Heart Attack
PRO 05/2013

Effective date: December 1, 2013

Approved date: September 29, 2013

Application: All heart attack claims on or after the effective date.

Policy subject: Decision making - Injuries

Purpose:

To establish adjudication guidelines for heart attack claims.

BACKGROUND

  1. POL 05/2013, Injuries – Heart Attack, has been approved by the Workers’ Compensation Board (WCB).
  2. The following procedure provides staff with guidelines for determining heart attack claims.

PROCEDURE

  1. Operations staff will develop all heart attack claims upon notice of an injury. Development will include details of the circumstances leading up to the initial onset of symptoms and the diagnosis of a heart attack. It may also include details of any prior related condition (POL 12/2017, Pre-Existing Conditions – Aggravation or Acceleration).
  2. Sources of information may include:
    1. The worker (active lifestyle outside of work, job history and description of duties).
    2. Any witnesses.
    3. The employer (confirmation of description of duties and employment history), and
    4. Relevant medical sources.
  3. Operations staff will evaluate the 24 hour period prior to the diagnosis of a heart attack to determine:
    1. If symptom onset occurred within a few hours of the work event, and
    2. Whether the duties performed were excessive and unusual. The work duties prior to the heart attack are to be compared with the typical job demands and the worker’s active lifestyle outside of work.
  4. A determination made under Point 3 is not a medical decision.
  5. A Medical Consultant may review cases where:
    1. The diagnosis is questioned, or
    2. The claim involves complex medical issues.

Policy references

Legislative Authority

Legislative Authority    The Workers’ Compensation Act, 2013
Sections 20, 23, 28, 29
The Workers’ Compensation General Regulations, 1985
Sections 22.3
 

Document History

(1)    January 1, 2014. References updated in accordance with The Workers’ Compensation Act, 2013.
(2)    POL and PRO 12/2007, Injuries – Cardiac (effective March 1, 2006 to November 30, 2013)
(3)    POL and PRO 04/2004, Injuries – Cardiac (effective August 1, 2004 to February 28, 2006).
(4)    POL 31/72, Injuries – Cardiac (effective April 19, 1972 to July 31, 2004).
 

Complements

POL 05/2013 Injuries – Heart Attack
POL 04/2014 Fatalities, Presumption
POL 03/2020 Injuries – Firefighters
PRO 03/2020 Injuries – Firefighters
POL 04/2017 Injuries – Occupational Disease
PRO 04/2017 Injuries – Occupational Disease
POL 02/2017 Injuries – Psychological
POL 12/2017 Pre-Existing Conditions – Aggravation or Acceleration

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Two people signing documents

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