Cardiovascular Injuries: A Heightened Standard

by | Mar 14, 2014

Nebraska has a special set of rules for cases in which an employee suffers a cardiovascular injury, such as heart attack or stroke. An employee must prove that both the legal and medical cause of his condition was his employment. Smith v. Fremont Contract Carriers, 218 Neb. 652, 358 N.W.2d 211 (1984); Leitz v. Roberts Dairy, 237 Neb. 235, 465 N.W.2d 601 (1991).

The legal test requires the employee prove he suffered some work-related stress or exertion which is greater than that in the ordinary non-employment life of the employee or any other person. The medical test requires the employee show by a preponderance of the evidence, through expert medical testimony, that the employee’s employment contributed in some material and substantial degree to cause the employee’s injury.

The Nebraska Court of Appeals recently reanalyzed the cardiovascular injury issue in Bolles v. Midwest Sheet Metal Co., 21 Neb. App. 822, __ N.W.2d __ (2014). Bolles, who had a history of cardiac health issues, was working to remove an air-conditioning unit outside on a very hot day. He suffered a heart attack and died. Evidence showed that 15 minutes to an hour prior to the heart attack, Bolles took a 30 minute drive in an air-conditioned truck. Bolles also took a few breaks to stand in the shade and drink water. Furthermore, the evidence showed that he was not an “active person” outside of work, was non-compliant with medications, had high blood pressure and cholesterol, and smoked. The compensation court found that Bolles’ widow met her burden of proof with regard to both factual and legal causation.

On appeal, the Court of Appeals noted that the Nebraska Supreme Court has adopted the following test for legal causation regarding a preexisting cardiovascular disease or condition: “an exertion- or stress-caused heart injury to which the claimant’s preexisting heart disease or condition contributes is compensable only if the claimant shows that the exertion or stress encountered during employment is greater than that experienced during the ordinary non-employment life of the employee or any other person.” Finding that the exertion Bolles was under at the time of his heart attack was greater than that experienced during the ordinary non-employment life of any other person, the Court affirmed the compensation court’s decision.

For more information regarding work-related cardiovascular injuries, contact Sara Hughes at or (402) 475-1075.