MO: Employer Owes for Heart Attack After Work-Related Arm Surgery

MO: Employer Owes for Heart Attack After Work-Related Arm Surgery

An employer owes for a heart attack after a work-related arm surgery, according to a recent Commission decision which modified a denial of benefits.  The administrative law judge found the claimant failed to show work was the prevailing factor in light of claimant's severe cardiovascular disease that previously required multiple stents and bypass surgeries.  The Commission, however, increased the award of disability and awarded future medical care. Lichtinger v Swiss Meats, DOLIR 7-1-11. 

Claimant suffered a heart attack shortly after he underwent a fasciotomy to repair a stab wound.  The Commission found the claimant not only established he had a new 25% BAW  disability, but he was entitled to future medical care, and his "new" heart condition combined with his "old" heart condition to obtain PTD  benefits against the second injury fund. 

The administrative law judge found the employer's expert, Dr. Schuman, a cardiologist, more persuasive on causation than claimant's expert, a family physician.  The cardiologist concluded the stress from the injury and surgery could represent a "tipping point" to represent a significant or substantial factor.  He concluded the MI would not have occurred but for the pre-existing cardiovascular disease and stated work was not the prevailing factor.  The Commission construed Dr. Schuman's report "in its entirety" supported work to be the prevailing factor in the new heart attack.  It is unclear whether Dr. Schuman ever addressed the correct statutory standard. Prevailing factor only required the accident to be the primary factor and not the exclusive factor.

The Commission further modified the award to allow open medical.  Claimant after his arm surgery obtained a pacemaker, a device that may ultimately require replacement.   Claimant had worked for the employer only a few months and quit a previous job as a roofer due to his heart condition.  Claimant had a previous cardiac treatment for 7 years, including multiple stents and bypass operations.  The recent case of Tillotson v St. Joseph Medical Center, WD 72948 (Mo. App. 6-14-2011), similarly, supports an award for future medical when future medical treatment is reasonably related to an accident, despite substantial pre-existing conditions. 

Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug's Mo. Workers' Comp Alerts.

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