January 30, 2015

Work Effort and Personal Risk Factors: Making Sense of Cardiovascular Claims

 In Renner v. AT&T (A-71-11) (068744), the petitioner was a telecommuting employee permitted to work from her home three (3) days a week. She worked for AT&T for 25 years. On September 24, 2007, the petitioner was working on a project through the night and into the morning. The record reflected that she sent an email to a co-worker at 12:26 a.m. and was still working in her office when her son woke up for school at 7:00 a.m. When the petitioner walked her son to the bus stop before 8:00 a.m., she grabbed her leg and stated that she felt a pain. She continued to work, but reported not feeling well to a co-worker at approximately 9:00 a.m. The petitioner completed the project at 10:30 a.m. About an hour later, the petitioner called Emergency Medical Service saying she could not breathe. She was pronounced dead on arrival at the hospital. An autopsy confirmed that the petitioner died of an embolism lodged in her pulmonary artery. Her husband then filed a dependency claim petition alleging that her death was caused by occupational exposure.

 At trial, both parties’ experts agreed that the petitioner’s cause of death was a pulmonary embolism, but disagreed as to how the embolism formed. The petitioner’s expert, Dr. Waller, testified that sitting at her desk the day before her death and the day of her death contributed to deep vein thrombosis. Dr. Waller opined that the pulmonary embolism was due to the sedentary nature of the petitioner’s job. The respondent’s expert, Dr. Kritzberg, concluded that the petitioner’s morbid obesity, birth control use, age, and an enlarged heart contributed more significantly to the petitioner’s death. He did not agree that there was any evidence of deep vein thrombosis. The Judge of Compensation found that Dr. Waller’s findings were more credible, found the death compensable, and awarded dependency benefits. The decision was affirmed by the Appellate Division.

 The New Jersey Supreme Court ultimately reversed the Judge of Compensation’s decision. In its review of N.J.S.A. 34:15-7.2, the court stated that the petitioner must demonstrate by the preponderance of evidence that the cardiovascular or cerebral vascular injury or death was caused by work effort or strain in excess of ‘the wear and tear of the claimant’s daily living outside of the claimant’s work responsibilities.” The court noted that the legislature amended the statute to prevent recovery from naturally occurring cardiac events at work.

 Upon review of the record, the court held that the petitioner failed to demonstrate that her death was as a result of a work effort or strain involving a substantial condition or event. The court found that prolonged sitting at her desk was not a substantial event. It noted that extended sitting was not compelled by the petitioner’s job. She was not confined to a space at her house and was free to take breaks or take phone calls standing up.

What It Means to You

This Supreme Court decision is important because it defines the proof necessary to establish a substantial event or condition for a cardiovascular claim. The court’s analysis focused on what is a “substantial condition.” The presumption is that cardiac events are naturally caused. If personal risk factors have contributed to the claimant’s death, then the claimant must establish that the risk factors caused by the work were greater than personal risk factors of his or her daily life. When handling a cardiovascular claim, a prudent claims professional should thoroughly investigate any personal risk factors that may have caused or contributed to the claimant’s death. As such, efforts should be made to secure all prior medical records. Also, claims professionals should be sure to secure a detailed job description upon the initiation of any cardiac claim.