Q: Is an employer obligated to provide a claim form when an employee has a heart attack at work particularly when the employee does not sustain any secondary injury?
A: The real question here is “Does the employer have knowledge from any source that the heart attack was/is potentially industrial?” (Labor Code §5401-5402). I recommend sending out the DWC-1 as well as all Reynolds notice(s). Here’s why: the heart attack happened at work. This is a strong fact supporting “knowledge” that it may potentially be work-related. Remember two prongs make it compensable: it arose out of and during the course of employment (Labor Code §3600). It would be a tough case to prove unless doctors make the link. However, if the employer fails to provide a claim form or is construed to have knowledge sufficient to trigger the necessity to provide one, an argument can be made that the employer had “constructive” knowledge of a potential injury, triggering a 90 day presumption that the injury arose out of and during the course of employment (Labor Code §5402). It is my opinion that employers’ best interests are served by providing the claim form as well as Reynolds notice. It is just as important that any carrier or third-party administrator be informed immediately. This will preserve the defenses in the case and protect against any automatic compensability presumptions. The potential exposure is just too high to gamble on withholding a claim form given the fact that the heart attack appears to have arisen “during the course of employment” to the extent that knowledge can be attributed to the employer of the incident if not the medical/factual cause.
For additional information on this issue, please contact Brian Duncan at firstname.lastname@example.org.