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A truck driver who suffered a dangerous blood clot while at work can't receive workers compensation benefits for his condition because he didn't prove causation from a legal or medical standpoint, the Nebraska Supreme Court ruled Friday.
George Wingfield was a truck driver for 35 years and typically worked 10-hour days in a seated position, records show. He had been working one month for Omaha, Nebraska-based Hill Brothers Transportation Inc. when he developed chest pains in February 2010.
Mr. Wingfield went to his doctor and was diagnosed with deep vein thrombosis, as well as a likely pulmonary embolism, records show. He received a filter to prevent future blood clots from entering his pulmonary system, but suffered leg pain and swelling, continued blood clotting, shortness of breath and difficulty standing for long periods of time.
Mr. Wingfield continued to work for Hill Brothers, albeit with more frequent breaks, until he hurt his back in a fall from his truck in October 2010, records show. He filed for workers comp benefits based on the February blood clot accident, claiming that his truck driving caused him to develop deep vein thrombosis and a pulmonary embolism.
The Nebraska Workers' Compensation Court dismissed Mr. Wingfield's claim, noting that Mr. Wingfield had prior episodes of deep vein thrombosis in 2005 and 2009, court records show. The court found that Mr. Wingfield failed to prove his employment at Hill Brothers had caused the February 2010 incident.
Mr. Wingfield appealed, saying the workers comp court erred in finding that his injury did not arise out of the course and in the scope of his employment, records show. He also argued that the court incorrectly used a “split causation” standard for on-the-job heart attacks to determine whether his job caused his blood clot and related problems.
The Nebraska Supreme Court unanimously upheld the workers comp court decision on Friday. In its ruling, the high court noted that comp claimants who suffer heart attacks must prove both legal and medical causation to receive benefits for such conditions.
Additionally, comp claimants in such cases must show that their condition was not “merely the progression of a condition present before the employment-related incident alleged as the cause of the disability,” the ruling reads.
“Under the legal test, the claimant must establish that the proximate cause of the heart attack was work-related and thereby break any causal connection between the natural progression of a pre-existing condition or disease and the injury at the workplace. Otherwise, the fact that the heart injury occurred at work would be strictly fortuitous,” the ruling reads. “Under the medical test, 'the doctors must say whether the exertion ... in fact caused this collapse.' The medical test establishes whether the exertion contributed causally to the collapse as a matter of medical fact.”
The high court found that it was appropriate to use a similar “split causation” standard to rule in Mr. Wingfield's case, since there are similarities between heart attacks and Mr. Wingfield's condition.
“The possible causes for Wingfield's development of deep vein thrombosis and pulmonary embolism demonstrate that his injuries were akin to the generalized nature of heart attacks, making it difficult to factually attribute his injuries to the work.,” the ruling reads. “As in cases of heart attack or stroke, the compensation court was required to address complex issues of causation and to determine whether Wingfield's injuries arose from a personal or employment-related risk. We therefore find it logical that the court extended the split test of causation to Wingfield's injuries in this case.”