Construction worker awarded workers’ comp for on-the-job heart attack

A road construction worker with a stop sign. Photo: HR Law Canada/Canva

A Nova Scotia construction worker has been awarded workers’ compensation benefits after suffering a heart attack on the job.

The worker, employed as a signer/driver/flagger, suffered the heart attack on Aug. 30, 2020. In December 2020, a case manager for the Workers’ Compensation Board of Nova Scotia ruled it was a compensable incident. The employer appealed that ruling.

The appeals tribunal said the general rule is that a “causal connection must be demonstrated between the workplace and a worker’s accident or illness, applying ordinary principles of causation.”

In short, in the present appeal, the question would be: Whether the heart attack would not have occurred “but for” the Worker’s employment activities, or whether the employment activities materially contributed to the heart attack.

However, given the fact the heart attack occurred at work, it is “presumed to have arisen out of his employment, unless shown otherwise,” it said.

For it not to be considered a compensable workplace injury, it must be shown that it was more likely than not the workplace was not a “material contributing factor” to the occurrence or timing of the worker’s heart attack.

What happened that day

The worker’s version: On Aug. 3, 2020, at around 11:30 a.m., the worker said he was moving barrels and laying out the signs, bases and cones on the worksite when he begin to feel chest pain and shortness of breath.

The barrels weighed about 18 pounds, and the worker said the crew was short-staffed that day — normally there were four people on the job, but that day there were three.

The weather was hot, in the high 20s with humidity, when the heart attack happened, the worker said.

The employer’s version: The employer, though, noted the worker had a significant history of heart issues, including cardiac events that occurred without exertion. His job was categorized as a “medium” level job with maximum lifting and carrying up to 30 pounds on an occasional basis.

There were no unusual duties that day, it said, and it disputed the fact the crew was short staffed. It was always intended to be a three-person crew. It also said the weather was cooler than the worker claimed, putting the temperature in the low 20s with a humidex in the high 20s. There was no heatwave, and the weather was typical for that time of year in Nova Scotia.

The case manager’s opinion

The case manager requested a medical opinion from a board medical advisor. A Dec. 15, 2020, opinion from Dr. Richard Stern stated in part:

“It is not correct to say that his job duties ’caused’”’ the diagnosis, as given his past history and risk factors he would be at high risk of having another heart attack in any case,” said Dr. Stern. “But there is ample evidence in the literature and in standard internal medicine/cardiology practice that in somebody with high underlying risk, sudden or unaccustomed physical activity, particularly in unusually hot or cold situations, can precipitate an actual attack. Therefore I feel it is as likely as not that his job duties contributed significantly to his heart attack occurring at that time.”

That was the only medical opinion before the appeals tribunal.

The ruling

The tribunal said there was no doubt the worker was engaged in physical activity on the job when he began experiencing chest pains and shortness of breath.

“Moreover, it is accepted that, at the very least, the humidex was in the high 20s at the time of the heart attack, such that it was at least somewhat hot at the time of the occurrence of the heart attack,” it said.

It said the employer did not demonstrate, on a balance of probabilities, that the workplace activities did not make a material contribution to the occurrence or timing of the heart attack.

The appeal was denied.

For more information see 2022-51-AD (Re), 2022 CanLII 122500 (NS WCAT).


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