If a worker has added stress in a particular workday and then suffers a heart attack later on that day, is it compensable?

Robert Scherf in Wyoming had a heart attack and died after a workday where he was performing physical labor, servicing a front end loader. The day of the attack he called his wife and said the work that day had been particularly hard, there was mud caked onto the machine that made it hard to take off the panel and get it back into place. He thought he pulled some rib muscles in servicing the machine and that he felt nauseated and light-headed. He did not go into work the next day saying he did not feel good and ended up going to the hospital where he was diagnosed with Acute ST elevation myocardial infarction, and he died that night.

He was employed by Mountain Construction Company as an oiler and was able to do his typical activities without any problems. In the oiler position he was expected to maintain heavy equipment and do things like ensure they had enough fuel, change oil, grease parts, and replace air filters. He was considered an active person but was a long-time smoker with hypertension (high blood pressure), hyperlipidemia (high cholesterol) and renal insufficiency. His widow sought workers’ compensation benefits which were initially denied.

The state’s workers compensation laws say that in order for a coronary condition to be compensable there needs to be a direct causal connection between the work performed and the cardiac condition exhibited. The work that the employee did that caused the cardiac condition has to take place during work and in a work activity that was unusual or different from the work that employees in that job do, not just work that the employee in question typically does. The symptoms of the cardiac condition also must present themselves in four hours after the worker was doing the work that caused the condition in the first place.

The Office of Administrative Hearings upheld the denial of Sharen Scherf’s claim, saying that she did not prove that the exertion was abnormal for a worker hired to service heavy equipment. She was able to prove that the exertion caused his heart attack and that it occurred within four hours of doing the work.

The case made its way to the Wyoming Supreme Court and they ruled that she should be awarded benefits. They heard the expert opinion of his cardiologist Dr. Rudoff. He said that Mr. Scherf had been doing his work at 8:30 p.m. on June 16 when he felt an abrupt pain through his chest and even though he finished work was moving slowly. When he went to the hospital the following morning he was already in cardiac distress. His doctor said based on the typical timeline of this diagnosis and the symptoms the patient experienced, the myocardial infarction that he died from started when he was at work the day before. He thought there was a direct connection between the heavy work and the onset of his cardiac condition, because the work triggered a rupture of plaque in his arteries and 90 percent of acute myocardial infarctions are caused by an acute plaque rupture. The doctor compared this scenario to the “snow shoveling myocardial infarction” where an individual who seems asymptomatic suddenly overexerts themselves and suffers an acute myocardial infarction.

Since his routine task of performing maintenance on the loader had the added not routine component of the mud that he had to get off, it was an unusual situation for any worker doing that job and not just for Mr. Scherf.