The widow of an injured worker who died of an overdose from opioids can’t receive workers compensation death benefits because his death was caused by conduct unrelated to his work accident, the Tennessee Supreme Court ruled Monday.

Charles Kilburn worked as a trim carpenter for employer Ryan Brown when he was involved in a motor vehicle accident in 2008 that caused fractures to vertebrae in his neck and disc herniations in his lower back. Mr. Kilburn underwent surgery to repair his injuries, but he continued to experience back pain and difficulty walking, according to court documents.

Mr. Kilburn’s doctor recommended further surgery, but his insurance company denied the surgery following a peer review by three physicians. A recommendation for epidural steroid injections was also denied. Mr. Kilburn was referred to a pain management clinic and restricted from returning to work, court records show.

In January 2010, a pain management specialist noted that Mr. Kilburn had begun taking extra opioid tablets because he felt the medication was no longer effective. He also told the doctor that he consumed alcohol while taking the medication. The pain management doctor recommended a program designed to wean Mr. Kilburn from the opioid medication, and Mr. Kilburn agreed to the plan, according to court documents.

Later that month, Mr. Kilburn’s wife found him unresponsive in bed. The medical examiner ruled his death an accident caused by acute oxycodone toxicity with contributory causes of hypertension and alcohol and tobacco use, court records show.

A Tennessee chancery court determined that Mr. Kilburn’s death was compensable in a claim filed by Mr. Kilburn’s wife, saying she had met her burden of proof to show that his death was a direct and natural consequence of his work injury. An appeal by Mr. Kilburn’s employer, which claimed Mr. Kilburn’s conduct created an intervening cause of death, was referred to a Special Workers’ Compensation Appeals Panel and later transferred to the high court for review.

A five-judge panel of the Tennessee Supreme Court reversed the decision of the chancery court in Judy Kilburn vs. Granite State Insurance Company, et al., relying on Tennessee case law that says a worker’s conduct can limit compensability of subsequent injuries that are a direct and natural result of a compensable primary injury.

“We conclude that … Mr. Kilburn failed to take his pain medicine in accordance with his physician’s instructions, which ultimately caused his demise,” the ruling said. “His death was no longer causally related to his work-related injury, and his overdose was an independent intervening cause.”