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Edmiston v. City of Hobbs and Liberty Mutual Insurance Co.6/17/1997
accident aggravates the preexisting condition by changing the course of the ailment or its treatment, the disability caused by the aggravated condition is fully compensable, without any apportionment based on the natural course of the condition. See . After all, in that situation the worsening is caused, at least in part, by the accident. On the other hand, if such aggravation of the condition is merely transient, there is no basis for considering it in determining permanent disability benefits. See Arellano v. Industrial Comm'n, 25 Ariz. App. 598, 545 P.2d 446, 452 (Ariz. Ct. App. 1976); Hash v. Montana Silversmith, 256 Mont. 252, 846 P.2d 981, 983-84 (Mont. 1993).
{39} How does this law relate to the present case? First, following Reynolds, even though Worker's myeloma apparently made her more susceptible to back injury , she is entitled to benefits for disability arising out of the injury to her spine from the work-related accident regardless of whether the myeloma made the injury more severe than it would otherwise have been or caused the injury to heal more slowly or less completely than it otherwise would have. (Such benefits also do not depend on whether the accident aggravated the myeloma.) There was no reason for the WCJ to consider what the course of the spinal injury would have been in the absence of Worker's myeloma at the time of the accident.
{40} Second, following both Reynolds and Leo, in determining Worker's entitlement to permanent-disability benefits the WCJ should consider the combination of Worker's work-related back injury and her myeloma as it existed at the time of the accident.
{41} Thus, I share much common ground with the majority. Where I part company is with respect to the limitations on recovery for the myeloma. The uncontradicted record establishes, and the WCJ found, that after Worker reached maximum medical improvement the state of her myeloma was the same as it would have been if she had not suffered her work-related back injury . Therefore, any increase in Worker's disability arising from the worsening of the myeloma after she suffered her back injury should not be considered in determining her permanent disability benefits.
{42} On this issue the present case is indistinguishable in any material respect from Holliday. There, the worker suffered from emphysema at the time of the work-related accident. The emphysema progressed until it rendered the worker incapable of working. We held that the worker was not entitled to benefits resulting from the disabling effects of the emphysema. I see no reason to distinguish Holliday on the ground that the emphysema in that case did not affect the worker's hand injury , whereas here the Worker's myeloma caused her back injury to be more severe than it otherwise would have been. The relevant question is whether the progression or treatment of Worker's myeloma was a natural and direct result of the work-related accident. If it was not, our statute does not permit recovery for the increased disability. See ยง 52-1-28(B).
{43} Reynolds is not to the contrary. The worker's total permanent disability in that case resulted from the combination of his back injury and his osteoporosis. Nothing in that opinion, however, suggests that worker would be entitled to compensation benefits for post-injury worsening of his osteoporosis. The causal relationship between a preexisting condition and a work-related accident can proceed in either of two directions: (1) the work-related accident may aggravate the preexisting condition or (2) the preexisting condition may cause the work-related injury to be more severe than it otherwise would have been. In the first situation the resulting condition itself is cause
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