Supreme Court rules firefighter’s heart condition claim is compensable

The Oregon Supreme Court in August reinstated a Workers' Compensation Board order finding a firefighter's claim for a heart condition (a heart attack caused by arteriosclerosis) compensable.

In SAIF v. Roger J. Thompson, the board had not been persuaded by a medical opinion that the firefighter's heart attack was not caused by his work, because the expert conceded that medical science does not currently know the ultimate cause of arteriosclerosis. The court held that the board's rejection of that medical opinion was not based on a legal requirement that the employer prove an alternative a cause for the condition, but was simply a factual finding that the opinion was not persuasive.

The firefighter's presumption statute requires the worker to prove certain "predicate facts," after which the presumption of compensability applies and the full burden of proof shifts to the insurer. In this case, it was not disputed that Thompson had proved the predicate facts for application of the presumption, and thus that the presumption applied.

The court emphasized that the insurer must prove that the cause of a firefighter's condition is "unrelated" to the firefighter's employment, not just that the employment was not "the major contributing cause" of the condition.

As for the specifics of the Thompson case, the Supreme Court interpreted the board's order simply to have said that the insurer's medical evidence was not persuasive and thus was insufficient to carry its burden of overcoming the presumption by clear and convincing evidence. The board reasonably rejected the opinion as internally inconsistent and otherwise unpersuasive, and did not require proof of an alternative cause for the firefighter's heart attack, the court said.

The court declined to decide the issue of whether an insurer can carry its burden of proving that a firefighter's disease is "unrelated" to the firefighter's employment by medical evidence to the effect that a condition subject to the firefighter's presumption is never caused by firefighting. However, the court seemed to suggest that it would find that the legislature's express determination that certain conditions are presumed to be caused by firefighting cannot be refuted by contrary medical evidence in an individual case.