Do You Have the Heart to Sue? An Analysis of The Compensability of Heart Attack Claims in Georgia

By:  Kenny Bishop, Associate, Georgia

In Georgia, heart attacks and strokes are not generally compensable as workers’ compensation injuries; however, if the Claimant can prove “by a preponderance of competent and credible evidence” that the Claimant’s employment duties caused or contributed to the condition, he may be able to collect workers’ compensation benefits.

While the burden of proof is a preponderance of the competent and credible evidence, this burden is heightened because medical evidence is required on the issue of causation.  O.C.G.A. § 34-9-1(4) states that an “injury” shall not include heart disease, heart attack, or occlusion of any coronary blood vessel, unless it is shown by a preponderance of the evidence, which shall include medical evidence, that such conditions were attributable to the performance of the usual work of employment. Yarbrough, 248 Ga. App. 693 (2001).  This is a unique rule because there is no statutory requirement for a medical causation opinion in other workers’ compensation injuries.  In Gardner v Employers Mut. Liab. Ins. Co., 139 Ga. App. 107, it was found that a fatal heart attack did not arise out of his employment where there was no evidence of a causal connection between the specific activities or exertion at work, or the activities and exertions in general.  This means that the Claimant must provide an opinion from a medical provider that the job actually caused or contributed to the heart attack or stroke and that he was not medically predisposed.  It is not sufficient just to create an inference that the job could have caused or contributed to the heart attack whereas in other cases, a judge can find an aggravation or injury without a specific medical opinion stating thusly.  Thus, the Claimant carries this somewhat higher burden of proof for heart attack claims.

The Claimant will attempt to prove that his job required him to perform physical activities that caused risk factors often associated with individuals’ work activities that include physical exertion, mental-emotional stress,  exercise in heat, and exercise in cold that ultimately contributed to the heart attack.  To strengthen our defense to such cases, it is imperative to get all of the Claimant’s prior medical records, including records from primary care physicians.  We should gather medical evidence that shows the Claimant’s risk factors for a cardiac event including his family history, past or present tobacco use, diabetes, elevated cholesterol, high blood pressure, irregular heartbeat, obesity, excessive alcohol use, prior illicit drug use, and certain medication usage.  We should also obtain a medical opinion that shows, perhaps, that the above conditions were present and caused the Claimant’s heart attack or that the heart attack, otherwise, was not related to his work environment.  Such a medical opinion may be more important if there is limited, or perhaps even no, prior documented record of a contributory history towards the cardiac condition.

Given the large amount of exposure possible in these type of cases and the Claimant’s heightened burden of proof, it is worth your time to dig deep into discovery to determine the root cause of the Claimant’s heart condition.  Ultimately, the defense of your claim may depend on the medical evidence you can provide to your medical expert.