Heart Attacks and California Workers’ Compensation Benefits

In California, if you or your loved one suffered an injury or death due to a heart attack or stroke you may be entitled to workers’ compensation benefits. If the stroke or heart attack was brought on by work exertion, stress or strain, it is a compensable injury when medical evidence shows that the work activity or environment caused the injury.

Often the worker had a preexisting abnormal cardiovascular or cerebrovascular condition. This preexisting condition is considered a contributing cause of the injury or death. However this doesn’t mean the worker isn’t still entitled to workers’ compensation benefits. Case law states that when the preexisting condition is aggravated by the employment, even though a healthy worker would not have been affected, the injured worker is still entitled to compensation. The rule stays the same even if the employee would have eventually died from the disease, regardless of his work. There must be evidence that the work hastened or produced the injury or death. (Lamb v. Workmen’s Comp. Appeals Bd., 11 Cal. 3d 274 (Cal. 1974))

When we talk about the work activity or environment causing or contributing to the injury this includes mental stress, physical stress or strain or exertion. It can be in the form of long-term stress such as that experienced by a miner or correctional officer or a single stress/exertion inducing event such as a heated argument or basketball game. The amount of actual stress or exertion does not need to be significant. There must be a stress or exertion on the particular injured or deceased worker and the analysis concerns the effect of the stress or exertion on the individual worker.

In workers’ compensation, apportionment, is the percentage of disability that was caused by the work injury and/or other factors including pre-existing conditions. When a workers’ compensation injury involves preexisting heart disease, there are often apportionment issues. The employer is liable for the “proportion of the disability due to the aggravation of such prior disease which is reasonably attributed to the injury” (Labor Code Section 4663). Courts have found where a work injury aggravated or “lighted up” a preexisting condition the employer is required to compensate for the entire disability and there is no apportionment between the work injury itself and the aggravation of the preexisting condition.  However the court is differentiated those cases where the disability is caused partly from the work injury and partly from the normal progress of the preexisting condition. (Bowler v. Industrial Acc. Com. (1955) 135 Cal.App.2d 534, 539 [287 P.2d 562].)  Clear as mud, right?

Often these cases require the opinion of a medical expert, a Qualified Medical Examiner, who specializes in cardiology to sort out the issues of apportionment, the big question of what caused the stroke or heart attack?

If the heart attack or stroke resulted in death the deceased worker’s minor dependents (and full or partial adult dependents) may be entitled to workers’ compensation death benefits. In cases where there are minor children left behind, a successful workers’ compensation claim can mean significant monetary benefits for the children until they turn age 18.

DISCLAIMER: This post provides general information only and is not intended to serve as legal advice.