Insurer Not Responsible for Workers’ Comp Claim Due to Overdose Death

By | August 26, 2019

The New Hampshire Supreme Court has affirmed a decision by the New Hampshire Compensation Appeals Board (CAB) denying an estate’s request that its insurer pay workers’ compensation benefits to the estate as a result of an overdose death.

The petitioner, Linda Quinn, is a widow of William Quinn and the beneficiary of his estate. She had appealed the CAB’s initial decision denying the Estate of William Quinn’s request that the Disability Rights Center of New Hampshire (DRC) and its insurer, Liberty Mutual Insurance Company, pay workers’ comp benefits as a result of William’s death due to “acute intoxication by the combined effects of heroin and oxycodone.”

Case Background

This came about after July 19, 2012, when William was involved in a work-related accident in which he fractured his left ankle, and he suffered from persistent pain as a result of multiple surgeries. He received various treatments for the pain and was later diagnosed with complex regional pain syndrome. Liberty Mutual paid workers’ comp benefits for his injury and treatments.

On January 23, 2016, William’s body was found by his wife, Linda, on the floor of their second home. Near his body were a bowl of crushed pills, a straw, an approximately half full wine bottle, a small black case with another straw in it, two unlabeled medicine bottles and an oxycodone pill bottle – which had been filled on January 11, 2016 – with about 70 pills gone, according to the court document.

The medical examiner concluded that the cause of Quinn’s death was “acute intoxication by the combined effects of heroin and oxycodone” as a result of “acute substance abuse.”

William had ingested heroin and oxycodone, each in a dose that was most likely sufficient on its own to have caused his death, the court document stated.

Workers’ Comp Claim

As a result of William’s death, his estate filed a claim for workers’ comp benefits. Liberty Mutual denied the claim, and the estate requested a hearing at the New Hampshire Department of Labor.

In September 2017, a Department of Labor hearing officer also denied the estate’s claim for benefits. The estate appealed that decision to the CAB, which held a de novo hearing in February 2018.

In its March 30, 2018, order denying benefits, the CAB concluded the New Hampshire workers’ comp law stating “[t]he employer shall not be liable for any injury to a worker which is caused in whole or in part by the intoxication…or by the serious and willful misconduct of the worker” precluded the payment of benefits.

The CAB found that the amount of oxycodone consumed by William at the time of his death was inconsistent with his prescribed dosage, and that heroin – which is illegal under both federal and New Hampshire law – was not part of his prescribed medical treatment.

With this in mind, the CAB determined that William’s intentional ingestion of significant overdoses of both heroin and oxycodone constituted serious and willful misconduct that was not related to his work injury. It denied the estate’s motion for rehearing, and the appeal followed.

N.H. Supreme Court Decision

The estate argued that it is entitled to benefits because New Hampshire law states that if an employee’s death results from a compensable work-related injury, then the employee’s dependents receive compensation. The estate also contended that “where a work-related injury leads to addiction or substance abuse and, ultimately, to death, that death is compensable by the workers’ compensation carrier,” according to the court document.

DRC countered that the CAB properly denied benefits because Quinn’s intentional ingestion of overdoses of heroin and oxycodone in an unprescribed manner was an independent intervening factor that broke the connection between his injury and his death.

In support of its argument, DRC cited Cate v. Perkins Machine Co., stating that even if an employee has a compensable work-related injury, post-injury conduct by the employee can operate to restrict or terminate the payment of benefits.

On appeal, The New Hampshire Supreme Court agreed with DRC’s argument, affirming that the CAB’s decision to deny workers’ compensation benefits in this case is supported by the recorded evidence.

About Elizabeth Blosfield

Elizabeth Blosfield is the East region editor at Insurance Journal. More from Elizabeth Blosfield

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