State court rulings require workers comp paymentsPosted On: May. 20, 2012 12:00 AM CST
While some state appellate courts recently have held that workers compensation payers are accountable for worker deaths from prescription drug overdoses, cases with similar legal considerations reach back decades.
For instance, courts in several states have weighed whether deaths caused by workers consuming prescribed sleeping and pain pills were intentional suicides, said Thomas A. Robinson, an author and workers comp expert.
Arguments in such cases often have focused on whether workers' actions amounted to “a break in the chain of causation,” Mr. Robinson said.
A similar issue arose in a November 2011 case heard by a Supreme Court of Tennessee Special Workers' Compensation Appeals Panel. The case of Judy Kilburn vs. Granite State Insurance Co. et al. involved Charles Kilburn, an employee who suffered neck and back injuries in a work-related auto accident.
He died of an accidental overdose of oxycodone prescribed for managing related pain. Before his death, he had sued his employer for comp benefits and, after his death, his widow sought to amend his complaint to receive death benefits.
But the employer argued the death was not compensable because it was not the “direct and natural result of a compensable injury.”
A trial court agreed, finding that “a negligent overdose of prescription pain medications breaks the chain of causation because it is an independent, intervening cause.”
But the appellate panel ruled that insufficient evidence was presented for the trial court to deny the widow's request to amend the complaint.
A month later, the Commonwealth Court of Pennsylvania ruled in J.D. Landscaping vs. Workers Compensation Appeal Board that the daughter of a worker who died from an overdose of drugs prescribed for a work injury also is entitled to benefits.
The case involved James Heffernan, who injured his lower back in 2002 and was found unresponsive in 2007. A forensic pathologist's report stated he “died from drug intoxication due to an overdose of fentanyl prescribed for his work injury.”
Utilization review showed that a doctor's treatment provided to the claimant—including prescriptions for docusate, fentanyl, oxycodone, Fentora, Lyrica and Sonata—was neither reasonable nor necessary.
While the employer argued that Mr. Heffernan's death stemmed from an accidental overdose of prescription pain medications that were neither reasonable nor necessary, the appellate court ruled that the utilization review determination addressed only reasonableness and necessity and was irrelevant in determining whether Mr. Heffernan's death was causally related to his work injury.