Illinois employers should review and take note of this important Commission decision which indicates simply because a heart attack or other cardiac event occurs while a claimant is working does not necessarily mean the accidental injury is compensable under the Act. Claimant and their counsel still must meet their burden of proof in demonstrating a compensable event through expert testimony and a preponderance of the evidence. As we indicated when Twice Over Clean was issued, we were greatly concerned any and all cardiac events or dysfunction might be covered in Illinois because claimant in that ruling was found to have arteries that were 95% occluded and his own doctor said he could have had a heart attack while brushing his teeth. It would appear our Commission is still using strong common sense in deciding when and if to provide Illinois’ high death benefit.

In Dragovan v. Western Utility Contractors Inc., 06 IL.W.C. 31304, No. 09 I.W.C.C. 0969 the Commission reversed an arbitration decision which found Decedent to have sustained fatal cardiac arrhythmia. It was undisputed Decedent in Dragovan had a labor intensive job. On the date of claimed loss, he had in fact been digging and performing strenuous physical labor. However this work was performed several hours prior to his death. Decedent was not performing heavy physical labor of any kind when the fatal cardiac event began.

Although Petitioner’s expert opined Decedent’s physical activity “led” to the fatal event, both experts agreed Decedent had a globoid-shaped heart with a longstanding occlusion of the descending coronary artery that left only a pinhole-sized opening, a condition that greatly increased the likelihood Decedent would experience cardiac arrhythmias, thus increasing the risk of sudden death. More important, both expert physicians also agreed Decedent’s heart was in such a diseased state little or no physical activity was needed for cardiac arrhythmia to occur. Nevertheless, the Arbitrator found this case to be analogous to Twice Over Clean and Petitioner’s expert to be more credible and awarded full death benefits. As we have indicated death benefits in Illinois are start at over $600,000 and now cap at $1,615,900!! We consider Illinois to be the third highest state for death benefits in the entire country.

On review the Commission disagreed and clearly distinguished this case from Twice Over Clean in that Decedent in this claim was neither performing physical labor at the time of the incident nor was he working at or near the level of physical activity as claimant in Twice Over Clean. To be clear, in Twice Over Clean the claimant was actually performing physically demanding labor outside in the cold in Minnesota when symptoms related to a non-fatal heart attack were experienced. In this case Respondent’s expert testified the physical activities performed earlier in the day by Decedent were too far away from a temporal perspective to be relevant in causation. Thus even with medical testimony that physical activity could precipitate cardiac arrhythmia and later death, the Commission viewed the facts and testimony in their entirety and issued a well-reasoned thoughtful decision which provides significant insight into how such claims should be handled.

This case is of extreme importance to anyone who might find themselves handling and/or defending a fatal or non-fatal cardiac or stroke claim. Please note this ruling might not apply to firefighters with five years or more of seniority—in Illinois, cardiac problems for such workers are presumed to be related to work.

Although it may seem at times as though the Act provides all-encompassing coverage to any employee who happens to be working at the time of a heart attack, stroke or other cardiac problems, thorough investigation and reliable expert testimony may speak to the contrary. With that in mind, we never recommend blind acceptance of cardiac claims simply because the incident occurs at work, it is the employer’s duty and right to fully investigate and make their decision after reviewing the facts in their entirety. Please don’t hesitate to contact us about handling, reserving or defending such claims.

This article was drafted by law student and KC&A paralegal Michael F. Sullivan. Please do not hesitate to reply with thoughts and comments or post them on our blog.