You Be the Judge

Is Death From Overdose Compensable?

The court must consider whether a fatal overdose is a direct consequence of a worker's comp injury.
By: | May 12, 2017 • 3 min read

A carpenter was severely injured in a motor vehicle accident during the course of his employment. He sustained fractures to vertebrae in his neck and disc herniations in areas of his lower back.


He underwent cervical spine surgery. His authorized physician also recommended lumbar spine surgery to combat his back pain, but that request was denied.

The carpenter took oxycodone to alleviate his back pain, and his physician referred him to a pain management clinic. The pain management specialist noted that he was concerned with the carpenter’s consumption of alcohol while taking his medication.

The carpenter also admitted that because he felt his medication was no longer effective, he took two opioid tablets at once even though he had only been prescribed one tablet at a time.

The pain management specialist recommended weaning the carpenter off the opioid medication and trying other options.

The carpenter’s wife stated that he seemed depressed and said she believed that he supplemented his medication with alcohol because it helped with his pain. She said that he sometimes drank alcohol before the accident.

Weeks later, the carpenter died. The medical examiner’s report stated that the cause of death was acute oxycodone toxicity with contributory causes of hypertension, tobacco use, and alcohol use.

The carpenter’s wife sought benefits. The trial court found that the wife established that the carpenter’s death was a direct and natural consequence of his work injury and awarded her benefits. The employer appealed.

Did the trial court err in determining that the worker’s death was compensable?

  • A. No. The carpenter suffered from severe pain and anxiety that diminished his faculties to the extent that he was at risk for inadvertently overdosing on pain medication.
  • B. Yes. The carpenter’s death was not causally related to his work-related injury because his overdose was an independent intervening cause.
  • C. No. The carpenter’s alcohol use increased after his injury.

How the Court Ruled

A is incorrect. The court found that the wife failed to show that the carpenter’s death was a direct and natural consequence of his work-related injury. Nothing in the medical record showed that the carpenter suffered from anxiety or withdrawal symptoms that clouded his judgment.


C is incorrect. The court said that the carpenter did not suffer from a prior illness that was exacerbated by his work-related injury. Rather, after the accident, his drinking continued in a similar manner as prior to the accident, but he was taking pain medication in addition to the alcohol.

B is correct. In Kilburn v. Granite State Insurance Co., et al., No. M2015-01782-SC-R3-WC (Tenn. 04/10/17), the Tennessee Supreme Court held that the carpenter’s wife was not entitled to benefits because his death was not causally related to his work-related injury.

The court explained that all the medical consequences that flow from the primary injury are compensable.

The court stated that the carpenter failed to take his medication in accordance with his physician’s instructions when he took more opioid medication than prescribed and consumed alcohol while taking the pain medication. This ultimately caused his death.

Therefore, his overdose was an independent intervening cause.

Editor’s note: This feature is not intended as instructional material or to replace legal advice.

Christina Lumbreras is a Legal Editor for Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Risk Management

The Profession

Verizon’s risk manager David Cammarata loves when his team can make a real impact on the bottom line.
By: | May 2, 2017 • 4 min read

R&I: What was your first job?

I was a financial analyst with the N.J. Casino Control Commission.

R&I: How did you come to work in risk management?

I was told at a Christmas luncheon in 2003 that I was being promoted into a new job.

R&I: What is the risk management community doing right?


I think the risk management community is getting a lot better at utilizing big data and analytics to manage risk. Significant improvements have been made, but there is still much more room for improvement.

R&I: What could the risk management community be doing a better job of?

I think that the insurance and brokerage communities need to really start thinking about what this industry is going to look like in 10 years. They need to start addressing how they are going to remain relevant. I think that major disruptions to existing business models will occur and that these disruptions combined with innovation and technological advances may catch many of today’s industry leaders by surprise.

David Cammarata, assistant treasurer, risk management and insurance, Verizon Communications Inc.

R&I: What was the best location and year for the RIMS conference and why?

San Diego, any year.

R&I: What’s been the biggest change in the risk management and insurance industry since you’ve been in it?

I think the advent of cyber risk and cyber insurance. For several years it has been, and it continues to be, the main topic of discussion at industry meetings.

R&I: What emerging commercial risk most concerns you?



I think the most scary scenarios include a nuclear, biological, chemical or radiological event, a widespread global health epidemic and/or a widespread state sponsored cyber shutdown.

R&I: How much business do you do direct versus going through a broker?

We do almost all of our business through a broker.

R&I: Is the contingent commission controversy overblown?

No. It’s a conflict.

R&I: Are you optimistic about the U.S. economy or pessimistic and why?

Optimistic because hopefully President Trump’s policies (lower taxes and less regulation) will be pro-business and good for the economy.

R&I: Who is your mentor and why?

My dad, who passed away many years ago. He was very influential during the formative years of my career. He taught me how important integrity and reputation were to your brand and he had a very strong work ethic.

R&I: What have you accomplished that you are proudest of?

I would have to say raising two awesome kids. My daughter is graduating from James Madison University this year as co-valedictorian. My son is finishing his sophomore year at Rutgers and has near perfect grades. But more importantly, both of my kids have turned out to be really good people.

R&I: How many emails do you get in a day?

A lot.

“I love it when the risk management organization is able to contribute in a way that makes a real impact to the corporation’s overall objectives. On several occasions we have been able to make real contributions to the bottom line.”

R&I: What is your favorite book or movie?

“My Cousin Vinny.” That movie makes me laugh no matter how many times I watch it.

R&I: What’s the best restaurant you’ve ever eaten at?



My dad used to take me to a place called Chick & Nello’s. It was an Italian place that did not have a menu. They came to your table and told you the two or three items they were making that day. The food was out of this world.

R&I: What is your favorite drink?

Iced tea. The non-alcoholic kind.

R&I: What is the most unusual/interesting place you have ever visited?

I can think of several places but for me it would be a tie between India and Italy. India just has such a different culture and way of life and Rome has breathtaking historical sites.

R&I: What is the riskiest activity you ever engaged in?

Well, one of the best thrill rides I’ve been on was Kingda Ka at Great Adventure. It feels risky but probably isn’t all that risky. I flew in a prop plane with my brother-in-law one time … that felt kind of risky. I have also parasailed, does that count? I think it definitely has to be driving on the N.J. Turnpike day in and day out.

R&I: If the world has a modern hero, who is it and why?


What about the Fukushima 50? I don’t think I could have done what they did.

R&I: What about this work do you find the most fulfilling or rewarding?

I love it when the risk management organization is able to contribute in a way that makes a real impact to the corporation’s overall objectives. On several occasions we have been able to make real contributions to the bottom line.

R&I: What do your friends and family think you do?

I don’t think they really know. My children see me as dad; others just see me as an executive with Verizon.

Katie Siegel is a staff writer at Risk & Insurance®. She can be reached at [email protected]