Could Mental Health Worker get Benefits for A-fib by Linking it to COVID-19?

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Booneville, AK (WorkersCompensation.com) – In Arkansas, medical conditions that are a natural consequence of a compensable workplace injury may entitle an employee to additional benefits. As one case illustrates, when defending against such cases, the best time to present medical expert testimony and other medical evidence is generally during the worker’s compensation commission’s review of the case. 

As a case involving an employee who contracted COVID-19 at work, and later developed atrial fibrillation, by the time an employer appeals a decision in court, it may be too late, even when it's questionable whether the primary injury and new medical condition are really related.

The employee, who worked in a youth mental health facility was obese and had a family history of heart disease when he contracted COVID-19. He spent months in the hospital, including intensive care, having contracted a particularly severe case.

After several weeks in a rehabilitation facility, he went home and began to experience symptoms of atrial fibrillation. He received workers’ compensation benefits for COVID-19.

The workers’ compensation commission then awarded him benefits for the A-fib. In doing so, it relied on a report of one doctor and testimony of a second doctor who noted that the employee had suffered a very severe case of COVID-19 followed by a deterioration of his general health, and that he had been diagnosed with A-fib. It also relied on the employee’s statement that he had not suffered A-fib prior to having COVID.

A third doctor, a cardiologist, indicated that he could not state with certainty whether the employee’s COVID caused his A-fib.

The employer appealed, arguing that the commission made the wrong decision because it interpreted the medical records improperly.

The court explained that when the primary injury is shown to have arisen out of and in the course of employment, the employer is responsible for any natural consequence that flows from that injury. The test is whether there is a causal connection between the injury and the consequences of the injury.

Was the employee’s atrial fibrillation compensable?

A. Yes. The commission determined that the medical evidence and the employee’s testimony were sufficient to show the A-fib was caused by COVID-19.

B. No. Neither of the doctors explicitly stated that the two conditions were causally connected.

If you selected A, you agreed with the court in Booneville Human Dev. Ctr. v. Foster., No. CV-23-750 (Ark. Ct. App. 12/07/24), which declined to overturn the commission’s decision.

First, the court rejected the employer’s argument that the employee had to show COVID was a “major cause” of his heart issue. That requirement, the court noted, applies to cardiovascular accidents, and was not relevant in this case.

The employer, the court stated, essentially argued that the commission, on reviewing the medical records and testimony, drew the wrong conclusion because that information never explicitly linked the employee’s COVID to his A-fib. Instead, the doctors merely listed the diagnosis and indicated that the employee had severe COVID followed by a deterioration of his health. The commission also overlooked the employee’s obesity and family history of heart disease, which could have caused his A-fib, according to the employer.

The court emphasized that the commission has authority to weigh medical evidence and determine the credibility of witnesses.

“Here, the Commission relied on [the employee’s] testimony that he had not been diagnosed with atrial fibrillation before his COVID-19 illness along with the medical records showing that [the employee] had a complicated course of COVID-19 that resulted in a deterioration of his health and included a diagnosis of atrial fibrillation,” the court wrote.

The court noted that the issue was not whether it would reach the same decision as the commission but whether reasonable minds could reach the same result.

Substantial evidence supported the commission’s ruling that A-fib was a natural consequence of the employee’s COVID-19.

The court affirmed the commission's finding that the A-fib was compensable.

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