A person’s job is often a contributing factor in a heart attack whether the incident happens at work or not.
Doctors agree that there is no one single cause of heart attacks. However, there are a number of recognised risk factors:
· Family history of heart disease;
· High blood cholesterol levels;
· Lack of exercise;
Rarely does a single heart attack have a single cause. Multiple contributing factors play a part. The Return to Work SA (formerly WorkCover) laws on heart attacks recognise that physical and emotional stress in the workplace can directly cause a heart attack, but more commonly trigger a heart attack in a person with pre-existing coronary heart disease.
Section 7(8) of the Return to Work Act 2014 (SA) says that where:
(a) A worker’s disability consists of the aggravation, acceleration, exacerbation, deterioration or recurrence of a pre-existing coronary heart disease; and
(b) The disability arises in the course of employment;
(c) It will be presumed in the absence of proof to the contrary that the employment contributed to the disability.
Section 7(8) creates a statutory presumption that where a heart attack arises in the course of employment, the employment will be presumed to have contributed to the heart attack. The presumption tips the burden of proof on the issue of causation in favour of the worker provided that the two preconditions in s7(8)(a) and (b) are met.
It’s important to remember that not all cardiac crises involve coronary artery disease. Some people suffer from cardiac arrhythmia (abnormal heart beat) which is a problem with the heart’s electrical activity rather than the coronary arteries. Severe arrhythmia can lead to cardiac arrest without necessarily involving coronary artery disease. Where a worker suffers a cardiac crisis solely due to arrhythmia and it arises from employment, they will have to prove that work was the cause without the benefit of the s7(8) presumption.
Generally, the phrase “arises from employment” speaks for itself.
However, the Tribunal decisions in heart attack cases on whether employment has contributed are wide and varied. If the heart attack occurs at work, it’s likely to be found to have been contributed by employment, particularly if the worker was engaged in strenuous activity, an emotional outburst, or a high level of workplace stress just prior to or at the time the symptoms occur. However, a worker’s heart attack was found to have been contributed by employment in one case when he was sitting in the tea room with co-workers. While it helps if the attack occurs at work for the purposes of a claim, it can still be found to have been contributed by employment if it occurs outside of work depending on the circumstances.
In Rigney  SAWCT 5, the worker had a longstanding history of depression and other associated psychiatric illnesses. He consumed alcohol to control feelings of frustration, anger, stress and anxiety and sometimes he would use alcohol in conjunction with prescribed medications. At his lowest points, he had self harmed with a couple of drug overdoses. The worker was employed at CDEP.
Prior to his fatal heart attack he already had an accepted WorkCover claim for depression. The Workers Compensation Tribunal found that significant stress at work led to heavy drinking in conjunction with prescribed medication to deal with his feelings of stress. On the day of his death, the worker was binge drinking. The toxic levels of drug and alcohol led to cardiac arrhythmia and then cardiac arrest. The Tribunal found that the worker’s heart attack was caused by his drinking as a sequel to his depression. The presumption in s7(8) was not even needed, even though the worker died at home.
Here are a couple of other examples of decisions where the worker’s claim was successful:
Kafka  SAWCT 46, the Tribunal found that the financial stress that the worker (company director) suffered due to bills not being paid by customers, and in particular a confrontation between the worker and an employee of his principal debtor on the day of his death about an unpaid bill, induced an emotional state that then contributed to the heart attack which caused his death later in the day while still at work.
Montgomerie  SAWCT77, the worker’s solicitors argued that the worker had inhaled carbon monoxide on the morning of his death which caused a significant reduction in blood oxygen saturation which in turn led to ischemia, reduced blood flow in the coronary arteries and then fatal arrhythmia. The Corporation’s lawyers argued that there was no relationship between the worker’s coronary artery disease and work. Even though the Tribunal was not persuaded that the carbon monoxide had contributed to the worker’s death, the Tribunal found that it did contribute to the worker’s death as the WorkCover Corporation had not rebuted the presumption in Section 7(8) by providing sufficient evidence that employment did not contribute to the aggravation, acceleration, deterioration and recurrence of the worker’s pre-existing coronary artery disease.
So, the lesson is that if you suffer a heart attack either at or outside work, you should consult a lawyer about submitting a claim for workers compensation even if some or all of the recognised classic contributing factors applied. If your spouse died from a heart attack and you think work contributed, you should also seek legal advice. You or your late spouse may have been a heavy smoker, over weight and unfit, and had a significant family history of heart disease, but that doesn’t necessarily mean that you don’t have a WorkCover claim.
Author: Mal Byrne
TGB is South Australia’s largest injury law firm. For a free initial interview about your compensation claim, contact Mal on (08) 8250 6668.