New York Painter Fails to Establish Causal Relation Between Employment and Myocardial Infarction

Stressing that the state's Workers' Compensation Board had broad discretion in weighing medical evidence as to causation, a New York appellate court affirmed a decision by the Board denying workers' compensation benefits to a painter who suffered a myocardial infarction and who shortly thereafter underwent a stent procedure [Matter of Rossi v. Albert Pearlman Inc., 2020 N.Y. App. Div. LEXIS 6629 (3d Dept. Nov. 12, 2020)]. Observing that the claimant's medical expert had been quite equivocal in his medical opinion, opining that it was "possible" that claimant's work activities "might" have contributed to his myocardial infarction, the appellate court said the Board was within its powers when it credited a contradictory medical opinion offered by the employer's medical expert.

Background

Claimant, who worked as a painter, filed a claim for workers' compensation benefits as the result of a myocardial infarction that he sustained on May 27, 2016. Claimant sought medical treatment at the hospital that same evening and remained in the hospital for a few days, during which time he underwent a stent procedure. He did not return to his job thereafter.

The employer and its carrier controverted the claim, asserting in relevant part that the infarction was not causally related to claimant's work. A WCLJ thereafter issued decisions establishing the claim for work-related myocardial infarction and awarding compensation. The Board ruled, inter alia, that claimant had failed to establish that his myocardial infarction was causally related to his work activities and disallowed the claim. Claimant's application for reconsideration and/or full Board review was denied.

On further appeal, the appellate court reviewed claimant's testimony, noting that he testified that on the day of the myocardial infarction, he was working in a basement that was not air conditioned or well ventilated, carrying around heavy objects and repeatedly climbing up and down a ladder. He experienced chest pain that came and went throughout the day and worsened after he completed his work and went home, at which point his wife took him to the hospital. Claimant stated that he did not notify the employer of his chest pain during the work day, and his supervisor testified that he was not aware of claimant's affliction until after claimant was hospitalized and could not report to work as scheduled.

Employer's Medical Expert Said No Causation

The court noted that conflicting medical evidence had been presented on the issue of causation. A cardiologist reviewed claimant's medical records and conducted an independent medical examination of claimant on behalf of the carrier. This expert opined that claimant's myocardial infarction was not causally related to his work. He based his opinion on the fact that claimant was performing his usual work activities at the time that he was stricken and had previously experienced symptoms of chest discomfort that were suggestive of a blockage of the coronary artery. The blockage was confirmed during a cardiac catherization at the hospital, and the cardiologist also pointed out that claimant reported, upon his admission to the hospital, that he experienced chest pain while eating a hotdog, not while he was performing his work activities. The physician accordingly rejected the proposition that claimant's work activities were responsible for claimant's myocardial infarction and instead attributed it to claimant's underlying coronary artery disease.

Claimant's Expert Disagreed

Claimant's expert was an internist who began treating claimant for atrial fibrillation in 2014. He indicated claimant had hypertension, hypercholesterolemia and a history of smoking and came to him in March 2016 after experiencing nonexertional chest discomfort. He stated that claimant underwent a stress test, which was normal, and that he thought claimant's symptoms were gastrointestinal in origin. The expert visited claimant in the hospital, during which time the expert indicated claimant related that he was performing heavy work in a hot basement when he experienced chest pain and shortness of breath. Based upon claimant's description, this medical expert opined that it was "possible" that claimant's work activities "might" have contributed to his myocardial infarction. He acknowledged, however, that claimant may have already developed a heart blockage in March 2016 that was not diagnosed.

Board Was Free to Credit Opinion of Employer's Expert

The court stressed that given the equivocal opinion on causation offered by claimant's medical expert, the Board was free to credit the opinion of the employer's expert and conclude that there was no causal relationship between claimant's myocardial infarction and his work activities. Substantial evidence supported the Board's decision and the court would not disturb it.