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

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]

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