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INSURANCE SERVICES
September 2018
Delivering essential employee benefit and commercial insurance information to customers and our members
INSURANCE ISSUE
When Injuries at Work Don’t Equal Workers’ Comp had occurred as a result of his employment. The insurer denied the claim and she appealed. WHY THE EMPLOYER IS NOT ON THE HOOK The court noted that the plaintiff had failed to show the two underpinnings of a workers’ comp claim: • That the death arose in the course of employment, and • That the death was related to employment. While it’s indisputable that the heart attack happened at work, the court said the evidence showed that it was not related to his work.
Not all workplace injuries or deaths are compensable and actions by supervisors can reduce your liability, as a recent court case shows.
day off if he was feeling poorly, but Kelly said he would work. Still, the supervisor gave him a light duty assignment in consideration of how he was feeling.
In the case, a heating and air conditioning technician died of a heart attack while working in an attic. His wife was denied workers’ comp death benefits by the insurance company and a workers’ comp judge on the basis that the heart attack was not related to work.
While the technician was laying a thermostat wire in the attic of the building, other workers heard moans and climbed the 15-foot ladder to investigate. They found him lying incoherent on the floor thrashing around and bleeding from his head, face and leg.
But the case could have gone the other way had the technician’s supervisor acted differently.
An ambulance transported Kelly to hospital, where he was pronounced dead. The autopsy findings revealed the presence of coronary artery disease, coronary heart disease, atherosclerotic heart disease, and ischemic heart disease.
In the case of Lisa Kelly vs. Workers’ Compensation Appeals Board in Pennsylvania, the technician, upon arriving at work, told his supervisor that he was feeling weak and tired. His supervisor told him that he could take the
The widow filed a workers’ comp claim for survivors’ benefits, claiming his heart attack
Kelly’s supervisor and other workers all said that the work the technician had been assigned was not strenuous work, like much of the other work they engage in. The doctor said that the autopsy indicated that the technician had been suffering from insufficient blood flow to the heart eight to 12 hours before coming to work, and that he was at risk for a heart attack regardless of what he had done that day. THE TAKEAWAY Workers’ comp attorneys say this case could have gone the other way had the supervisor not acted appropriately. In this case, he did the right thing by offering to send Kelly home for the day and, when the worker refused, he was instead assigned light duty. While employers are responsible for keeping their workers safe, they cannot do much about their underlying health problems.
V M A M E A N S VA L U E - A D D E D
C O N TAC T U S
For a quote on workers’ comp insurance, business insurance, or health insurance, please contact David Katz.
David Katz CA License #0712961 415-489-7614 david@vma.bz