Floyd Wilcut v. Innovative Warehousing

The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by $\S 287.480$ RSMo. We have reviewed the evidence, read the briefs of the parties, heard oral argument, and considered the whole record. Pursuant to § 286.090 RSMo, the Commission reverses the award and decision of the administrative law judge dated May 16, 2005. The award and decision of Chief Administrative Law Judge Jack H. Knowlan, Jr., is attached hereto. The findings therein are incorporated to the extent they are not inconsistent with the findings, conclusions, award, and decision herein.

Employee was a Jehovah's Witness. A tenet of his religion is that it is a sin to accept blood products, including blood transfusions. On April 13, 2000, employee sustained a motor vehicle accident arising out of and in the course of his employment. Employee suffered severe injuries requiring surgery. Employee, and his family on his behalf, refused to accept blood transfusions during and after the surgery although employee's treating physicians recommended transfusions to save employee's life. Employee died April 20, 2000. Employee's dependent widow seeks an award of death benefits.

The award of the administrative law judge contains a detailed list of undisputed facts and an accurate summary of the evidence presented. Those portions of the administrative law judge's award are incorporated herein and we will not repeat them beyond the summary we provided in the preceding section.

The evidence overwhelmingly supports a finding that employee would have survived his work injuries if he had accepted a blood transfusion to reverse his anemia. Employer has presented uncontroverted evidence that employee, and then his family on his behalf, consistently refused blood transfusions with full knowledge that employee would live if he accepted them and employee would die if he refused them.

Employer argues that employee's refusal to accept the life-saving transfusions was unreasonable and, therefore, the Commission must deny compensation pursuant to § 287.140.5 RSMo. Section 287.140.5. reads as follows:

No compensation shall be payable for the death or disability of an employee, if and insofar as the death or disability may be caused, continued or aggravated by any unreasonable refusal to submit to any medical or surgical treatment or operation, the risk of which is, in the opinion of the division or the commission, inconsiderable in view of the seriousness of the injury. If the employee dies as a result of an operation made necessary by the injury, the death shall be deemed to be caused by the injury.

Thus, the first issue before us is: was employee's refusal to accept blood transfusions "unreasonable" such that

employer is relieved of liability for the consequences of the refusal?

The administrative law judge phrased the issue: whether, given his beliefs as a Jehovah's Witness, the employee's decision was unreasonable. Therefore, the administrative law judge determined that employee's refusal to accept blood transfusions was reasonable because a reasonable Jehovah's Witness in employee's situation would have refused blood transfusions.

We acknowledge the administrative law judge's thoughtful consideration of this matter, but we respectfully decline to follow his reasoning. We are persuaded by the reasoning of the California court in Martin v. Industrial Accident Commission, 304 P.2d 828, (Cal. App. 1956):

No question is presented as to the reasonableness of [employee's] belief or of his religion, but the question presented to the commission and found upon by them was whether, in the light of all of the evidence including his religious beliefs, it was unreasonable for him to refuse to accept a treatment necessary to save his life.

Martin, 304 P.2d at 830.

In short, the Martin court recognized that a refusal based upon a reasonable religious belief is not per se a reasonable refusal. Rather, all of the evidence surrounding the refusal must be considered, including the religious belief.

The Martin court noted that the California statute, like § 287.140.5, "imposes a condition to the employer's liability that the death of an employee must arise out of his employment and that it should not exist where death is the result of the voluntary act of the employee in refusing medical attention." Id. The rationale of Martin is that a reasonable refusal does not break the causal link and a resulting death arises out of and in the course of employment. On the other hand, an unreasonable refusal breaks the causal link and a resulting death does not arise out of employment, but rather arises out of employee's voluntary act of refusing.

Applying the rationale of Martin, we consider the reasonableness of employee's refusal to accept blood transfusions in light of all of the evidence, including employee's religious beliefs. We find the following evidence relevant to this determination:

- The physical risk of the transfusion was minimal compared to the benefit, i.e., an almost certainty that employee would have survived his injuries.

- Employee was 53 years of age at the time of his death.

- The spiritual risk of the transfusion from the perspective of a Jehovah's Witness was the commission of a capital sin, which would hinder prayer and could prevent enjoyment of everlasting life.

- Jehovah's Witnesses believe that Jehovah forgives, so if employee had lived, employee may have been able to atone for the sin of accepting the blood transfusion.

Based upon the foregoing, we conclude that employee's refusal to accept the life-saving blood transfusions was unreasonable and, thus, broke the medical causal link between the work-related accident and his death. Accordingly, we conclude that employee's death did not arise out of and in the course of his employment and employer is not liable for the payment of death benefits in this matter.

Dependent's brief makes reference to § 287.140.9 RSMo as a basis for the administrative law judge's decision. Dependent suggests that § 287.140.9 "trumps" the provisions of § 287.140.5. That subsection reads:

Nothing in this chapter shall prevent an employee being provided treatment for his injuries by prayer or spiritual means if the employer does not object to the treatment.

The administrative law judge did not mention this section in his decision but we address it to the extent that dependent raises another theory of compensability. We reject dependent's argument. Under the plain language of the statute, § 287.140.9 RSMo is not applicable under the facts of this case. Section 287.140.9 relates solely to prayer or spiritual means the goal of which is treatment of an employee's injuries. Employee's refusal to receive

the blood transfusions was not for the purpose of treating his injuries; it was for the purpose of complying with a religious edict so he could remain free of sin.

Finally, contrary to dependent's assertions, this case is not about an individual's freedom to exercise his or her religion. This case is about who should bear the consequences resultant from the exercise of one's religion. Under the facts of this case, the employee's dependent must bear the consequences of employee's decision to strictly observe a tenet of his religion.

The award and decision of Chief Administrative Law Judge Jack H. Knowlan, Jr., issued May 16, 2005, is reversed. The award is attached hereto solely for reference.

Given at Jefferson City, State of Missouri, this $7^{\text {th }}$ day of June 2006.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

CONCURRING OPINION FILED

William F. Ringer, Chairman

Alice A. Bartlett, Member

DISSENTING OPINION FILED

John J. Hickey, Member

Attest:

Secretary

I submit this concurring opinion to disclose the fact that I was previously employed as a partner in the law firm of Evans and Dixon. While I was a partner the instant case was assigned to the law firm for defense purposes. I had no actual knowledge of this case as a partner with Evans and Dixon. However, recognizing that there may exist the appearance of impropriety because of my previous status with the law firm of Evans and Dixon, I had no involvement or participation in the decision in this case until a stalemate was reached between the other two members of the Commission. As a result, pursuant to the rule of necessity, I am compelled to participate in this case because there is no other mechanism in place to resolve the issues in the claim. Barker v. Secretary of State's Office, 752 S.W.2d 437 (Mo. App. 1988).

Having reviewed the evidence and considered the whole record, I join Commissioner Bartlett in reversing the award of the administrative law judge and denying benefits in this matter.

William F. Ringer, Chairman

review of the evidence as well as my consideration of the relevant provisions of the Missouri Workers' Compensation Law, I believe the decision of the administrative law judge should be affirmed.

Due to employee's work accident, employee and his family were presented with the following options; hold true to their faith in the confidence that God would take care of employee in what remained of this life and in the afterlife, or, violate a basic tenet of their faith in the hope of healing employee so he could live out the relatively short duration of his life on earth with the sincere belief that the violation may condemn employee to eternal damnation and forfeit eternal life.

"Voluntary" means, "proceeding from the will; produced in or by an act of one's own choice." WEBSTER'S THIRD NEW INTERNATIONAL DICTIONARY 2564 (3d ed. 1971) (emphasis added). For this family of faith, there was no real choice. Contrary to the suggestion of the majority of the Commission, remaining true to their faith was not a voluntary act.

The decision of the majority denies to employee's family the protection due them under the Missouri Workers' Compensation Law solely because they exercised their faith. The administrative law judge acted properly in interpreting the statute in such a manner that this family could freely exercise their faith yet retain the protection afforded them by the Workers' Compensation Law.

I respectfully dissent from the decision of the majority of the Commission to deny benefits in this case.

John J. Hickey, Member