Drugs vs. Proximate Cause
The proximate cause of an accident may not always be that obvious in a WC claim.
One area that Workers Comp insurance companies and self insureds spend a large amount of money to deny and defend claims is when an injured employee is deemed to have alcohol or drugs in their system. Many employers, TPA, and insurance carriers have a rude awakening when the employee is awarded benefits by their respective Workers Comp Commission.
I do not agree with the premise, but this happens often. Before a denial is issued the carrier, employer or TPA, the question has to be asked – Was the drug or alcohol in the employee’s system the proximate cause of the incident?
One of my first denials that was lost at an Industrial Commission hearing when an employee that was stoned on pot and fell through an open skylight into a bathtub. The file was denied and defended. The Deputy Commissioner awarded benefits as the PROXIMATE CAUSE of the accident was not due to the marijuana intoxication of the employee.
OK, back to the title of this post. Recently, in Montana, a worker at a tourist attraction was mauled by a grizzly bear while on the job. The worker had smoked pot just before beginning work. The worker had to enter a bear cage and was mauled by the bear.
The employer had denied the incident saying the employee was a volunteer and the fact that he smoked pot caused the accident. The Workers Compensation judge did not see it that way and awarded benefits. The judge also concluded that the proximate cause was not the worker having smoked pot.
Great article James.