Sadly, we see many catastrophic injuries which occur on the job. While all such tragic situations are devastating to the family of an injured worker, the most devastating must be the cases where the worker is actually killed by the work injury. Though justice is important in every case, somehow it just seems that much more important when the injured worker is not here to fight for him or herself.
When a worker has a fatal injury, the key question is whether the incident at work was a “substantial contributing factor” in causing the death. Sometimes, the issue gets a bit confusing when some other medical condition, having nothing to do with work, also plays some role in the situation. Recently, in Manitowoc Co., Inc. and Sentry Insurance v. Workers’ Compensation Appeal Board (Cowan), the Commonwealth Court of Pennsylvania was confronted with such a case.
Here, the worker was killed when he fell about six feet from a crane platform. A witness described that the worker was on the platform and, while crouching, his eyes rolled back, and he fell off the platform striking his head on the floor. The worker initially had a pulse, but then stopped breathing. He was then resuscitated and transported to the hospital, where he passed away. An autopsy concluded that the cause of death was “cardiac dysrhythmia due to mitral valve prolapse.”
A Fatal Claim Petition was filed and litigated before a Workers’ Compensation Judge (WCJ). The medical expert offered by the Claimant testified that, based on the statements of the witnesses (that the injured worker was still alive when he fell) and the medical records, the injured worker did not experience cardiac arrest at the time of the fall. Also noted was that the autopsy report did not show a heart attack or coronary artery disease, and that no cardiac arrhythmia was found in the hospital prior to the death.
The medical expert concluded that the injured worker’s death “was the direct result of falling onto his head, which caused a closed-head injury with a massive concussion and a diffuse axonal injury, leading to anoxic brain injury and cerebral edema.”
The workers’ compensation insurance carrier presented the testimony of two medical experts who, predictably, testified that the death was cardiac in nature, and not the result of the fall from the platform. After considering all of the evidence, the WCJ found the opinion of the medical expert offered by the Claimant most credible, and granted the Fatal Claim Petition. Specifically, the WCJ found that the death resulted from the fall from the platform (many cases have already established that the reason why an injured worker falls is generally not relevant, if the resulting injury is not the normal part of a non-work-related condition). This decision was affirmed by the Workers’ Compensation Appeal Board (WCAB).
The primary argument by the workers’ compensation insurance carrier on appeal to the Commonwealth Court of Pennsylvania was that the opinion of Claimant’s medical expert was equivocal because the doctor suggested more than one theory regarding the exact cause of death. This was detailed by the Court:
“At the hearing, Dr. Stoner set forth four possible explanations regarding the connection between Father’s fall and his death: (1) the fall caused mid-brain hemorrhaging and death; (2) the fall caused a massive head injury, resulting in cardiac and respiratory arrest, anoxic brain injury, and death; (3) the fall caused a blood clot in the back of Father’s throat, impairing his ability to breath and causing anoxic brain injury and death; or (4) the fall caused closed-head trauma, mid-brain hemorrhaging, secondary anoxic brain injury, and death.”
In affirming the decision of the WCJ, the Court noted that, regardless of which specific theory was reviewed, each of the theories involved the injured worker being killed as a result of the fall from the platform (and not from a cardiac event). Indeed, Claimant’s medical expert specifically stated, “‘with a high degree of medical certainty,’ that absent the head trauma, (the injured worker) would still be alive.” Simply offering alternate theories did not render the opinion equivocal, since the opinion consistent among the theories was that the blow to the head caused the death. Also, the fact that a cardiac event may have caused him to fall is irrelevant, since the opinion accepted by the WCJ (the ultimate finder of fact) is that the cardiac event did not cause the death.