Evidence-Burden of proof-Relation of cause and effect between injury and subsequent disability.

In order to support an award of compensation the relation of cause and effect between an alleged injury and subsequent disability must be shown by substantial evidence.

Appeal from Award of Referee Jacob Snyder, Dist. No. 6. Claim Petition No. 1804.

MACKEY, Chairman, March 22, 1917:

The Referee made an award of compensation in this case upon the testimony of the claimant to the effect that while he was in the course of his employment for the defendant on August 15, 1916, he felt severe pain in his abdomen while lifting a piece of slate. He continued to work for some time and did not consult a physician until the 11th day of the following month. He served no notice of the accident upon his employer and there were no eye witnesses to the occurrence, although two witnesses testified that he had told them at or about that time that he had hurt himself by lifting a slate. The physician who attended him testified that the trouble that he discvered was in the left spermatic cord. He found the left testicle retracted to the left abdominal ring. This organ was atrophied.

There is no evidence in this case to connect a tender spermatic cord on the symptoms described by the physician with a pain in the abdomen experienced several weeks before. In our judgment if there had been an injury to the left cord in August it would have manifested itself immediately by the development of symptoms, pains, tenderness, swelling and incapacity for work. In this case no obtrusive symptom appeared until nearly a month afterward. Because of this long quiescent period between the alleged injury and the appearance of any signs of trouble in the claimant's left spermatic cord, it is our opinion that there is no relationship of cause and effect between these two conditions.

The medical testimony did not attempt to establish the Referee's conclusion. The claimant testified to no injury to the testicle. The evidence discloses no experience of pain in the spermatic cord nor testicle.

We cannot base an award upon the testimony of the claimant that in lifting he experienced a pain in his abdomen when nearly a month afterward a physician found a swollen spermatic cord. The relationship of cause and effect must be established by evidence, not by inference.

The award of the Referee is accordingly set aside.

JOSEPH POPOBIES vs. CONSOLIDATED EXPANDED METAL COMPANY.

Permanent injury-Loss of three fingers-Loss of the use of a hand.

An employe accustomed only to manual labor suffered an injury to his hand which resulted in the amputation of his index finger at the second joint, the middle finger back of the second joint, and the third finger at the second joint, leaving the thumb and little finger intact. After the amputations he had but little power to grasp articles with the injured hand.

HELD: The use of his hand has been permanently lost and he is entitled to compensation therefor.

Appeal from Award of Referee L. E. Christley, District No. 8. Claim Petition No. 1534. Affirmed.

In Maseth vs. Hubbard & Company, II Department Reports, page 1281 our Brother Scott said "in applying the letter and spirit of the Workmen's Compensation Act of 1915 we will have regard not so much to what may be true as to the exceptional man capable of taking up special and particular lines of employment after he may have suffered an injury but rather as to what is true of the average man in the general line of the employment in which he may be when the injury overtakes him in the course of such employment, and as to what will meet the disability and needs of the average man at the very time the injury occurs.'

We will follow, in this respect, the rule announced by the courts of Massachusetts in Donovan's case, 217 Mass. 76, 104 N. E. 431 when considering a similar statute of that State wherein it was held 'that the statute was to be construed broadly for the purpose of carrying out its manifest purposes.'

Thus early the Board in adopting this opinion set our standard in respect to hand injuries, the principles of which have been followed by it in many cases since and applied as uniformly as possible to the facts and circumstances of each particular case. See Oliver vs. Standard Steel Springs Co., II Department Reports, page 2534; Reinhard vs. Egypt Silk Mills, II Department Reports, page 2874; Coleman vs. Lemont, II Department Reports, page 2793; Maseth vs. Hubbard & Company, II Department Reports, page 1281; Lebanensky vs. Foerderer Glue Factory, II Department Reports, page 2297; Garner vs. Grier Brothers, II Department Reports, page 1533; Wassick vs. MeKeesport Tin Plate Co., II Department Reports, page 2792; Graber vs. David Lupton's Sons Co., II Department Reports, page 2174.

In the case of Maseth vs. Hubbard & Company (supra) it is said "what injury shall amount to a permanent loss of the use of a hand is mainly a question of fact to be found from the evidence, considered in the light of a fair interpretation of the terms of the Act."

In Maley's case, 219 Mass. 136, 106 N. E. 559 the court held, that "where a hand cannot be used in its ordinary manner, but can be used only as a hook, it is incapable of use within the meaning of the Act, and the incapacity of use need not be tantamount to the actual severance of the hand." Commissioner Scott in the Maseth case after a review of all the testimony concluded that "a fair consideration of this testimony even in the most favorable light to the defendant, convinces us that there is no practical efficiency or earning power left in the hand. That after practice the injured employe might perform some necessary personal services to himself such as to feed and dress himself is not sufficient use of the hand as is contemplated by the relation of the employer and employe in a manual occupation and such occupation as must be considered in this case; nor does it show practical earning power that the hand and stumps of the four injured fingers might be used as a hook to carry certain things and that generous and kindly disposed employers are willing to take the claimant back into their employ at his former wages is not material nor controlling in arriving at a decision as to the permanent loss of the use of the hand where the injury to the four fingers of the hand is permanent and the loss of the principal parts of the fingers complete."

In the case under consideration, the claimant suffered an injury on the 27th day of June, 1916, while in the employ of the defendant. He was operating a shearing machine. The Referee has found that his right hand and fingers were caught in the shears, mashing and lacerating said fingers to such an extent that the first finger is cut off at the second joint; second finger about one-third way back of the second joint; third finger at the second joint; leaving the thumb and little finger intact."

The condition of this hand is further shown by the medical testimony of Dr. Edward W. Dean who described it as follows: "Q. Would you kindly describe where the fingers are amputated?

A. The index finger amputated at the second joint; second finger or middle finger amputated back