Fatal Claim Petition Denied Based on Causal Relationship
To win a contested workers’ compensation case in Pennsylvania, the injured worker must prove that he or she suffered an injury while in the scope and course of employment and that he or she is disabled as a result of such injury. The situation only changes moderately when the injured worker is actually killed in the accident, and it is a Fatal Claim Petition being litigated. In that case, the burden is to prove that the injury, or the conditions at work, caused (or were a “substantial contributing factor” in causing) the death of the injured worker.
Recently, the Commonwealth Court of Pennsylvania examined what is needed to show that the conditions of work were indeed a substantial contributing factor in causing the death of an injured worker. In this case, Justus v. Workers’ Compensation Appeal Board (Bay Valley Foods), the injured worker was found unresponsive locked inside a shed that contained chemicals. The presence of the chemicals, and initial incorrect assumptions regarding what happened, led to a delay in diagnosing the actual problem – a subarachnoid hemorrhage. The injured worker passed away before treatment for the subarachnoid hemorrhage could be performed.
The widow of the injured worker filed a Fatal Claim Petition. Though the subarachnoid hemorrhage was unrelated to the work duties, the Petition alleged that the conditions at work led to a delay in treatment, which became a substantial contributing factor in the death of the injured worker [That the original condition need not be caused by work for subsequent damages to be compensable is a topic we have discussed previously]. Specifically, it was alleged that the distance of the shed from the main building caused a delay in finding the injured worker, and the presence of the chemicals in the shed caused an incorrect diagnosis, leading to a delay in proper treatment.
After hearing the evidence, the Workers’ Compensation Judge (WCJ) dismissed the Fatal Claim Petition. Essentially, the WCJ concluded that the widow failed to show that she could meet the necessary burden of proof, to show the death was work related. The delay in finding the injured worker, and getting the correct diagnosis, did not “aggravate” the condition, said the WCJ. Upon appeal, the Workers’ Compensation Appeal Board (WCAB) affirmed, finding that “the working conditions were not shown to have affected Decedent’s diagnosis and treatment.”
The case was then appealed to the Commonwealth Court of Pennsylvania. The Court immediately disagreed with the finding of the WCAB, noting that, “It is clear from the record that conditions of the workplace, and in particular the existence of chemicals in the cooling shed that led the first responders to provide erroneous information to UPMC Hamot, could be found to have produced a significant delay in Decedent’s receipt of proper treatment following his SAH.” Despite this correction, the Court then affirmed the holding. The Court found that the medical evidence offered by the widow did not meet the burden that was required.
In agreeing the Fatal Claim Petition was properly dismissed, the Court reviewed the opinion of the medical expert offered by the widow:
“In his report, Dr. Vey opined, within a reasonable degree of medical certainty that ‘workplace-related delays encountered in [Decedent’s case] substantively contributed to his poor outcome, lessened his likelihood of achieving a more improved result, and reduced his chances of survival.’ (Id.) This testimony did not establish, within a reasonable degree of medical certainty, that the delay in treatment was a substantial cause of death. Dr. Vey reported that the medical condition that caused Decedent’s death was an SAH, which was not related to his employment with Employer.”
With all due respect, this author would have to disagree that the opinion stated above could not support a finding that the delays involved were a substantial contributing cause of the death. By “contributing to his poor outcome” and reducing “his chances of survival,” wouldn’t the delays, by definition, be a substantial contributing factor? If this opinion is found credible, it is unclear why this opinion could not have supported such a finding.