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FILE NAME: Contract Unit W orkers Comp Claims (WCC) DATE: 1956 DOC#: WCC051 DOCUMENT DESCRIPTION: W orkers Comp File - McCarrell, Ervey File Name C o n tra c t U n it C la im File: E rv e y M c C a rre ll D e c. 1 4 /5 6 Scanned ? yes Source JMA: N S-JM Start Year 1 9 5 6 Stop Year 1956 Contents claim Notes WORKERS' COMPENSATION APPEALS BOARD - CALIFORNIA (INDUSTRIAL ACCIDENT COMMISSION, prior to 1966) APPLICANT ERVEY'`Mc CARRELL ___________________ CASE #LA 176684 Insulation Worker _______ ________________ DATE CLAIM FILED INJURY ALLEGED Dec. 14, 1956_____________________________________ Injury to throat & l u n g s ________________________ ALLEGED DATE OF INJURY Nov. 14, 1956___________________ _ EMPLOYER/TNSURER Armstrong Cork Co./Travelers et. al. including J-M Corp. OTHER NOTES No apparent Canadian carrier DATE OF RESOLUTION Dec. 14, 1959______________________________________ RESOLUTION Compromise & Release $13,500 settlement among 6 employers/carriers DOCUMENTS COPIED 1) Compromise & Release_____________ 2) Med Rpt of Urabec to Travelers of Oct. 12, 1959 # OF 6PAG! 2 CLAIMANT ___ < L ^ v f r .i| W e . C a v i r e J I__________________________________ __ L California Workers' Compensation Appeals Board CARRIERS INVOLVED: oThe AETNA Casualty & Surety Co. oAmerican Automobile Ins. Co. oAmerican Employers Ins. Co. oAmerican Motorists Ins. Co. oArgonaut Ins. Co. oAssociated Indemnity Corp. oCalifornia Casualty Indemnity Exchange oCalifornia Compensation & Fire Co. oCasualty Ins. Co. of California oEmployers Liability Assurance Corp.Ltd. oEmployers Mutual Liability Ins. Co. of Wisconsin oFidelity & Casualty Co. of New York Fireman's Fund Ins. Co. oGeneral Accident, Fire & Life Assurance'Corp. Ltd. oGlobe Indemnity Co. oGuarantee Insurance Co. oGreat American Ins. Co. oHardware Mutual Casualty Co. (Sentry olndustrial Indemnity Co. Industrial Indemnity Exchange olnsurance Co. of North America Ins. Co.) Liberty Mutual Ins. Co. Lumberman's Mutual Casualty Co. oMaryland Casualty Co. oMichigan Mutual Liability Co. oMission Insurance Co. oNational Automobile & Casualty Ins. Co. oNew Amsterdam Casualty Co. oOcean Accident & Guarantee Corp.Ltd. Pacific Employers Ins. Co. oPacific Indemnity Co. Reliance Ins. Co. (Standard; Accident Ins. Co.) oRoyal Indemnity oSecurity Ins. Co. of Hartford (U.S. Casualty Ins. Co.) oState Compensation Insurance Fund oTransport Indemnity Co. The Travelers Ins. Co. oThe United Pacific Ins. Co. oU.S. Fidelity & Guaranty Co. oZenith National Ins. Co. oZurich Ins. Co. o ________________________________________ o ______________________________________________________________________ o ______________________________________________________________________ o ______________________________________________________________________ o 5/81 1 WORKERS' COMPENSATION APPEALS BOARD 2 STATE O F CALIFORNIA 3 EHVEY 0. McCARRELL, 4 A C ase N o. 56 LA 176-684 5 Applicant 6 vs. 7 ARMSTRONG CORE COMPATII, et al, ( THE TRAVELERSINSURANCE COMPANY, l 8 et al. I \ I 1 I I 9 Defendant' I 10 11 I hereby certify that the attached documents are true 12 and correct copies of the original documents filed in the records > 13 of this office in the above-entitled matter. 14 ATTEST my hand and the Seal of the Workers' Compensation 15 Appeals Board of the State of California. 16 17 18 19 20 21 22 23 24 Bated at San Francisco, 25 California, this 6 day 26 of April, 1981 27 M PAJtTM CNT O F tH O U tn U A L CU A TtO N t B IV I W M O F INBWBTWIAL A C C IM W T * \ . / ' - s r - '-. ac: e-;- c ^ :: v i z i l i ',f] ;,''l 14 PM 3 07 1 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION QJ*,,THE STATE ffiryALIFORN 2 -------- --:rERE.E CASE NO. 56 LA 176-684 3 4 ERVEY 0. McCARRELL, 5 Applicant r ^-- JAN 1 4 5S g V/iLL'iM KAPLAN 37 SKRmXV 6 -V S - 7 ARMSTRONG CORK COMPANY, a corporation; THORPE INSULATION COMPANY, formerly 8 known as PLANT RUBBER & ASBESTOS COMPANY; UNITED CORK COMPANY, a corporation; PLANT 9 RUBBER it ASBESTOS WORKS; FIBREBOARD PAPER PRODUCTS CORPORATION; MARINE ENGINEERING 10 & SUPPLY COMPANY; LARRY CARR, doing business as LOS ANGELES MARKET REFRIGERATION it ENGIN 11 EERING COMPANY; PARAFFINE COMPANY, INCORPORA TED; J. T. THORPE, INCORPORATED; JOHNS12 HANVXLLB SAXES CORPORATION; PLANT INSULATION COMPANY; THE TRAVELERS INSURANCE COMPANY, a 13 corporation; LIBERTY MUTUAL INSURANCE COMPANY, a corporation; PACIFIC EMPLOYERS INSURANCE 14 COMPANY, a corporation; STANDARD ACCIDENT INSURANCE COMPANY, a corporation; FIREMAN'S 15 FUND INSURANCE COMPANY, a corporation; OWENS-CORNING GLASS COMPANY; THE AETNA 16 CASUALTY & SURETY COMPANY, a corporation, COMPROMISE AND RELEASE AGREEMENT 17 Defendants 18 19 The parties hereto, for the purpose of compromise only, 20 hereby submit the following agreed statements of fact: 21 1. Ervey 0. McCarrell, the applicant herein, born 22 3, 1903, claims that while employed during the period of 1942 to 23 date, as an insulation worker at marl mum earnings for Armstrong Co: 24 Company, a corporation, whose compensation carriers were The 25 Travelers Insurance Company, a corporation, and The Standard 26 Accident Insurance Company, a corporation; The Thorpe Insulation 27 Company, formerly known as Plant Rubber & Asbestos Company, whose 28 compensation carriers were Pacific Employers Insurance Company; 29 the United Cork Company, a corporation, whose compensation carrier 30 was the Liberty Mutual Insurance Company, a corporation; the Fibre 31 board Paper Products Corporation, formerly known as the Paraffine 32 Company, Inc., sued herein as Paraffine Company, Inc., and by Plan -1- 1 Rubber & Asbestos Works, formerly a wholly owned subsidiary of 2 Plbreboard Paper Products Corporation, under Its then name of the 5 Paraffine Company, Inc., which was permisaably self-insured; the 4 Marine Engineering and Supply Company whose compensation carrier 5 was Pacific Employers Insurance Company; Larry Carr, d/b/a Los 6 Angeles Market Refrigeration and Engineering Company, whose compel 7 sation carrier is unknown; J. T. Thorpe Incorporated, whose comp 8 satlon carrier was Pacific Employers Insurance Company; Johns- 9 Manville Sales Corporation, whose compensation carrier was The 10 Travelers Insurance Company; Plant Insulation Company whose cooper n sation carrier was the Pacific Employers Insurance Company and 12 Fireman's Fund Insurance Company; and the Owena-Corning Glass 13 Company whose conpensatlon carrier was The Aetna Casualty & Surety 14 Company, a corporation; all of which above alleged employments 15 being at various locations throughout the State of California, sus 16 tained an Injury arising out of and occurring in the course of his 17 enployment, allegedly consisting of occupational exposure to asbes 18 tos, resulting in the claimed injuries and disabilities to the che 19 claimed herein. 20 2. The actual weekly wages of the employee at the time 21 of claimed injury were maximum. 22 3. The nature of the employees present disability is in 23 dispute, and the employee has returned to work irregularly since 24 the cessation of payments of temporary disability. 25 Disability indemnity has been paid to the applicant 26 herein in the sum of $4,160.00 at $40.00 per week for the period 27 of December 5, 1956 through December 4, 1958. The amount due and 28 unpaid to the employee is in dispute. 29 5. The parties hereby agree to settle any and all 30 on account of said injury by the payment of the sum of $13,500.00 31 over and above all monies paid heretofore, which sum is to be con 32 tributed as follows: -2- ( Y t4. 1. Flbreboard Paper Products Corporation, 2 formerly known ae The Paraffine Company, Inc., sued 3 herein as Paraffine Company, Inc., and b y Plant 4 Rubber & Asbestos Works, formerly a wholly owned 5 subsidiary of Plbreboard Paper Products Corporation 6 under its then name of the Paraffine Company, Inc. $ 3,295 7 2. Standard Accident Insurance Company, 8 a corporation 0- < n / . 5,70fl 9 3* Travelers Insurance Company, corporation .'8,940 10 4. Fireman's Fund Insurance Company, a 11 corporation 5 12 5. Liberty Mutual Insurance Company, a 13 corporation 135. 14 6. Pacific Employers Insurance Company, a 15 corporation 1,350. 16 7. TOTAL $13,500. 17 Prom said sum shall be deducted the sum of ^ i~cr~ 18 for attorneys' fees payable to William T. Hays, attorney for appli 19 cant, as well as the deduction of any and all valid liens of recorc 20 from said sum. 21 6. It is agreed b y and between the parties hereto that 22 any and all medical treatment not already furnished by the defen 23 dants herein is to be borne by the applicant only, and not by any 24 of the defendants herein. 25 7. That applicant's attorney, William T. Hays, requests 26 an attorney's fee ^ , and has received the previous 27 attorney's fee in the amount of ~ , if any. 28 8. The name and address of applicant's attorney is: 29 William T. Hays, 6331 Hollywood Boulevard, Los Angeles, California.. 30 9. REASONS FOR COMPROMISE: 31 A bona fide dispute exists between the parties as to 32 whether or not the applicant in fact sustained an industrial injury -3- t C 1 alleged, It is further contended that the disability payments z to date in fact should be acredited to any claim for permanent dii 3 ability, assuming an industrial injury to have occurred, rather tl 4 as temporary disability inasmuch as the condition was permanent a1, 5 initio. It is further denied that the applicant is in need of or 6 entitled to further medical treatment, assuming that he sustained 7 an industrial injury. e It is further agreed by and between the parties hereto' 9 that in the event said Compromise and Release is approved, a dis 10 missal with prejudice may issue in favor of Larry Carr, d/b/a. Los 11 Angeles Market Refrigeration & Engineering Company, Owens`-Corning 12 Glass Company, and the Aetna Casualty & Surety Company, a corpora- 13 tion. Further, the parties desire to avoid the hazards, delays ar 14 costs of further litigation, and buy their peace. All medical re 15 ports now of record are, by reference, made a part of this agreeat 16 as though written herein. 17 10. The undersigned respectfully request that this 18 Compromise and Release agreement be approved. 19 11. Upon approval of this Compromise and Release agreer 20 by the Industrial Accident Commission, and payment in accordance 21 with the provisions hereof, said applicant releases and forever di 22 charges said employers and insurance carriers, and each of them, < 23 their officers, agents, servants, employees and assigns of them, i 24 each of them, and the nurses, physicians and surgeons of them, anc 25 each of them, whether acting individually or on behalf of them, ,or 26 any of them, from all claims and causes of action, whether now knc 27 or ascertained, or which may hereafter arise or develop as a resul 28 of said injury and/or employments, including any and all liability of said employers and said insurance carriers, and each of them, t 29 the dependents, heiTB, executors, representatives, administrators 30 31 or assigns of said applicant, and in further consideration of pay 32 ment in accordance herewith, applicant agrees that this release wi -4- X I >ly to all unknown and unanticipated injuries and damages re sul 2 m such accident, casualty, event, employment and/or employment 3 well as all those now disclosed and all rights under Section 1 4 the Civil Code of California are hereby waived. 5 Section 15^2 of the Civil Code of California reads as 6 7 "A general release does not extend to claims \ - which the creditor does not know to suspect . 'v 8 to exist in his. favor at the time of execu--- =-- ting the -re lease , -which,-if"known by hiaV ~ 9 must have materially affected his settlement with the debtor." XO XI 12. It is understood and agreed b y all of the parties 12 ereto that the applicant herein has not received unemployment com- 13 ensatlon disability benefits from any source. 14 WITNESS THE EXECUTION HEREOF this day of 15 , 1959 at Los Angeles, and San Francisco, Callfomie 16 17 > ^P ? f { 2 e ,j's u ERVB5r'0:"TECAHREIl, 'pplcit 18 HAYS & MC LAUGHLIN 19 20 By Attorneys for Applicant 21 ARMSTONG CORK COMPANY, A CORPORATION; 22 TRAVELERS INSURANCE COMPANY, a corpora tlon, , 23 By; HERLIHY & HERLipr^) 24 25 Per r ' U U . " , 0 P. Attorneys r o w above defendants 26 ARMSTRONG CORK COMPANY, a corporation; 2/ STANDARD ACCIDENT INSURANCE COMPANY, a corporation 2i 2` 31 FIBREBOARD PAPER PRODUCTS CORPORATION, 3 formerly known as The Paraffine Company n. IInncc..,, sauneddbhyerPeLAiNnTaRsUBPBarEaRff&inAeSBECSomTpOaSny, WORKS, formerly a wholly owned aubaidla -5- T i / c 1 of Flbreboard Paper Products Corpora' under Its then name of The Paraffine 2 Cocqpany, Inc. 3 By: BRQBECK, PHLEGER it HARRISON 4 tl ' \ ' Per r-- -^. , - 5 Renaido Sciaronl, Jr., Attorneys' for above defendants 6 UNITED CORK COMPANY, a corporation; 7 LIBERTY MUTUAL INSURANCE COMPANY, a . corporation, 8- 9 George R. Haswei^, Attorney for above 10 .^ e fe n d ^ n ts ^ . 11 By B. Lou Lamoreaux, Attorney 12 JOHNS-MANVILLE SALES CORPORATION, a 13 corporation; THE TRAVELERS INSURANCE COMPANY, a corporation, 14 15 16 17 PLANT INSULATION COMPANY, a corporati FIREMAN'S FUND INSURANCE COMPANY, a 18 corporation. 19 By -frl 20 Harold shoop. Representative 21 MARINE ENGINEERING & SUPPLY COMPANY; J. T. THCRPB, INCORPORATED; PLANT 22 INSULATION COMPANY; PACIFIC EMPLOYERS INSURANCE COMPANY, a corporation, 23 By: C L O P T O N P E N N Y 24 /S * / y ' i /y, 25 Per Robert , iiunz, Attorney for aboy 26 defendants 27 STATE OP CALIFORNIA ) SS COUNT* OF 'EOSyANGSIS ) 28 On this hr,r day of i''t-- , 19 , before me, the 29 undersigned, a Notary Public In and for the said County and State, residing therein, duly commissioned and sworn, personally appeared 30 ERVEY 0. McCARRELL, known to me to be the person whose name is sub scribed to the within Instrument, and acknowledged to me that he 31 executed the same. IN WITNESS WHEREOF, i have hereunto Bet my hand and affix 32 my official seal the day and year in this Certificate first above written. . .- ,,-- . Notary Public in and for said County and State of California  (. ( JOHN H URABEC.M O , |T J 3 Q I MtOICAL 0 / ' i : t U l ,, l , ( S 111 w*f (ill" I r a n i LO I .N C C IC S I /. C *u rQ N IA 12 O ctober 1959 The T ravelers Insurance Company, 510 W est Sixth S tre e t, L os A ngeles 14, C alifo rn ia. Re: McCARRELL, ER V EY O ., 56 LA 176-684 A rm strong C ork Co. It Johns- M anville C orporation, B 8289902 & 8789244 G entlem en: M r. E v e ry O. M c C a rre ll cam e to m y office on S eptem ber 4, 1959 f o r an exam ination and an evaluation of bis p resent pulm onary condition. A t the tim e of his v isit the following m edical history and physical exam ination w ere obtained. Age : 56; Occupation: A sbestos w orker; M arital Status: M arried; B irthplace: T exas, M arch 3, 1903; In C alifornia since 1922. Fam ily H istory: F ather: Age 84, living and well; M other: D eceased a t the age of 41, cause unknown; B ro th e rs : T h ree, living and w ell; S is te r s : T h re e , living and well; Children: None, P resen t Illness: The patient stated that he was in apparently good health until the la tte r p a rt of 1956, A t th at tim e w hile a t w ork a t the V alley S team Plant he had an episode of strangling allegedly due to the inhalation of d u st in his working environm ent. He subsequently developed a sev ere cough and was seen by D r. R obert K ennicott of Los A n g eles. He was exam ined and bad a ch est x -ra y taken. B ecause of the n atu re of the findings he w as r e f e r r e d to D r. Reginald S m art who at the p re se n t tim e is still his attending physician. He was advised to stop his w ork im m ediately. His cough continued and has been present ever since. It has however slightly dim inished since he is not exposed to irrita n ts . He has a slight hurting in his chest in the su b stern al a r e a . He is s h o rt of b re a th w ith slig h t e x ertio n . As p a r t of the study h e was r e f e r r e d to the la b o ra to ry of D r. H. M otley w here e x e rc is e te s ts w e re perform ed. He stated that the diagnosis of his case in p a rt was based on D r. M otley's re p o rt. Sputum studies w ere also perfo rm ed but no definite diagnosis was m ade from the study, at le a st if any diagnosis was m ade, he was not told anything about it. F o r some tim e now he has been seeing D r. S m art a t in te rv a ls of e v e ry six to eight w eeks and D r. M otley a t in te rv a ls of about every six months.  > . ---- 7 A t the p re s e n t tim e he sta te d th a t he has a h u rtin g in h is c h e s t and the ends of his fingers and toes becom e so re. He is not p articu larly aw are of these unless he e x e rc ise s. His p rin cip al com plaint a t th is tim e is his cough which he stated was very em barassing and which m akes him v ery nervous and shaky. He has been receiving cold shots to keep from getting colds. P rev io u sly , he stated that he had only m ild colds but seem ed to catch them e a sily . His th ro at a t this tim e seem s to be irrita te d a ll of the tim e . He has had no nasal stuffiness and he is not a mouth b reath er. He w ears g lasses fo r reading only. He has had no headaches or sym ptom s relativ e to his e a rs . He has had no night sw eats'or fever. -He has had no orthopnea, nocturnal dyspnea or ankle ' edem a. His digestion is good. His bowel m ovem ents a re re g u la r. He denied any nausea, vom iting, d iarrh ea, constipation, jaundice, re c ta l bleeding, souring o r gas. F or a tim e som e pills that w ere p rescrib ed tended to upset h is stom ach but he is now receiving another p ill to com bat this. He stated that he has had no recen t bleeding from hem orrhoids. He denied any symptoms re la tiv e to the g e n ito -u rin ary sy stem . 'He sta te d th a t his en erg y was p o o r. He lacked am bition and drive. He w as m oderately tire d a t the end of the day. He slept well and felt fairly rested after a night's sleep . If he exerted him self he tire d very easily but he adm itted that he re c u p e rate d v ery easily as he could relax easily. He also stated that if he exerted him self in any way he becam e b reathless m ore easily as he did not seem to have the "re sp ira to ry re se rv e ". A t the o n set of h is illn e s s he w eighed about 185 lb s . H e now w eighs about 196 lb s. On his forearm s he has had in term itten t episodes of sm a ll capillary hem orrhages. Habits: He denied using tobacco and alcohol. He drinks about three to four cups of coffee a day. P a st M edical H istory: He denied any previous serio u s illn e ss. He has had slight attacks of tonsillitis in the p ast but he has not had his tonsils rem oved. He had a le ft herniorraphy in 1947. He had a h em orrhoidectom y in 1954. Occupational H istory: He stated that he sta rte d to w ork w ith asbestos m aterials about 1939. F o r about five y ears he stated he w orked with the Plant Rubber and A sbestos works doing m arin e insulartioa w ork. F o r about ten y ears he worked for the A rm strong Cork Company insulating steam pipes and b o ilers. He worked in the field a t boiler houses and steam plants. He stated th at this was m oderately dusty w ork m o st of the tim e. No m ask s w ere worn, in this type of w ork. In addition to the above occupations fo r s e v e ra l y e a rs he drove a lunch wagon and did various types of w ork in different restau ran ts. Physical examination revealed a well developed, w ell nourished, adult white m ale who did not appear acutely or chronically ill. The skin of his face had a ruddy complexion and his lips w ere of a slightly dusky co lo r. He had an interm ittent dry unproductive cough. T e m p e ra tu re: 9 7 .6 ; P u lse : 72, regular; Blood P r e s s u r e : 106/72; Weight; 200 lbs. I Head and Neck: Byes: reactions and movemert s norm al. E a rs : m o d erate am ount of so ft wax in both c a n a ls , d ru m s g ro ssly n o rm a l. Nose: mucous m em branes m oist, slightly sw ollen, passages ample. Mouth: o ral hygiene fa ir. -- D entition: m oderate num ber of m o la rs ex tracted , m oderate num ber of ' fillings, rem aining teeth slightly tarnished. Pharynx: m ucosa diffusely reddened. Tonsils: m oderate size, smooth. Neck: no adenopathy, stiffness or abnorm al pulsations. Chest: sym m etrical, slight increase in the a-p d iam eter. K Lungs: b reath sounds slightly dim inished b ilaterally , scattered fine m oist rales in both low er lobes, a t the bases posterio rly and laterally . H eart: regular rhythm , no m u rm u rs. Abdomen: no m asses or tenderness, well healed le ft herniorraphy sc a r. Genitalia: norm al. Rectum: sm all external tags p resen t. E xtrem ities: finger nail beds w ere dusky in color, the nails w ere widened and slightly curved and slight clubbing of the fingers was p re se n t. The toes w ere essentially the sam e. Fluoroscopic exam ination of the chest showed an accentuation of the m arkings of a fine lin ear c h a ra c ter localized principally to the low er halves of each lung field. The cardiac silhouette was not significantly enlarged. The diaphragm s w ere round and smooth and moved about three centim eters with resp iratio n . A la rg e s e rie s of c h e st film s taken a t the office of D r. S m a rt as w ell as se v e ra l film s taken a t the H ospital of the Good S am aritan X -ra y D ep artm en t as well as a few taken by D r. Paul Quainlance w ere available for review . The e a rlie st film s w ere those taken at the H ospital of the Good Sam aritan and w ere dated 11-20-56. These film s showed a scattered fine b asilar infiltration in the lower halves of both lung field s. The m inor in terlo b ar fissu re on the rig h t appeared to be slightly d ep ressed . A dhesions w ere p re se n t to the domes of both diaphragm s m ore on the left than the right and som e adhesions w ere also presen t at the h ea rt border on the left. The apices and the costophrenic angles appeared to be relatively c le a r. The film s taken at the office of D r. S m art begin w ith a group taken on 12-10-56. In this group som e of the overshot film s show a fine in filtrativ e p ro cess in the low er lung fields b ilaterally below the levels of the second in te rsp a c e s. F ilm s taken on 8*27-57 show no essential change. The film s taken on 12-9-57 a re also slightly overshot and show no significant change. The 2-5-58 and 4-4-58 film s show no change. A Bucky film taken on 7-30-58 shows the infiltration to appear to be slightly m ore d iscrete but this m ight be due to radiologic technique. Subsequent-films a re dated 8-27-58, 10-10-58, 12-19-58, 1-27-59, 3-i8-59, 5-14-59, 7-16-59 show no additional significant change. A Bucky film, taken on the la tte r date shows the fine d isc re te - infiltration to be in extent and in the areas noted in the o riginal film of 11-20-56. T here w ere 33 film s in this s e r ie s . In five of th e se film s the dates w ere not discernible. / S ix film s fro m the office of D r. P a u l Q uaintanee w e re a ls o av aila b le fo r review . These w ere dated 1-18-57 and 12-5-58. They w ere of ra th e r poor quality and grossly did not show any changes from the film s taken above. There is no question about the appearance of this p a tie n t's lung fields which suggest the presence of a diffuse pulm onary fib ro sis, which historically w as not p re s e n t in film s taken by D r. H olla G. K a rsh n e r in N ovem ber 1944. > On the basis of this p atient's occupation a diagnosis of an occupational pneumoconiosis has been m ade by several of his attending physicians. Although the x - r a y ap p earan ce of the c h e st is co m p atib le w ith su ch a diagnosis such an x -ra y appearance could be sim ulated by other conditions. In this instance the diagnosis of an asb esto sis a n d /o r an occupational pneum oconiosis has not been confirm ed with absolute certainty from the his to-pathological study of a lung biopsy. F ro m the review of the film s it is my im p ressio n th at no-significant change has o c c u rre d in the ap p earan ce of the ab n o rm al m a rk in g s sin c e the o rig in a l film of D ecem ber 1956. It m ust be rem em bered th a t w ith changes in radiologic technique slig h t differences in the ap p earan ce of the lung fie ld s o ccu r and such changes cannot always be attrib u ted to actual pathological changes. In D r. S m a rt's r e p o r t of A ugust 26, 1959 he sp eak s of chan g es due to a subacute bronchitis. 1 wonder if these changes are not due to x -ra y technique ra th e r than to changes in the underlying pulm onary pathology. y Some em phasis is placed on this patien t's in creased susceptibility to colds. No definite reaso n is given fo r this except th at it is contented th at im m unizations with cold and flu vaccines w ill confer an im m unity. This contention is based in p a rt on the fact that this patient had allegedly freedom fro m colds the previous w inter when he bad receiv ed the above vaccines. If such w ere true the treatm en t of colds would be a re la tiv e ly sim ple m a tte r. 'With this e x teat of pulm o n ary a s b e s to s is o r pneum oconiosis I -would expect a co n sid erab ly g re a te r d e g re e of pulm onary function im p a irm e n t. C erta in ly the pulm onary function stu d ies done on F e b ru a ry 10, 1959 do n o t in d icate a disabling degree of pulm onary function considering the extensive pulm onary m arkings in both lung fields. His p resen t physician, intim ates that his apparent p re se n t im provem ent is on the b asis of his stero id and IPPB treatm ents. I do not know of any reference in the literatu re in which it has been dem onstrated th at the use of stero id s has a lte re d or im proved a tru e parenchym al fibrosis. ' As regards the use of IPPB treatm ents this does im prove pulm onary ventilation but in this instance if one accepts D r. M otley's findings this has not been a p a rtic u la r problem during the period of observation. Thank you for the privilege of being p erm itted to see M r. M cC arrell. Very truly yours, /ior^a H. U rabec, M . D.