I would now order. The majority opinion finds, on the first issue, that the Division erred in basing its decision upon an independent medical report made by a physician appointed by the Division and accompanied by denial of the right to cross-examine and rebut. Absent the Dr. Goulding medical opinion, the district court simply chose the opinion of Dr. Movius as against the conflicting opinion of Dr. Roussalis. Whereas, the Division had chosen the opinion of Dr. Roussalis as bolstered by the independent opinion of Dr. Goulding. Remand to the Division is the proper remedy because this Court or the district court is otherwise placed in the position of having to pick and choose wnich of the conflicting opinions should be accepted. This is a task properly for the trier of fact and should not be determined on appeal. Remand is a well recognized technique for this situation. See Johnson v. Industrial Accident Board, 157 Mont. 221, 225, 483 P.2d 918, where this Court unanimously said: "Finally the scope of a district court's power to reverse an order of the Industrial Accident Board was described in Moffett v. Bozeman Canning Co., 95 Mont. 347, 351, 26 P.2d 973, as: "'The district court on appeal from the board is not justified in reversing a finding of the board unless the evidence clearly preponderates against such finding.' In fact, a ruling by the Industrial Accident Board is presumed to be correct, and in the instant case the only evidence heard by the district court that had not been heard by the Board in the 1965 hearing was the testimony of Dr. Itoh, previously referred to. Therefore, the evidence before the district court clearly did not preponderate against the Board's order of 1966, hence the ruling of the Board should have been affirmed in the district court. "The cause is reversed and remanded to the district court with directions to return the matter to the Industrial Accident Board for its further consideration with regard to the specific injury statute application." See also: Dean v. First Trust Company, 152 Mont. 469, 452 P.2d To the same effect are the three cases cited in the majority opinion, McAndrews, Bagley, and Rasmussen. The majority opinion walks away from the effects of this line of cases by finding that Dr. Movius's subsequent testimony was "substantial and convincing". Thus, this Court has now become the finder of fact in gauging the quality of medical opinion. 4 Justice

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