WSI v. Felan, et al.
Annotate this CaseWSI appealed a judgment ordering payment of death benefits to Gloria Felan. In 2017, Fred Felan was injured when driving a loaded truck that tipped on its side. Julie Schulz of KBO Farms, Fred’s employer, arrived at the scene a short time later. Fred declined an ambulance but agreed to allow Schulz to drive him to the hospital. At the hospital Fred complained of left chest and rib pain. X-rays taken at the hospital did not reveal any fractures. The next morning, Schulz picked Fred up from the hotel. She noted Fred was falling asleep during the meal and expressed concern he should return to the hospital to get checked again. Fred declined. Fred was discovered dead in his hotel room two days after the accident. WSI accepted Fred’s claim for injuries relating to his truck accident for contusion of thorax. WSI also did not believe Fred died from his work-related injury because Fred had multiple health problems including some related to his heart and diabetes. An autopsy confirmed Fred died of congestive cardiomyopathy and arteriosclerotic heart disease. Gloria thereafter filed a claim for death benefits. WSI would deny this claim, but an ALJ reversed the agency’s denial. WSI argued the ALJ and the district court misapplied the law by failing to properly apply N.D.C.C. 65-01-02(11)(a)(3). The North Dakota Supreme Court reversed the ALJ and district court, finding the ALJ was not provided objective evidence of the claimed injury: Fred died of a cardiac arrhythmia caused by blunt force trauma to his chest cavity. However, a medical expert admitted there was no objective medical evidence that an arrhythmia occurred. Rather, the conclusion the expert reached was a result of deductive reasoning. “As our precedent indicates, objective medical evidence may be established by a physician’s medical opinion based on an examination, a patient’s medical history, and the physician’s education and experience. However, objective medical evidence may not be established solely by deductive reasoning. On this record, the ALJ erred in concluding there was objective medical evidence of a cardiac arrhythmia.”
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