Tennessee Appellate Court Finds Conflict Between City’s On-the-Job-Injury Policy and State Statute Setting Forth Presumption in Firefighter Death Cases

Most workers in Tennessee are covered by workers’ compensation laws. However, some are not. For example, some public employees are not entitled to benefits under the same system that a fast food restaurant employee or factory worker would be covered.

In such cases, the employee (or, in a fatal illness or accident case, the worker’s family) may be entitled to some alternative type of benefits following an accident or sickness caused by the worker’s conditions of employment, but such a suit may be pursued more in the nature of a Tennessee personal injury or wrongful death lawsuit than a “regular” worker’s compensation case. Some governmental entities’ work injury coverage is administered through a third-party administrator who makes the initial decision in the case. This may be reviewed by an administrative law judge, a chancellor or circuit court judge, and, eventually, the appellate court.

Facts of the Case

In a recent case, the plaintiff was the widow of a city fireman who passed away in 2015. At the time of his death, the decedent had worked for the city’s fire department for some 20 years. His pre-hire physical examine revealed no signs of hypertension or other heart disease. After having completed a 24-hour workday that required him to manage calls on five separate calls, the decedent passed away within 12 hours of leaving his post. The widow sought on-the-job-injury benefits for the fireman’s death. The defendant’s third-party administrator denied the widow’s claim on the basis that no autopsy had been performed on the decedent as was required under the city’s on-the-job injury policy.

The widow filed a petition for review in the Shelby County Chancery Court. The trial court entered an order voiding the city’s on-the-job-injury policy insofar as it required an autopsy to be submitted as a prerequisite to the payment of death benefits in the case at bar. According to the chancery court, this policy was in direct conflict with Tennessee Code Annotated § 7-51-201, which provided a presumption that the death of a firefighter caused by hypertension or heart disease occurred in the line of duty and in the course of his or her employment. The trial court then remanded the case to the administrative law judge for a new hearing, giving the judge specific instructions that the autopsy provision should not influence the proceedings in any way. The city appealed.

The Court’s Decision on the Issues

On appeal, the city argued that the trial court had erred in finding that its on-the-job-injury policy requirement of an autopsy was in conflict with the presumption statute. The Tennessee Court of Appeals disagreed with this contention and affirmed the chancery court judge’s ruling. According to the reviewing tribunal, the administrative law judge should have applied the presumption statute without consideration of the city’s policy requiring an autopsy.

This did not necessarily mean that the widow would receive death benefits, as she still had to prove that the fireman had been employed by a regular fire department, that he suffered from hypertension, heart disease, or a disease of the lungs, and that, prior to his injury or death, he had been given a medical exam that had not revealed lung disease, heart disease, or hypertension. If the widow made such a showing, she was entitled to a presumption that the fireman’s death was work-related. The burden then shifted to the city to offer competent medical evidence showing that there was no substantial connection between the fireman’s job and his injury or death.

Schedule an Appointment to Speak to a Lawyer About Your East Tennessee Personal Injury Case

The Hartsoe Law Firm handles many types of wrongful death cases in Knoxville and other cities in east Tennessee. To schedule a time to come in and tell us more about your loved one’s accident, call (865) 804-1011. There is no charge for the consultation, and we can travel to your home for the appointment if you need us to.