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Proximate Cause – Does A Bear Smoke Pot In The Woods?

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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.

Picture Of Drugs Proximate Cause In Bottle
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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.

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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