5th Circuit affirms LHWCA benefits for stroke at work

by Matthew H. Ammerman on March 8th, 2012

Archie Crawford fell while getting out of a helicopter onto an offshore oil platform on March 12, 2008. Crawford's knee buckled, and he fell down two stairs. The next morning his left foot and three fingers on his left hand felt numb. Crawford asked to go see a doctor. He claimed that request was denied by his supervisor. By March 14, 2008, he was experiencing numbness in his upper body and said he continued to ask to see a physician landside. Five days after his incident, he was taken by helicopter to Lafayette General Medical Center where physicians diagnosed him with a stroke. Island Operating Co. v. Dir., Office Worker's Comp. Programs, 2012 U.S. App. LEXIS 3037 (5th Cir. Feb. 16, 2012)(unpublished).

Crawford’s employer and its LHWCA carrier, Louisiana Workers' Compensation Corporation (LWCC), argued Crawford’s stroke was a preexisting condition that was unaffected by his work. Crawford had pre-existing conditions that could have caused or contributed to his stroke: coronary artery disease, diabetes, cardiomyopathy, hyperlipidemia, tobacco use and high blood pressure. Crawford v. Island Oper’g Co., et al., BRB No. 10-0688 (July 8, 2011).

The Section 20 presumption determined this case. Administrative Law Judge Rosenow found that the stroke was unrelated to his work. However, Judge Rosenow found that Crawford invoked the Section 20 presumption of compensability because his stroke was aggravated by the delay in his receipt of treatment because Crawford was unable to leave employer’s platform. The aggravation rule requires an employer "to compensate an employee for the full extent of the employee's disability, including any preexisting disability that the work-related injury worsens." Strachan Shipping Co. v. Nash, 782 F.2d 513, 515 (5th Cir. 1986). Judge Rosenow found LWCC offered no evidence to rebut the presumption of an aggravation, and, therefore, the stroke was compensable.

LWCC’s argument on appeal was that Section 20 presumption should not have been invoked -- delay did not make Crawford’s stroke worse because the damage was already done. Dr. Wael Karim, a neurologist who treated Crawford, testified that Crawford’s stroke would cause permanent and irreversible damage, except in some cases where blood thinner is administered within three hours of the stroke's onset. However, the Fifth Circuit said that Dr. Karim also testified that a stroke victim should receive treatment as soon as possible to possibly reverse some of the damage caused by the stroke. Also, post-stroke treatment includes controlling a patient's blood pressure, diabetes, and stopping the patient from smoking to try to avoid further damage.

Judge Rosenow found Crawford’s stroke was progressed in part by delay. The Fifth Circuit affirmed the award of LHWCA benefits because LWCC failed to rebut the presumption of compensability. The appeals court said Crawford’s case was not like Charpentier's heart attack – an earlier case decided by the Fifth Circuit. The medical evidence in that case showed that Charpentier’s heart attack would have escalated to a fatal cardiac arrest no matter where he was at that time, with the possible exception of the hospital." Ortco Contractors, Inc. v. Charpentier, 332 F.3d 283, 291 (5th Cir. 2003). That same medical evidence was not present in Crawford’s case to rebut the presumption.

Island Operating Co. v. Dir., Office Worker's Comp. Programs, 2012 U.S. App. LEXIS 3037 (5th Cir. Feb. 16, 2012)(unpublished).

Posted in LHWCA: Presumption, LHWCA: Intervening Cause    Tagged with Aggravation Rule, Longshore, Stroke, Section 20 Presumption



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