Certiorari on the relation of Jostens, Inc., and its compensation insurer to review a decision of the Worker's Compensation Court of Appeals awarding compensation to Mary Boldt for permanent partial disability which the compensation court found had been caused by an occupational disease. Our review of the record requires us to reject relator's claim that the medical evidence adduced by employee is insufficient to support the finding of causal relation between her work and her disability.
Employee began work at Jostens in 1964 in the ribbon department, where she applied heated glue to diplomas. The glue was made from animal products and had an odor described as rotten and wet, and like dirty socks. In subsequent years employee
Dr. Richard Woellner, a specialist in pulmonary diseases who testified on behalf of relators, agreed with the diagnosis. Both physicians said that the etiology of Goodpasture's Syndrome is unknown. Dr. Dines said that it is an immunologic disease in which it is thought that the victim develops antibodies to some antigen (a substance to which he is hypersensitive) and that these antibodies react against the kidneys and lungs. He also said that the antigen to which a victim reacts "can probably be many different things and different for different people" and that it is not known whether the reaction results from one exposure to an antigen or from multiple exposures. Dr. Woellner said that it is not even known whether Goodpasture's Syndrome is produced by an antigen, and that he had no opinion as to the cause of employee's contracting the disease. Dr. Dines, however, expressed the opinion that employee's exposure to glue fumes "had a great deal to do with her illness, and certainly caused aggravation." Based on this opinion the compensation court found that this exposure had produced employee's disease.
Citing Hiber v. City of St. Paul, 219 Minn. 87, 16 N.W.2d 878 (1944), and Zappa v. Charles Mfg. Co., 260 Minn. 217, 109 N.W.2d 420 (1961), relators contend that Dr. Dines' opinion lacks an adequate factual foundation and therefore cannot serve as a basis for the finding of causal relation between employee's work and her illness. Although they stress the fact that the cause of Goodpasture's Syndrome is unknown, disability resulting from other diseases of unknown cause has often been held compensable. E. g., primary biliary cirrhosis (Pommeranz v. State, Dept. of Public Welfare, Minn., 261 N.W.2d 90, filed herewith); dermatomyositis (Reierson v. Land O'Lakes Creameries, 287 Minn. 179, 177 N.W.2d 301 ); cancer (Pittman v. Pillsbury Flour Mills, 234 Minn. 517, 48 N.W.2d 735 ). In this case, Dr. Dines' opinion was based on the recognized theory that Goodpasture's Syndrome is an immunologic disease, on his experience with this disease (from which he concluded that "offending irritants and fumes can play a great part" in many cases), and on the fact that employee had been in good health prior to contracting her illness. In the present state of knowledge about Goodpasture's Syndrome, a more complete foundation for the doctor's opinion could not have been furnished and, as in Pommeranz v. State, Dept. of Public Welfare, supra, which also involved an immunologic disease of unknown etiology, we hold the foundation was sufficient.
Relators also urge that Dr. Dines' opinion did not express reasonable medical certainty and was no more than a hypothesis about the cause of employee's illness. Read in isolation, some of the doctor's statements
Cf. Insurance Co. of North America v. Myers, 411 S.W.2d 710, 713 (1966), an action for death benefits under the Texas Workmen's Compensation Act, in which the Texas Supreme Court said:
See, also, Hiber v. City of St. Paul, supra.
Making allowance for the characteristic caution of medical experts and viewing Dr. Dines' testimony as a whole, we have concluded that it shows the doctor's basic opinion to be that employee's illness had been caused and aggravated by her exposure to the glue fumes. The evidentiary bases for this opinion, discussed above, permit the inference that it is probably true. It is well established that the truth of the opinion need not be capable of demonstration, that an expert is not required to express absolute certainty in the matter which is its subject, and it is sufficient if it is probably true. Sullivan v. Hagstrom Const. Co., 244 Minn. 271, 69 N.W.2d 805 (1955). We conclude that the finding of causal relation has sufficient evidentiary support.
Relators' final contention — that employee did not give notice as required by Minn.St. 176.141—has no merit since relators concede that Jostens had actual knowledge in May 1972 that employee was quitting work because of her lung condition. Knowledge of the disease, as distinguished from knowledge of causal relationship between the disease and the employment, is sufficient. Fitch v. Farmers Union Grain Terminal Assn., 274 Minn. 234, 143 N.W.2d 192 (1966).
Employee is allowed $350 attorneys fees.
OTIS, J., took no part in the consideration or decision of this case.