Highlights of Noteworthy Decisions
- Board Directives and Guidelines (cardiac conditions) (unusual physical exertion)
- Heart attack
- Heart condition
- Subsequent incidents (outside work)
The worker suffered a heart attack at work on February 6, 2002. The Board granted entitlement, finding that the worker came within the provision in Board policy for unusual physical exertion. The worker returned to work on April 8, 2002. He suffered a second heart attack at home on May 3, 2002. The worker appealed a decision of the Appeals Resolution Officer denying entitlement for the second heart attack, as well as for congestive heart failure in 2010. Board policy allows entitlement for cardiac conditions if there was unusual physical exertion with no significant delay in onset of symptoms. Entitlement in these circumstances is granted on the basis of aggravation of a pre-existing non-work-related condition. If the condition has stabilized and a permanent impairment evaluation has been conducted, entitlement will not be granted for a subsequent cardiac condition unless there is a new work-related occurrence which merits allowance under a new claim. In this case, entitlement was granted for the heart attack in February 2002, on the basis of aggravation of his pre-existing condition by physical exertion. There was no new work-related occurrence after that time. The worker's family doctor cleared the worker to return to full-time, regular work in April 2002. This was persuasive evidence that the worker's condition had stabilized. The Panel noted that the Board policy does not require that the worker be fully recovered or symptom-free in order for the provision to apply but, rather, only that the worker's condition must have stabilized. The policy states that further entitlement will not be granted for a subsequent condition if the condition has stabilized and a permanent impairment evaluation has been conducted. In this case, the worker was granted a 19% NEL award, but the evaluation was not conducted until November 2002. It would not make sense to base entitlement on the date on which a NEL evaluation is arranged. The policy should be read as precluding benefits for further cardiac problems if the condition has stabilized and the worker has reached maximum medical recovery from the acute compensable condition. The Panel concluded that the worker did not have entitlement for the second heart attack in May 2002. The worker also did not have entitlement for the congestive heart failure that became symptomatic in 2010. The problems in 2010 were the result of the natural progression of the worker's coronary artery disease which was non-compensable and which pre-dated the first heart attack. The Panel distinguished a number of Tribunal decisions referred to by the worker on the basis that, in those decisions, the worker's condition had not stabilized following the original compensable heart attack. The appeal was dismissed.