dissenting:
I respectfully dissent from the principal opinion and suggest that it represents a usurpation of the legislative prerogative and purports to overrule many holdings of our supreme court while at the same time paying lip service to them.
A closer analysis of some of those opinions, as well as other holdings of the supreme court, is instructive.
The leading case in this State on the subject of repeated trauma is International Harvester, cited in the principal opinion. In that case the court considered whether repeated exposure to noxious fumes from a welding operation which gave rise to pulmonary emphysema was com-pensable under the Workers’ Compensation Act. The court held it was not compensable.
The court first rejected the claim under the Workmen’s Occupational Diseases Act (Ill. Rev. Stat. 1959, ch. 48, par. 172.36 et seq.), holding that emphysema was a general disease of life. With the 1975 amendments to that Act, especially the definitions of “occupational disease” and “disablement,” it is improbable that the court would reach such a result today.
The court exhaustively reviewed prior authority and came to the conclusion that no award could be made under the Workers’ Compensation Act because no accidental injury had occurred. The court defined such an injury, saying:
“[A]n injury is accidental within the meaning of the Act when it is traceable to a definite time, place and cause and occurs in the course of employment unexpectedly and without affirmative act or design of the employee.” International Harvester Co. v. Industrial Com. (1973), 56 Ill. 2d 84, 89, 305 N.E.2d 529.
In cases decided since International Harvester, the supreme court has held strictly to the definite-time-place-and-cause requirement.
In Lawless v. Industrial Com. (1983), 96 Ill. 2d 260, 449 N.E.2d 850, the claimant had previously been diagnosed as having a hernia but kept working until he had a specific episode of pain while on the job. There was medical testimony that the hernia developed gradually and not as a result of any one recent injury such as occurred on the day of the pain. The supreme court affirmed the decision of the Industrial Commission denying benefits, finding that the medical evidence indicated that the pain experienced by the claimant was not prompted or accelerated by any one specific accident but by accumulated stress over a period of time. The claimant did not sustain the burden of showing that his condition was in fact aggravated by his employment duties and that the aggravation was attributable to a specific time, place, and cause rather than the effect of prolonged stress on his body.
In Lyons, cited in the principal opinion, a bus driver with a preexisting back condition felt a “twinge” while loading freight but continued working for several days and did not report the accident immediately. The supreme court upheld the denial of benefits and the finding that no accident had occurred. There was no direct evidence of a lifting injury aside from plaintiff’s own assertions; there was evidence of a preexisting condition which may not have been work-related and which supported a finding that the condition developed gradually over time.
In Goldblatt Brothers, Inc. v. Industrial Com. (1981), 85 Ill. 2d 172, 421 N.E.2d 909, defendant sought recovery for injuries sustained when a sofa he was loading fell on his shoulder, knocking him to the floor. Some of the medical testimony indicated that the claimant had previously suffered from an arthritic condition which progressively deteriorated. The supreme court upheld an award under the Workers’ Compensation Act, stating that proof of existence of a preexisting condition will not necessarily bar an employee’s claim. It is enough if there is evidence supporting the inference that there was an accidental injury which aggravated a preexisting disease or condition, and the accident need not be the sole causative factor in bringing about the disability. The court stated further that a causal connection between a claimed injury and an accident may be established by a chain of events showing that prior to the accident the employee was fully capable of performing manual job tasks and that immediately after the accident such ability was diminished. See also Board of Education v. Industrial Com. (1983), 96 Ill. 2d 239, 449 N.E.2d 839.
In Caterpillar Tractor Co. v. Industrial Com. (1982), 92 Ill. 2d 30, 440 N.E.2d 861, the claimant had a preexisting rheumatoid arthritis condition and experienced a "stabbing pain” while lifting a 90-pound metal casting. The supreme court upheld the workers’ compensation award and reiterated the rule that a preexisting condition does not bar recovery so long as the condition is aggravated or accelerated by a claimant’s employment. The court noted a limitation to this rule, however, which denies recovery where a claimant’s health has deteriorated to the point that any normal daily activity is an overexertion, or where activity engaged in on the job presents risks no greater than those to which the general public is exposed.
Thus, in Greater Peoria Mass Transit District, cited in the principal opinion, the court set aside an award where plaintiff dislocated her shoulder while she was merely reaching for an object in the course of her employment. The court found that the testimony was sufficient to trace the injury to a definite time, place, and cause, but found that because of her preexisting condition, the risk of dislocation was personal to the claimant. The court stated that the injury was the result of normal activity rather than a risk incidental to employment and likened the condition of the claimant’s shoulder to a “time bomb” waiting to go off. See also Board of Trustees v. Industrial Com. (1969), 44 Ill. 2d 207, 254 N.E.2d 522.
In Lambert, cited in the principal opinion, the claimant had a long history of back problems and injured his back in a fall, which he reported to his supervisor, but did not request medical help and instead continued working for several months. The court upheld the decision denying benefits finding that the long-term effects of work-related stress on the claimant’s back were not compensable under the Act since he did not show that his bodily structure gave way at a specific place and time.
Finally, in Bunney, cited in the principal opinion, the claimant sought recovery under the Workers’ Compensation Act and the Worker’s Occupational Diseases Act on the theory that dust inhaled at the grain elevator where claimant worked aggravated his preexisting emphysema. The court reversed an award under the Worker’s Occupational Diseases Act, finding that the mere showing that the condition was aggravated by claimant’s employment was not sufficient to support an award prior to the 1975 amendment of the Act since emphysema was an “ordinary disease of life.” The court also upheld the denial of benefits under the Workers’ Compensation Act, finding that the case was virtually identical to International Harvester in that the claimant did not suffer a sudden disablement from the aggravation of his emphysema and his body structure did not suddenly give way; rather, claimant suffered from a gradually debilitative disease.
A review of these cases confirms that recovery under the Workers’ Compensation Act will be allowed where a claimant suffers a sudden disablement or breakdown in his physical structure or where he can identify a particular and isolated injurious event which aggravates or accelerates a preexisting condition. The preexisting condition itself need not be caused solely by factors in the employee’s work environment or by his work duties so long as the injurious event is a contributing cause of the physical breakdown. In contrast, where the manifestation of the injury or condition occurs gradually or is the result of prolonged stress or repeated exposure to work conditions, recovery will be denied. The supreme court has refused, most clearly in International Harvester, to apply the repeated-trauma theory to find that each exposure or impact is a separate accidental injury.
Three relatively recent supreme court decisions have dealt specifically with the carpal tunnel syndrome under circumstances much like the instant case. All of them relied upon the definite-time-place-and-cause requirement of International Harvester.
In General Electric, cited in the principal opinion, the claimant’s work required her to pick up three-pound coils, place them in a processing machine, and then remove them when they weighed about seven pounds. One day she experienced a sharp pain in her wrist and reported to the nursing station. The argument was advanced that no definite time, place, or cause had been fixed, but the court rejected it, holding that the employer’s own records established the accident date. This apparently was a reference to the records of the nursing station.
In Johnson v. Industrial Com. (1982), 89 Ill. 2d 438, 433 N.E.2d 649, the claimant worked for the same nursing home as in the case at bar, loading, transporting, and unloading a large food cart. She also claimed carpal tunnel syndrome injury. However, the court held that none of the medical evidence established a causal connection between the claimant’s work and her ailment.
In Caterpillar Tractor Co. v. Industrial Com. (1983), 98 Ill. 2d 400, 456 N.E.2d 1366, the claimant’s testimony was in conflict as to when he first noticed carpal tunnel syndrome symptoms; furthermore, at no time did he inform his treating physicians that he suffered an injury on the job and made no mention of injury when filing group insurance forms. The supreme court said that the case was almost a replay of Johnson and found again that there was no evidence, medical or otherwise, of a connection between claimant’s work duties and his ailment. The court noted that the accident date was stated in the application as January 14, 1977, but there was no indication in the record of any unusual occurrence on that date.
General Electric was distinguished on the basis that in the record there was a specific description of the employee’s movements which supported an inference of repeated trauma appeared, together with a specific date after which she could no longer perform her job.
All of this authority reiterates and reemphasizes the rule of International Harvester: to be compensable under the Workers’ Compensation Act, an injury must be accidental; to be accidental, an injury must be traceable to a definite time, place, and cause. The term “accidental injury” subsumes and encompasses a cause-and-effect analysis; the accident is viewed as the cause and the injury as the result. Therefore, most cases may be analyzed in terms of causation. This appeared to be the basis of decision in the three carpal tunnel syndrome cases described above. In General Electric the sudden sharp pain coupled with the medical evidence supported the Commission’s determination of accident; the opposite situation obtained in Johnson and Caterpillar-, there was insufficient evidence to support a finding of accident. Thus, the cause of the injury is much narrower in scope than that posited by the repeated-trauma theory. It is not impossible for repeated trauma to lead up to an accident, but the accident, itself, the cause of the injury, must be pinpointed by clear evidence; it is not sufficient that a bodily structure eroded to the point of uselessness; there must be a precise moment of collapse and dysfunction.
There are a number of practical reasons for the rule. An exact time, place, and cause may be necessary to determine which employer and which compensation insurance carrier are on the risk; whether any statutory amendments are applicable; and, as in the case at bar, whether any limitations problem exists.
In the instant case, there was insufficient evidence of accidental injury within the meaning of the rule discussed above. There was no evidence of anything unusual happening on October 4, 1976. Claimant testified that she worked a regular day on that date. She continued to work following her visit to Dr. McLean up to the time of her surgery in August 1977. Dr. McLean in his deposition described the surgery as elective, claimant’s condition not having deteriorated to the point at which it might be described otherwise.
Claimant’s difficulty in establishing an accidental injury is demonstrated by a variety of factors in the record: (1) choosing October 5, 1976, a date upon which she did not work, as the date of the accident; (2) the backdating to October 4, 1976, by the arbitrator sua sponte; (3) the fact that the visits to Dr. McLean were not precipitated by any dramatic change in her condition, but were referrals by claimant’s personal physician; (4) the claim that a report was made to the employer but no specific date was ever established as in General Electric; (5) the vagaries in claimant’s testimony; (6) Dr. Rivero’s report stating that claimant’s condition resulted from her employment in contrast to Dr. McLean’s deposition in which he stated that he did not know what caused claimant’s symptoms; (7) the fact that Dr. Rivero had examined claimant for conditions in her right hand, while the instant litigation was over the left hand.
We are well aware of the deference due to a decision of the Industrial Commission by reviewing courts. However, in this case there is not a scintilla of evidence to establish that an accidental injury within the meaning of the rule occurred to claimant on October 4, 1976. Hence, the decision of the Commission is against the manifest weight of the evidence and should be reversed.
We are also aware that the Workers’ Compensation Act and the Worker’s Occupational Diseases Act are complementary (International Harvester Co. v. Industrial Com. (1973), 56 Ill. 2d 84, 305 N.E.2d 529), but that a dichotomy exists between them in the matter of a disabling condition which develops gradually. Prior to 1975, “occupational disease” was defined as:
“[A] disease arising out of and in the course of the employment. Ordinary diseases of life to which the general public is exposed outside of the employment shall not be compensable.” (Ill. Rev. Stat. 1973, ch. 48, par. 172.36(d).)
“Disablement” was defined as:
“[T]he event of becoming disabled from earning full wages at the work in which the employee was engaged when last exposed to the hazards of the occupational disease by the employer from whom he claims compensation.” Ill. Rev. Stat. 1973, ch. 48, par. 172.36(e).
“Occupational disease” is now defined as:
“[A] disease arising out of and in the course of the employment or which has become aggravated and rendered disabling as a result of the exposure of the employment. Such aggravation shall arise out of a risk peculiar to or increased by the employment and not common to the general public.” (Ill. Rev. Stat. 1983, ch. 48, par. 172.36(d).)
Further, the term “disablement” as now defined means:
“[A]n impairment or partial impairment, temporary or permanent, in the function of the body or any of the members of the body, or the event of becoming disabled from earning full wages at the work in which the employee was engaged when last exposed to the hazards of the occupational disease by the employer from whom he or she claims compensation, or equal wages in other suitable employment.” Ill. Rev. Stat. 1983, ch. 48, par. 172.36(e).
It can thus be seen that the legislature, in an apparent reaction to International Harvester, wrote the analogue of the repeated-trauma theory into the Worker’s Occupational Diseases Act, but has not amended the Workers’ Compensation Act accordingly, despite the numerous decisions of our supreme court following the definite-time-place-and-cause requirement.
This being the fact, I can find no sanction for the judicial legislation contained in the principal opinion.
The authorities cited from Ohio and Maine are not persuasive. Clearly they were decided under local statutes, and in any event by the court of highest resort in those jurisdictions.
I would reverse the order of the circuit court of Peoria County.
LINDBERG, J., joins in this dissent.