Heart attacks on the job: are they covered by workers compensation?
Lately, we've had several visitors to the site searching for information about heart attacks. We take that to mean that people are trying to determine whether a heart attack that occurs in the workplace is a compensable event. Not everything that occurs in the workplace is deemed compensable and that is particularly true of illnesses. Generally, a heart attack in and of itself would not be a compensable event. The acid test for compensability would revolve around whether it can be determined that the heart attack is an event that has arisen out of and in the course of employment.
First, as with anything related to workers comp, your state law will prevail. Because workers comp legislation varies by state, there is no universal dictate that would apply nationally so we are speaking in generalities here. Heart attacks and strokes can be complex issues and may require legal consultation.
"Arising out of employment" means that a heart attack would have to be job related, or in other words, did the heart attack happen because of the work? Was there a causal connection? "In the course and scope of employment" generally would have to do with the time, place, and surrounding events.
Illnesses and conditions are often progressive in nature, and they may be due to other or unknown causes, such as family history, obesity, smoking, etc. It would be up to the worker to prove that the heart attack was related to or caused - at least in part - by the work. Were there precipitating work factors, such as unusual physical exertion or mental stress? Also, in any discussion of heart attacks, the issue of pre-existing conditions often comes into play. While pre-existing conditions would generally not be compensable, they would also not necessarily be a bar to compensability. If it can be shown that the work aggravated or accelerated a pre-existing condition, compensability may be granted.
Here are a few interesting cases in various jurisdictions that deal with heart attacks or heart conditions. (Readers, please feel free to post comments if you have other examples or links to other cases.)
Longshore & Harbor Workers Compensation Act - Court decision restates law regarding employer’s burden of proof to rebut presumption of coverage