Employer A.C. Lawrence Leather Co., joined by its insurer Liberty Mutual Insurance Co., appeals from the decision of the Appellate Division of the Workers’ Compensation Commission affirming the hearing commissioner’s grant of employee Jeffrey Brackett’s petition for restoration of 100% benefits. The employer argues that the Appellate Division erred in not apportioning the employee’s present total incapacity between a 1978 work-related back injury and two 1985 non-work-related back injuries. The employer contends that it should not be responsible for the employee’s entire incapacity because the hearing commissioner found that although the 1978 injury causally contributed to the employee’s incapacity, the 1985 back injuries that had no relation to his work were “probably the major contributing factors.”
Richardson v. Robbins Lumber, Inc., 379 A.2d 380 (Me.1977), controls this case. In Richardson the employee injured his back in two separate work-related incidents. Several months after the second work-related injury, the employee injured his back in a non-work-related motor vehicle accident, and as the result of the three injuries became totally disabled. Id. at 381-82. The employee filed two petitions for award of compensation based on the two work-related injuries. The hearing commissioner dismissed both petitions. On his appeal to this court the employee in Richardson argued that the commissioner erred in requiring him to prove that his disability was caused solely by the work-related incidents. Id. at 382. The employer responded that the automobile accident was an independent intervening cause that severed the causal chain between the prior work-related injuries and the current incapacity. Id. at 383. We agreed with the employee and held that “the proper approach to the causation question requires that the commissioner first determine whether a work-related injury occurred. If that inquiry is answered in the affirmative, the critical question then becomes whether the work-related injury remained a substantial factor in causing the ultimate disability.” Id. (citation omitted) (emphasis added); see also Smith v. Dexter Oil Co., 408 A.2d 1014, 1015-16 n. 2 (Me.1979) (Richardson held that “despite the occurrence of a subsequent non-work-related illness or injury, the continuing incapacity is nonetheless compensable if it results from a combination of the original work-related injury and the independent, intervening cause.” (Emphasis in original)). In Richardson, 379 A.2d at 383, we also stated that a work-related injury remained a “substantial factor” if the injury remained “a cause” of the ultimate condition. In the later decision of Smith v. Dexter Oil Co., we not only defined the term “substantial” as real or actual rather than important or predominant, we also expressed our disapproval of the use of that term because it has “imported unnecessary confusion into the analysis of causation issues in compensation cases.” 408 A.2d at 1015-16 & n. 2.
*778In the case at bar Brackett on January 3, 1978, sustained a work-related back injury for which he received total disability, pursuant to two approved agreements, for four days following the injury and for the period from September 8, 1978, to January 15, 1979. Brackett returned to work full time, although he had intermittent back pain, until he injured his back again in a non-work-related motor vehicle incident on July 22, 1985, followed by a sneezing incident the next day. Brackett had back surgery and has since been totally incapacitated.
As in Richardson, the hearing commissioner here found that the 1978 work-related back injury causally contributed to the employee’s present .medical condition and incapacity. The commissioner’s further finding that the car and sneezing incidents were probably the major contributing factors is not significant. The work-related back injury remained a cause in Brack-ett’s total incapacity, and the total incapacity is thus fully compensable under Richardson.
The entry is:
The decision of the Appellate Division of the Workers’ Compensation Commission is affirmed.
It is ordered that the employer pay to the employee $750 for counsel fees plus reasonable out-of-pocket expenses for this appeal.
ROBERTS, WATHEN, CLIFFORD and COLLINS, JJ., concurring.