If a worker dies while on the job, and the actual cause of death is unknown, does the employer have to pay workers’ compensation benefits? In North Carolina, the answer is yes.
In a Sept. 20, 2022, decision, the North Carolina Court of Appeals found that an employer must pay workers’ compensation benefits to a deceased worker’s estate “where the circumstances bearing on work-relatedness are unknown and the death occurs within the course of employment.”
Died in crash, cause of death = heart disease
On July 18, 2017, Toney Frye, a truck driver for Hamrock LLC, was driving a dump truck filled with asphalt on a stretch of highway that was steeply graded, curvy and notorious for crashes. The dump truck crossed the double yellow lines and collided head-on with another vehicle before crashing into an embankment and coming to a rest on its side.
Multiple witnesses saw Frye driving the truck prior to the crash. They reported Frye was driving at an unsafe speed. One witness said she saw Frye with a cigarette in his left hand and his left arm resting on the truck’s window as heavy smoke billowed from the rear axles of the truck. He appeared conscious, calm and didn’t seem to be slumped over the steering wheel.
Frye and the front-seat passenger of the oncoming vehicle were declared dead at the scene. The immediate cause of Frye’s death was listed as “multi-system trauma” and “motor vehicle collision.” An autopsy conducted at the request of the employer revealed the actual cause of death was ischemic heart disease secondary to coronary heart disease.
The Pickrell presumption
On October 9, 2017, Hamrock filed a Denial of Workers’ Compensation Claim, stating the reason as, “No injury by accident during the normal course and scope of employment. The employee’s cause of death
was related to an idiopathic health condition and not related to any trauma or work incident.”
Frye’s estate requested a hearing about the workers’ compensation claim on Aug. 24, 2018. The hearing was conducted by a North Carolina Industrial Commission Deputy Commissioner who agreed with Hamrock and denied the claim.
The estate took the matter to the full North Carolina Industrial Commission, that ruled in November 2021 that the estate was entitled to the Pickrell presumption, which states that “where the circumstances bearing on work-relatedness are unknown and the death occurs within the course of employment, claimants should be able to rely on a presumption that death was work-related, and therefore compensable, whether the medical reason for death is known or unknown.”
The commission also found that Hamrock failed to provide sufficient evidence to rebut that presumption.
Frye’s estate was awarded 500 weeks of death benefits, burial and funeral costs, and payment of all medical bills that were incurred as a result of Frye’s death.
‘Circumstances bearing on work-relatedness’ are what matter
On appeal with the North Carolina Court of Appeals, Hamrock argued that the commission erred by concluding that the Pickrell presumption applied in this case.
Hamrock asserted that for the Pickrell presumption to apply, Frye needed to have been “found dead,” but the appeals court pointed out that this argument applied the presumption too narrowly.
In Pickrell v. Motor Convoy Inc., the North Carolina Supreme Court “reasoned that a presumption of compensability would be appropriate in these cases” since “employers may be in a better position than the deceased’s family to offer evidence on the circumstances of the death.” Typically, employees are the last to see the deceased alive and the first to discover the body.
Hamrock relied on this language to support its argument that the Pickrell presumption shouldn’t apply since Frye wasn’t found dead by co-workers. The employer argued this was evidence proving the commission erred by expanding the scope of the presumption beyond what the state Supreme Court intended.
But the appeals court found that being found dead isn’t, in and of itself, a necessary condition for application of Pickrell. Instead, it’s the circumstances bearing on the work-relatedness that are critical in this situation, so the appeals court overruled the argument and upheld the commission’s decision.