Highlights of Noteworthy Decisions
- Delay (treatment)
An underground miner suffered a stroke while underground. The stroke was not work-related but the worker claimed that delay in receiving treatment, due to his underground employment, contributed to the severity of his resulting disability. The worker appealed a decision of the Appeals Resolution Officer denying entitlement. The worker testified that he suffered the stroke at 8:05 pm. The employer indicated that the stroke occurred at 8:50 pm. The worker was admitted to hospital at 11:26 pm. A CT scan was performed and the worker was assessed on the National Institute of Health (NIH) stroke scale. The worker's score was only 4. Given the low score, his young age of 51 and his improving status, it was determined that the worker was not a tissue plasminogen activator (TPA) candidate. It was also noted that the TPA window of four and one-half hours had just passed. By the morning, the worker' condition had deteriorated. There was an absence of evidence that any delay contributed to the worker's disability. The determination that the worker was not a TPA candidate was based on his low NIH score, age and improving status. It was not that the TPA window had just passed but there was no indication that this was significant in determining that the worker was not a TPA candidate. The Panel concluded that the decision not to administer a TPA had no connection to the worker's employment. The Panel also noted that the delay between the stroke and the medical treatment was will within the median delay indicated in medical literature of three to six hours between stroke and treatment in the general population. The appeal was dismissed.