California provides several workers’ benefits, including payment for medical treatment, short- and long-term disability, and death benefits. This program covers one-time injuries, as well as job-related injuries and illnesses that worsen over time. But what about heart attacks? What if you have pre-existing heart disease when an attack occurs?
If you have questions about whether you are covered by insurance benefits offered to full or part-time employees, a workers’ comp attorney could help. Let our firm assist you with your heart attack workers’ compensation claim in Santa Ana.
According to California Labor Code § 3700, all full and part-time employees are entitled to workers’ compensation insurance benefits. These benefits offer peace of mind that employees injured on the job, or those who fall ill because of their job, may have the resources to pay bills and support families until they can return to work. If they cannot resume their former careers, permanent disability and job retraining could also be an option.
Illnesses such as lung disease that is exacerbated by working in a job involving toxic chemicals seem easy to label as job-related, but heart attacks may not be so obvious. Benefits could be given if a healthy worker’s exertion or stress at work causes a heart attack. But what if the worker had a predisposition for a heart attack? A Santa Ana attorney could analyze the facts of a workers’ compensation claim and help establish if their job was the cause of the heart attack.
Case law helps define how workers’ compensation insurance treats heart attacks. Lamb v. Workmen’s Comp. Appeals Bd., 11 Cal. 3d 274 (Cal. 1974) settled some aspects of determining if a heart attack qualifies for state benefits. Employees with pre-existing cardiovascular diseases, such as hypertension, atherosclerosis, or reduced blood flow to the heart, may still be eligible to apply for workers’ benefits.
If the pre-existing condition is aggravated by stress or exertion on the job benefits may be apportioned depending on the percentage of the heart attack that was caused by work-related tension.
Even if a healthy worker would not have been affected by exertion or stress identical to that of a worker who suffers a heart attack, benefits are available to the person who suffered the heart attack. A worker whose condition could eventually lead to death without the job stress or exertion may also be eligible for benefits.
A Santa Ana attorney could help determine if an employee who suffered a heart attack on the job is eligible for workers’ compensation benefits.
When pre-existing heart disease is behind a worker’s heart attack claim, apportioning the cause of the injury may fall to a qualified medical examiner (QME) if the insurance carrier and injured worker cannot agree on how much of the incident was work-related. QMEs are an important part of your case, and in most cases, it is important that you discuss your case with a workers’ compensation attorney before you see, or select a doctor. The QME will review disputed claims and offer expert opinions about how much on-the-job stress and exertion could have contributed to the employee’s heart attack.
Either party may be eligible to ask for a QME exam and do it for multiple reasons including determining if an injury is work-related, determining periods of temporary disability and extent of permanent disability, and disputes regarding the necessity of future medical treatment. A Santa Ana attorney could help a worker who suffered a heart attack pursue a QME review that helps eligibility for workers’ compensation.
California has presumptions for public employees engaged in police or firefighting duties. If a police officer or firefighter suffers a heart attack that medical episode could be found to be 100 percent job-related, even if they have a pre-existing heart condition. A skilled workers’ compensation attorney could further explain these unique benefits for Santa Ana police officers and firefighters who suffered a heart attack on the job.
California provides generous benefits for employees who are injured on the job or develop a work-related illness. Even with pre-existing conditions such as heart disease, employees may be eligible for full or apportioned benefits, depending on their job type and how much exertion contributed to their heart attack.
One of the most challenging situations involving heart attack workers’ compensation claims in Santa Ana is allocating what percentage of the attack was caused by the job versus pre-existing heart conditions. An attorney could help you navigate the state system and determine if you are eligible for benefits. Call us today to discover your legal options.
