Fatal heart attack a result of job conditions?

Worker's estate claimed fatal heart attack was caused by slow treatment of earlier heart attack at work

This instalment of You Make the Call looks at a claim for compensation benefits by the estate of a worker who died of a heart attack.

The worker was employed seasonally for an Ontario energy company for 20 years. In the summer and early fall, he worked on a barge that serviced work sites out in lakes. His duties included maintenance, docking and steering the boat. He didn’t perform heavy labour such as loading and unloading.

The worker had a family history of hyperlipidemia, a condition of elevated fats in the bloodstream, and also suffered from high blood pressure, hypertension and high cholesterol. He had also been a smoker for a period of time and after quitting, gained weight and became obese.

On June 4, 1998, the worker began to experience heart attack symptoms while steering the boat in rough weather. Shortly thereafter, the boat turned around and he was transferred to a tug, which took him to an ambulance waiting on shore. The total time it took before he reached the ambulance was one hour and 40 minutes.

After two weeks, the worker recovered and wanted to return to work quickly for financial reasons. He was cleared to return to work on modified duties for one month and returned to his regular duties with his doctor’s permission without any further incidents.

On Sept. 21, 2003, while at home on a day off, the worker had a second heart attack and died. His estate claimed it was entitled to workers’ compensation benefits because his second heart attack was from damage incurred from the delay in treatment of his first attack, which stemmed from his job. A medical consultant indicated the time between initial symptoms and the administering of the proper drugs is “critical” and a delay can increase the level of permanent damage to the heart.

The Workplace Safety and Insurance Act says a worker is entitled to benefits when an injury is sustained by “accident arising out of and in the course of his employment.” The Workplace Safety and Insurance Board Operational Policy Manual also specifies benefits for a heart condition when there is a “causal relationship” between the condition and a workplace accident and it is a disablement arising out of employment.
You Make the Call

Did the worker’s job contribute to his heart attacks?
OR
Was his employment not a significant contributor to his condition and death?


If you said the worker’s employment was not a significant contributor to his fatal heart attack, you’re right. The tribunal found the worker’s job duties were fairly light without physical labour that might aggravate his condition. After his first heart attack, the tribunal said, his duties didn’t change and he worked for another five years without incident. At no point did he request or need ongoing modifications to his job.

The tribunal also found, despite the delay in receiving treatment during his first heart attack, it didn’t significantly contribute to his second one. Diagnostic imaging showed his heart appeared normal afterwards and he was discharged six days later after a successful exercise test. A stress test and examination in October 1998 showed “no significant impairment” from the first attack.

The tribunal found it was likely the contributing factors to the worker’s fatal heart attack were his high blood pressure, hypertension and obesity, family history of hyperlipidemia and heart disease and his smoking.

“It was evident from the medical information that the worker had significant predisposing risk factors for a heart attack,” the tribunal said. “The worker was tested and sent on to return to his normal job and performed without complaint for another five years.”

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