Heart Attacks and Worker’s Compensation Claims

In February, 2010, while working as a truck driver for Hill Brothers Transportation, Inc. based in Omaha, Nebraska, George Wingfield felt ill and complained of chest pain.  His doctor diagnosed him with deep vein thrombosis and a pulmonary embolism; both of these conditions are types of blood clots.
Wingfield, who had been a truck driver for 10 years prior to working for Hill Brothers, had suffered deep vein thrombosis twice in the past prior to working for Hill Brothers.  After the February 2010 diagnosis he received treatment, but continued to experience shortness of breath and could not stand for long periods of time.  He returned to work at Hill Brothers and was permitted to take frequent breaks.  In October, 2010, Wingfield fell at work, hurting his back.  He filed a workers’ compensation claim based on the blood clots he suffered in February 2010, claiming that his duties as a truck driver caused him to develop deep vein thrombosis and a pulmonary embolism.  Wingfield’s claim was denied because he failed to show how his medical conditions were related to his job.

On-the-Job Injuries and Workers’ Compensation

Employees, in various trades throughout the United States, suffer many different types of ailments from conditions and incidents related to their jobs.  Employees regularly fall at work breaking bones, injuring backs, and suffering head injuries.  Particularly hazardous jobs may result in employees suffering from injuries due to the handling of or inhaling chemicals.  Employees, whose job requires them to drive a company vehicle, are often injured in accidents while on the road.  Under state workers’ compensation statutes, these types of injuries are compensable as long as they were proven to be work-related.  While not every injury that occurs at work is compensable, it is likely that the employee will receive workers’ compensation benefits if the specific work-related accident or incident can be directly connected with a worker’s injury.

However, what if there is not one specific accident or incident that can be tied to a specific employee injury or condition?  For instance, the employee may develop a medical condition such as a cardiac problem or a medical condition becomes worsened over the course of time because of job-related activities.  These types of cases can prove challenging for the employee as it is difficult to link the medical condition to work conditions.  Due to this complex issue, many states, such as Nebraska, now require that that employee, who suffered a heart attack or other progressive medical condition, establishes more proof in order to receive worker’s compensation benefits based on a heart attack or other cardiac issues.

Split Causation Standard

In the Wingfield case, Nebraska applied a two part standard, referred to as the “split causation” standard, to determine if an employee’s medical condition is compensable under the employer’s workers’ compensation insurance.  The employee must establish both legal causation and medical causation.  In reviewing Wingfield’s case, the Nebraska Supreme Court compared the development and progression of blood clots to the development and progression of a heart attack.  It concluded that Wingfield had to show that the proximate cause of his medical condition was work-related and thereby “break any causal connection between the natural progression of a pre-existing condition or disease and the injury at the workplace.”

The Nebraska Supreme Court determined that Wingfield had failed the medical portion of the split causation test as he was unable to medically prove that his condition was work-related.  In other words, it concluded that Wingfield could have suffered a pulmonary embolism or deep vein thrombosis anytime or anywhere, even if he never worked at Hill Brothers.

Impact of Wingfield

The effect of the Wingfield case ruling will be felt beyond Nebraska and beyond cases that are based on heart attacks or blood clots.  Whenever an employee files a workers’ compensation claim based on medical condition that typically develops over time, the employee will have to establish a strong connection between the development of that condition and his or her job.  If this cannot be done, the employee will lose.

What type of evidence do you think Wingfield or other employees in similar situations would have to present to prevail and be awarded workers compensation benefits?

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