A heart attack is one of the most serious medical events a worker can suffer—and one of the most difficult to prove as work-related under California’s workers’ compensation system. Despite being life-threatening, heart attack claims are frequently denied by insurance carriers that attribute them to personal risk factors, not the job.
At Employees First Labor Law, we understand how stress, exertion, heat exposure, and extreme working conditions can directly contribute to cardiac events. This blog will walk you through when a heart attack may qualify for workers’ compensation, how California law treats these claims, and what to do if your case is denied.
Can a Heart Attack Be a Compensable Injury Under Workers’ Comp?
Yes. Under California Labor Code §§ 3200 et seq., a heart attack may be covered if the injured worker can show that the event “arose out of and occurred in the course of employment” (AOE/COE). This means:
- The employment contributed to or exacerbated a cardiac condition
- The heart attack happened at work or was triggered by work activities
- The worker was engaged in job duties or exposed to work conditions that led to the event
Unlike a fall or machinery accident, heart attacks are often internal and cumulative injuries, making them more complex to prove. Workers must usually demonstrate industrial causation using medical and circumstantial evidence.
Common Work-Related Causes of Heart Attacks
Many California jobs expose workers to conditions that increase cardiovascular risk. Common factors that contribute to compensable heart attacks include:
- Extreme physical exertion (lifting, loading, standing for hours)
- High-stress work environments (e.g., emergency rooms, law enforcement)
- Overtime and long shifts with no adequate rest or breaks
- Exposure to heat or cold, especially in construction, agriculture, or delivery roles
- Inadequate hydration or rest
- Cumulative psychological stress, often seen in healthcare, caregiving, and warehouse jobs
Even where pre-existing conditions are involved, California law recognizes that an industrial injury can “light up” or aggravate an underlying condition and still be compensable.
Legal Standard: Substantial Contributing Cause
In workers’ comp, the burden of proof is on the injured worker to show that the employment was a substantial contributing cause of the heart attack. It does not need to be the only cause. A Qualified Medical Evaluator (QME) or Agreed Medical Evaluator (AME) can provide an expert opinion on whether job duties substantially contributed to the event.
An insurer may point to risk factors like:
- High blood pressure
- Obesity
- Smoking history
- Genetic predisposition
However, if work conditions accelerated, aggravated, or triggered the heart attack, the claim may still be valid. These cases often hinge on detailed medical records, expert opinions, and job duty analyses.
Who Has a Presumption of Heart Condition Coverage?
Under California Labor Code § 3212, certain first responders—including firefighters, peace officers, and other public safety employees—are entitled to a rebuttable presumption that heart conditions are work-related. This legal presumption dramatically shifts the burden of proof to the employer.
For non-public safety workers, the standard rules apply: industrial causation must be proven with evidence.
Common Employer and Insurance Tactics to Deny These Claims
- Blaming lifestyle or genetics instead of the job
- Arguing the event happened off-site or “off the clock”
- Claiming there was no single incident (disregarding cumulative trauma)
- Downplaying job stress or exertion (especially if the worker was in a managerial or sedentary role)
- Delaying or denying medical care authorization to undermine the case
At EFLL, we’ve seen how heart attack victims are often treated unfairly, particularly when they cannot immediately return to work or are hospitalized without giving formal notice to HR. These should never be reasons to deny valid benefits.
Benefits Available for a Work-Related Heart Attack
If the heart attack is accepted as industrial, you may qualify for:
- Temporary disability (TD): Wage replacement while you recover
- Medical treatment: Including hospitalization, surgery, cardiology, rehab
- Permanent disability (PD): For lasting impairment or limitations
- Supplemental job displacement benefits: If you can’t return to your usual work
- Death benefits: For surviving dependents in fatal cases
These benefits are essential, especially given the financial toll of cardiac events. California law provides that all necessary and reasonable medical treatment must be covered without co-pays or deductibles.
What If Your Claim Was Denied?
Don’t give up. Denials are common in heart attack claims, but they are often overturned with skilled legal representation. If your claim was denied:
- Request a panel QME through the DWC Medical Unit
- File for an expedited hearing if TD benefits or treatment were denied
- Hire a workers’ compensation attorney to subpoena job records, get expert opinions, and cross-examine insurer doctors
At EFLL, we regularly overturn denials, force medical authorizations, and win permanent disability awards in cardiovascular injury cases. We work on contingency, meaning you pay nothing unless we win.
Protect Yourself After a Work-Related Heart Attack
If you believe your cardiac condition is work-related, take these steps:
✅ Notify your employer in writing as soon as possible
✅ Get medical attention and report all symptoms accurately
✅ Document stress, hours, and physical duties
✅ Call a workers’ comp attorney to preserve your rights
Delays in notice or treatment can hurt your claim—but that doesn’t make it invalid. Our team can still help you build a case even after emergency hospitalization.
Call EFLL: We Fight for the Injured, Not the Insurers
Heart attacks devastate workers and families—physically, emotionally, and financially. If you or someone you love suffered a cardiac event that may be job-related, don’t let the insurance company blame your genetics or habits.
At Employees First Labor Law, we know how to fight back. We’ll gather the records, consult with cardiologists, and pursue every dollar in benefits you’re owed under California law.
📞 Call us for a free case review. You don’t pay unless we win. Your health and livelihood matter—and we’ll stand with you every step of the way.
