CASE NO. 1501 CRB-1-92-9
COMPENSATION REVIEW BOARD
WORKERS’ COMPENSATION COMMISSION
FEBRUARY 14, 1994
UTC/PRATT & WHITNEY
LIBERTY MUTUAL INSURANCE CO.
SECOND INJURY FUND
The claimant was represented by Leon M. Rosenblatt, Esq., Rosenblatt & Mills, 10 North Main Street, West Hartford, CT 06107.
The respondents were represented by Robert M. Brennan, Esq., Law Offices of Rosenbaum & Brennan, 655 Winding Brook Drive, P.O. Box 695, Glastonbury, CT 06033.
The Second Injury was represented by Michael Belzer, Esq. and Brewster Blackall, Esq., Assistant Attorneys General, 55 Elm Street, P.O. Box 120, Hartford, CT 06101-0120 who did not file a brief.
This Petition for Review from the August 26, 1992 Finding and Award of the Commissioner for the First District was heard April 30, 1993 before a Compensation Review Board panel consisting of Commissioners Frank Verrilli, James Metro and Angelo L. dos Santos.
ANGELO L. dos SANTOS, COMMISSIONER. The respondents appeal from the First District Commissioner’s August 26, 1992 Finding and Award. On appeal, the respondents challenge the factual findings and legal conclusions of the trial commissioner in support of his award. Because we agree with the respondents that the commissioner’s critical findings and conclusions are not supported by evidence in the record, we vacate the award and order further proceedings consistent with this opinion.
On September 25, 1984, the claimant was employed as a firefighter by the respondents. His duties included fire fighting and prevention, drills and training, and servicing extinguishers. On September 25, 1984, the claimant was carrying a fire extinguisher up stairs when he developed chest pain diagnosed as angina. As a result of this incident, the claimant was totally disabled for a time and incurred bills for medical care. The claimant did not have a heart attack or infarction.
By Finding and Award dated January 18, 1989, the Commissioner At Large acting for the First District determined that the physical exertion required of the claimant in carrying a fire extinguisher up stairs superimposed on his pre-existing coronary artery disease caused the angina attack. The commissioner therefore concluded that the angina attack of September 25, 1984 arose out of and in the course of the claimant’s employment and ordered the respondents to pay all workers’ compensation benefits to which the claimant was entitled as a result of the September 25, 1984 angina attack.
In later formal proceedings, which are the subject of this appeal, the claimant sought an award of permanent partial disability. In support of his claim, the claimant produced a report of his treating cardiologist, Dr. Anthony LaSala, indicating that the claimant’s angina became unstable in December, 1990, necessitating bypass surgery. Dr. LaSala ascribed a 30% permanent partial impairment of the heart because of the claimant’s coronary artery disease. Dr. LaSala further opined that the 1984 compensable angina attack was related to and was the first clinical expression of the claimant’s coronary artery disease.
In accordance with the evidence, the trial commissioner found that the surgery and coronary artery disease were related to the compensable angina sustained in September, 1984. The trial commissioner further found that the claimant has sustained a 30% permanent partial impairment of the heart and ordered the respondents to pay 234 weeks of specific benefits. This appeal followed.
The respondents mount a multi-pronged attack on the commissioner’s Finding and Award. Common to each challenge to the trial commissioner’s decision is the contention that the award is not supported by the evidence, the facts found by the commissioner, or any reasonable or permissible inferences drawn from those facts. We agree.
It is not disputed that the claimant’s 1984 angina attack was caused by his employment. “Angina,” now used almost exclusively to denote “angina pectoris,” is spasmodic, choking or suffocative chest pain associated with coronary artery disease. See The Sloan-Dorland Annotated Medical-Legal Dictionary (1987), p. 35. It is not a disease but a symptom (pain) of the underlying heart disease brought about by inadequate blood flow to the heart due to reduced artery capacity. Id.
Dr. LaSala ascribed the claimant’s permanent partial impairment of the heart to his underlying coronary artery disease. While the claimant has established a causal relationship between his employment and the angina attack in 1984, there has been no finding that the underlying coronary artery disease itself, the basis for the award of specific benefits, arose out of and in the course of the claimant’s employment. Nor has there been a finding that the claimant’s permanent partial impairment was made materially and substantially greater by the compensable 1984 angina attack. A finding that the claimant’s coronary artery disease is related to the compensable angina attack is not sufficient. To sustain an award, the employment must be a proximate cause of the disablement. McDonough v. Connecticut Bank & Trust Co., 204 Conn. 104, 110-118 (1987); Madore v. New Departure Mfg. Co., 104 Conn. 709 (1926).
Similarly, no proof was offerred to causally link the claimant’s ongoing anginal condition to the 1984 work-related episode of chest pain. To the contrary, as an episodic and symptomatic condition, the claimant’s angina is necessarily an expression or symptom of the underlying coronary disease.
Accordingly, rather than simply proving that the surgery and coronary artery disease were medically related to the compensable incident of angina, it was incumbent upon the claimant to produce evidence and for the commissioner to find that the claimant’s coronary artery disease, which caused both his ongoing anginal condition necessitating surgery in 1990 and his 30% permanent partial impairment of the heart, was causally related to the employment, that is, that the disabling disease arose out of and in the course of the claimant’s employment or, at least, that the 1984 attack of angina played a causal role in necessitating the subsequent surgery and producing the permanent impairment. Absent such findings, the award cannot stand. Fair v. People’s Savings Bank, 207 Conn. 535, 538-42 (1988); McDonough v. Connecticut Bank & Trust Co., supra, 117-18, quoting Senzamici v. Waterbury Castings Co., 115 Conn. 446, 448-49 (1932).
In as much as the claimant and the commissioner both appear to have confused the compensability of an attack of pain with the compensability of the underlying disease, we will remand this case to the commissioner for further proceedings. In those proceedings, the claimant should be given the opportunity to offer additional evidence to fill the evidentiary gaps revealed by our review of the record. “Cases under the Work[ers’] Compensation Act are upon a different basis from actions between ordinary litigants. No case under this Act should be finally determined when [this tribunal] is of the opinion that, through inadvertence, or otherwise, the facts have not been sufficiently found to render a just judgment.” Cormican v. McMahon. 102 Conn. 234, 238 (1925); Charette v. Jensen Mobile Home, 10 Conn. Workers’ Comp. Rev. Op. 1, 936 CRD-6-89-11 (1991).
We, therefore, vacate the award and remand the case for further proceedings consistent with this opinion.
Commissioners Frank J. Verrilli and James J. Metro concur.