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Court of Appeal, Fourth District, Division 3, California.

Michael FREIL, Petitioner, v. WORKERS' COMPENSATION APPEALS BOARD and City of Fountain Valley, Respondents.

No. G009688.

Decided: January 31, 1991

Seth Kelsey, Huntington Beach, for petitioner. Secia & Davidson and Rick M. Secia, Orange, for respondents.


 Fountain Valley Police Officer Michael Freil endured a bizarre sequence of mishaps.   On duty and suffering from a head cold, he blew his nose in the restroom of the city garage.   He then became dizzy and nauseated.   Freil called for help, and his supervisor took him to the hospital.   There the officer was given an anti-nausea medication.   The agreed medical examiner determined the drug caused a stroke which permanently disabled Freil from police work.

Is the officer entitled to a service-connected disability retirement?   Yes.

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The city concedes that if the vertigo and nausea had caused Freil to fall while on duty and sustain an injury requiring treatment, the impairment from the fall (see Employers Etc. Ins. Co. v. Ind. Acc. Com. (1953) 41 Cal.2d 676, 678, 263 P.2d 4) and any additional malady suffered as a result of the medical treatment would have been compensable (see Ballard v. Workmen's Comp. App. Bd. (1971) 3 Cal.3d 832, 839, 92 Cal.Rptr. 1, 478 P.2d 937 [employee's addiction to drugs prescribed to alleviate pain from industrial back injury was a compensable injury even though “her personality problems also were contributing factors”] ).   If the resulting injury had also caused disability, the city admits the officer would have been entitled to a service-connected disability retirement.

But the city maintains the vertigo and nausea were simply natural symptoms of Freil's cold and in no way related to his employment.   Had Freil developed those symptoms after blowing his nose at home or while off duty, there is no question the resulting stroke would not be compensable.   Thus, argues the city, the vertigo and any injury resulting from its treatment (as opposed to treatment for a discrete injury precipitated by the vertigo) do not become compensable simply because Freil happened to blow his nose at work.

 But the law on the point is to the contrary:  “Where an employee is injured in the course of employment, it is irrelevant to the application of the conditions of compensation that the same injury might have occurred outside the course of that employment.”  (Bell v. Macy's California (1989) 212 Cal.App.3d 1442, 1451, 261 Cal.Rptr. 447.)   In Bell, a pregnant department store clerk developed severe pains while at work and went to the store's dispensary, which was open to both employees and the public.   The dispensary nurse dismissed as unnecessary the employee's request that a physician be called;  her diagnosis was gas pain.   An ambulance was not summoned for almost an hour.   By that time, the damage suffered as a result of the employee's ruptured uterus was irreversible;  and her baby was brain-damaged.

The Court of Appeal determined the injuries to the employee, her husband, and unborn child were all covered by the exclusive provisions of the workers compensation statutes.   The court first noted, “[t]he parties assume that Bell's ruptured uterus was unrelated to her employment save only that it occurred during working hours and on Macy's premises.”  (Id. at p. 1447, 261 Cal.Rptr. 447.)   The court then observed, “Once it is established that an injury arose out of and in the course of employment, ‘[a]ll that is required is that the employment be one of the contributing causes without which the injury would not have occurred.  [ ]’  ․ [¶] ․ Though the determination that a particular activity is sufficiently work-related to satisfy the conditions of coverage is a factual inquiry, ‘when the facts are undisputed and all point in the same direction, resolution of the question becomes a matter of law.  [ ]’  [Citation.]   Based on the undisputed facts, we find that the trial court's implicit determination that Bell's visit to the company clinic arose out of and in the course of her employment was correct.”  (Id. at pp. 1448–1449.)   Applying the rationale of Bell, we find the express finding of the Workers Compensation Appeals Board that Freil's injury did not arise out of and in the course of his employment to be incorrect as a matter of law.

We begin by reciting the basic tenet that “[t]his two-pronged requirement is the cornerstone of the workers' compensation system.  [Citation.]   In applying it, this court must be guided by the equally fundamental principle that the requirement is to be liberally construed in favor of awarding benefits.”  (Maher v. Workers' Comp. Appeals Bd. (1983) 33 Cal.3d 729, 732–733, 190 Cal.Rptr. 904, 661 P.2d 1058, emphasis in original.)   An injury precipitated by an employee's “normal bodily movements ․ [is deemed to arise out of and in the course of employment] unless there is a positive showing that the cause of disability is an inherent defect of the employee.”  (2 Hanna, California Law of Employee Injuries and Workmen's Compensation (2d ed. 1990, rel. 175/83583) § 10.08[4].)  For example, employees with congenital back problems who injure their backs while using the restroom at work have not been entitled to compensation.  (Southern Bell Tel. and Tel. Co. v. McCook (Fla.1977) 355 So.2d 1166;  Sacks v. Industrial Comm'n. (1970) 13 Ariz.App. 83, 474 P.2d 442.)   But employees whose knees appeared to spontaneously give way or whose backs “snapped” upon rising from a stooped position were awarded compensation benefits on the theory the injuries arose out of and during the course of their work.  (See, e.g., Bethlehem Steel Co. v. Industrial Acc. Com. (1944) 9 Cal.Comp.Cases 41;  Maryland Casualty Co. v. Industrial Acc. Com. (1940) 5 Cal.Comp.Cases 108.)

There was no evidence that Freil had ever previously suffered debilitating side effects from blowing his nose.   On the date of his injury, he was on duty and expected to carry out the full responsibilities of a patrol officer.   Although he had a cold, the symptoms apparently did not prevent him from working.   The symptoms did require him to blow his nose, however, in order to ease congestion.   This was of benefit to the employer because Freil had to be able to contact the public and communicate via the radio.   So long as the vigorous noseblowing bore a relationship to his ability to carry out his duties, the chain of events that led to his stroke and disability must be viewed as arising within the penumbra of legitimate activity in the workplace.

There is an additional factor to consider in determining whether Freil's injuries are compensable under the workers compensation system:  The employer's decision to seek medical treatment for an ailing worker.   After the onset of his vertigo, no one appeared to take the time to determine whether the medical problem was work-related:  Freil's supervisor simply took charge and transported him to the hospital where the debilitating injection was administered.   The Supreme Court has recognized “that injury from medical treatment is compensable where the treatment is required at least partially for the employer's benefit or where it is required as a condition of employment.   This is true whether the medical treatment aggravates a preexisting industrial injury or a preexisting nonindustrial condition [citation], or whether the treatment is ‘furnished by the employer, his insurance carrier, or was selected by the employee.’  [Citation.]”  (Maher v. Workers' Comp. Appeals Bd., supra, 33 Cal.3d at pp. 737–738, 190 Cal.Rptr. 904, 661 P.2d 1058.)   In this case the treatment may not have been required, but it was provided.   That is enough.  (See also Bell v. Macy's California, supra, 212 Cal.App.3d at p. 1451, 261 Cal.Rptr. 447.)

 As already noted, where the facts are not in dispute, the question of an employee's entitlement to benefits becomes one of law.   (Eckis v. Sea World Corp. (1976) 64 Cal.App.3d 1, 7, 134 Cal.Rptr. 183;  see also Laeng v. Workmen's Comp. Appeals Bd. (1972) 6 Cal.3d 771, 774, 100 Cal.Rptr. 377, 494 P.2d 1.)   Here, the only evidence before the workers compensation judge and the Workers Compensation Appeals Board was that Freil blew his nose so vigorously while at work that another medical condition requiring treatment ensued.   He became disoriented and nauseated and was taken to the hospital by his employer.   The chain of causation is clear and undisputed.   Freil's reaction to the drug was extreme and, perhaps, rare;  but it occurred.   He is entitled to a service-connected disability retirement.

The decision of the Workers Compensation Appeals Board is annulled, and the cause is remanded for further proceedings consistent with this opinion.

CROSBY, Associate Justice.

SONENSHINE, Acting P.J., and MOORE, J., concur.