NY Hair Salon Owner Fails to Show Causal Connection Between Rude Customers and Her Heart Attack

A New York appellate court, weighing conflicting medical evidence as to the causal connection, if any, between a business woman’s heart attack was causally connected to her employment, recently affirmed a finding by the state’s Workers’ Compensation Board that found the business woman’s heart attack had its origin in the woman's advanced, triple vessel, obstructive coronary artery disease, and not in two emotional encounters the woman had with separate customers a few minutes before she sustained the attack [Matter of Issayou v Issayuou Inc., 2019 N.Y. App. Div. LEXIS 5814 (July 25, 2019)]. The court added that while mental injury from work-related stress can be compensable in New York, the business owner had failed to show that her stress level was greater than that of other similarly situated workers.

Background

Claimant had owned and operated a hair salon for 17 years. She testified that on the morning she sustained her heart attack, an elderly woman came to the entrance of the salon and made a “bad” or “mean” comment to the business owner, and a few minutes later the business owner was required to deal with a “difficult” and “nasty” customer, who asked the owner about her religion and then left without paying for the service provided.

Conflicting Medical Evidence

Claimant brought forth a medical report from an internal medicine physician who acknowledged that claimant had preexisting, asymptomatic coronary artery disease, but who concluded that the two incidents that occurred at work on March 25, 2016 — which he characterized as “very emotional events” — contributed to claimant’s heart attack and cardiac problems. Although the physician conceded that claimant had 99 percent occlusion or blockage in one artery and “significant” occlusion in another artery that were not related to her work, he opined that there was a “direct relationship” between the heart attack and the incidents in the salon.

The carrier’s physician took a different view. He concluded that the cause of claimant’s cardiac condition was advanced, triple vessel, obstructive coronary artery disease. The physician found no evidence that there was any relationship between claimant’s work activity and her cardiac obstructions, psychiatric conditions or heart attack. The doctor noted claimant’s history and ongoing complaints of anxiety and depression, for which she had been medicated and treated by her primary physician, and that she had not received psychiatric care. The doctor concluded that, although stress could contribute to a heart attack, the incidents at the salon were “minimal” and did not entail “significant stress” or a “stressful event” so as to contribute to claimant's heart attack.

Presumption of Compensability

The Board concluded that the carrier had rebutted the presumption of compensability found in N.Y. Workers’ Comp. Law § 21(1), and with the presumption removed, found that claimant had failed to establish a causal connection between her employment and the heart attack. It also found that the level of stress faced by the claimant was no greater than that experienced by other similarly situated workers. Accordingly, it found she had failed to establish a compensable mental injury claim.

Appellate Court

The court stressed that the resolution of conflicting medical opinions, particularly with regard to the issue of causation, was within the exclusive province of the Board. Noting that the Board found the opinion of the carrier’s expert to be more persuasive, the court said it would accord the appropriate deference to that assessment. Accordingly, the court found that substantial evidence supported the Board’s determination that the carrier rebutted the presumption and that claimant's heart attack was not causally related to the employment.

Given the conflicting evidence, the court also found that the Board had rationally concluded that the incidents of rude or demanding clients, as described by claimant, were “relatively insignificant” and that “dealing with unpleasant customers during the course of her work day did not rise to the level of stress greater than that experienced by other similarly situated workers. The Board’s findings would not be disturbed.