Heart Attacks at Work Under Washington’s Industrial Insurance Act

The ramifications for suffering a myocardial infraction (heart attack) at work are significant.  If the worker dies, the spouse and minor children are entitled to substantial awards of money, potentially to include a pension for the remainder of the spouse’s lifetime, if the claim is found to be compensable under Washington’s Industrial Insurance Act.  If the worker doesn’t die, there will still be very expensive cardiac rehabilitation and medication costs which will typically devastate the worker’s finances and often force the worker and his/her family into bankruptcy if the heart attack claim is denied.>

Washington is in the minority of states which treat heart attacks at work as being different than other sudden injuries at work, such as those which may occur to the musculoskeletal system (and may easily injury workers or non-workers alike, from all walks of life).  Washington requires heightened proofs from the injured worker before the Department of Labor and Industries will pay in a heart attack at work claim.  This is despite the fact that Washington doesn’t formally require compensable injuries to “arise out of” employment, but generally only requires the lesser standard that compensable injuries occur within “the course of” employment.  In other words, the normal rule is one of “strict liability.”  If an injury occurs while the worker is in the course of employment, the injury is almost certain to be covered by Labor and Industries law. Heart attack at work cases are very different.  In heart attack cases, the Department of L&I often denies the claim.

The Department of Labor and Industries typically denies or rejects heart attack at work claims regardless of whether these are filed under “injury” or “occupational disease” theories.  The Department very often takes the position that the heart attacks at work do not fall within the statutory definition of “injury” which requires a showing of a “sudden and tangible happening, of a traumatic nature, producing an immediate or prompt result, and occurring from without, and such physical conditions as result therefrom.” The Department of Labor & Industries almost universally denies heart attacks plead as occupational diseases since all people regardless of occupation (or even whether they have a job) are subject to suffering a heart attack at work due to poor health, which is to say regardless of any “particular risk” inherent to the worker’s employment.

Heart attack at work cases may become the subject of jury trials in Washington.  Heart attack claims are very often among the most expensive and difficult for the injured worker or a decedent’s estate to prosecute.  Washington calls it “workers’ compensation insurance,” but generally our state does a poor job providing coverage for those workers who suffer this type of cardiac injury on the job.  Therefore, until the legislature does something to fix this problem from Olympia, any worker who suffers what they believe to be a work-related heart attack (i.e., “coronary occlusion” or “myocardial infarction”) should do all of the following:

1. Document the nature of any and all “unusual exertions” or stresses made on the day of the heart attack, as an injury claim will be denied under current law unless the claimant can show that such an “unusual exertion” due to physical or mental efforts out of the normal for the affected individual was also a “proximate cause” of the heart attack;  An unusual exertion might b related to any of the following or other unlisted circumstances:
   1. Unusually hot or cold weather, such as if the worker suffers a heart attack on the hottest day of the year while working on hot asphalt as a member of a road construction crew.
   2. New job requirements such as lifting and carrying heavier objects than normal;
   3. New or “out of the ordinary” work hours, conditions or other demands, such as having to work significant overtime while trying to meet a deadline for which the worker is also placed under considerable stress.  Keep in mind that the activity need not be one which is entirely new or unfamiliar to the worker; the worker’s exertion with respect to the activity needs to be “unusual” to the point of proximately causing the heart attack.
2. Ask your attending Internal Medicine Physician, Cardiologist and/or Family Physician to provide you a statement of Prima Facie Medical Evidence (“PFME”) signed by them.  The doctors will hopefully understand what is required in such a request, but for simplicity’s sake, the PFME statement will typically be a treatment/progress or “S.O.A.P.” note that contains the following three elements:
   1. A history of the events leading to the heart attack, including specifically all circumstances which contributed to the event and/or help prove that there was an “unusual exertion” leading up to that cardiac result;
   2. The most precise diagnosis possible.  For instance, this will hopefully include whether or not there was a partial or full occlusion.  The diagnosis will be properly supported by objective medical evidence such as the identification of specific blood markers which occur in the aftermath of a heart attack.
   3. A statement of causal relation expressed to a reasonable degree of medical certainty, i.e., on a “more likely than not” basis.  For example, such a statement may be made as:  “In my opinion, the [diagnosed condition] was caused by the occupational history recounted above, and is therefore work-related on a more probable than not basis.”
3. Ask your Attending Physician to lay out a written plan for any such curative care as can be provided to you under your particular circumstances.  The plan should include specific types of physical therapy required, medications, and expectations for the amount of time that you will likely be unable to return to your work of injury.  This will help all parties and litigation participants to determine the relative value and costs of pursuing your claim versus other options which may also be available to you.
4. Consult our experienced Washington Labor and Industries attorneys regarding your work-related cardiac injury case.  We have the experience and technical knowledge to properly assess and litigate your claim.  There’s hardly a more valuable claim to you than one involving your heart, so don’t risk making fatal mistakes in the complex litigation area.  Without question, you should consult an experienced L&I litigation attorney immediately for this type of injury or occupational disease case.

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