New Hampshire Injured Worker’s Death from Heroin and Oxycodone Overdose is not Compensable
The Supreme Court of New Hampshire recently affirmed a decision of the state’s Compensation Appeals Board (CAB) that denied death benefits to the widow of a worker who died of an overdose of both oxycodone and heroin — he had been prescribed oxycodone for chronic pain following a workplace injury [Appeal of Estate of Quinn, 2019 N.H. LEXIS 171 (Aug. 20, 2019)]. Quoting Larson’s Workers’ Compensation Law, § 10.01, et seq., the Court agreed that the deceased worker’s actions in taking excessive amounts of the drugs was an independent intervening cause of the worker’s death and, accordingly, no workers’ compensation benefits were payable.
Background
In July 2012, Quinn was involved in a work-related accident in which he fractured his left ankle. He underwent multiple surgeries, and, as a result, suffered from persistent and “profound” pain. He underwent various treatments for the pain, and was later diagnosed with complex regional pain syndrome. His employer’s carrier paid workers’ compensation benefits for both the injury and subsequent treatments.
Quinn was prescribed opioid medications to manage his pain, and he became dependent on them. In 2015, Quinn’s doctor attempted to wean him off of the opioid medications, but Quinn experienced increased pain, attempted suicide, and was hospitalized for further suicidal ideation. Later that year, however, Quinn attended an in-patient program where he was successfully weaned off of the opioid medications. The carrier paid workers’ compensation benefits for the in-patient program. Afterward, Quinn did not use opioid medications for a period of months; however, in September 2015, Quinn was again prescribed oxycodone for his pain.
On January 23, 2016, Quinn’s wife found Quinn’s body on the floor of their second home. Near his body were a bowl of crushed pills, an approximately half full wine bottle of wine, drug paraphernalia, and an oxycodone pill bottle, dated 12 days prior to his death, with 70 pills gone. The medical examiner concluded that the cause of Quinn’s death was “acute intoxication by the combined effects of heroin and oxycodone” as a result of “acute substance abuse.” Quinn had ingested heroin and oxycodone — each in a dose likely sufficient, on its own, to have caused his death.
Serious and Willful Misconduct
A Department of Labor hearing officer denied the Estate’s claim for benefits. The CAB affirmed, finding that pursuant to N.H. Rev. Stat. Ann. § 281-A:14, the employer was not liable for the death because the consumption of the amount of oxycodone at the time of death was inconsistent with Quinn’s prescribed dosage, and that heroin was not part of Quinn’s prescribed medical treatment. The CAB determined that Quinn’s intentional ingestion of significant overdoses of both heroin and oxycodone simultaneously constituted serious and willful misconduct and were an independent, intervening cause breaking the chain of causation.
Supreme Court’s Opinion
The Estate contended that Quinn’s work-related injury lead to his addiction or substance abuse and, ultimately, to his death and that accordingly the death was compensable. The employer and carrier countered that the CAB properly denied benefits because Quinn’s intentional conduct was an independent intervening cause that broke the causal chain between the original injury and his death.
The Court agreed with the employer and carrier. Quoting Larson, the Court indicated Quinn’s ingestion of the excessive amounts of the drugs amounted to a second, independent cause of his death. The Court observed that the CAB had found that even if one accepted that Quinn was addicted to legally prescribed oxycodone as a direct result of his work-related injury, his intentional ingestion of significant overdoses of both heroin and oxycodone simultaneously constituted serious and willful misconduct. Quinn’s widow bore the burden of proof as too causation. There was sufficient support for the CAB’s decision and the Court, therefore, affirmed.