Heart-Lung Presumption Applies To Diseases With No Known Cause

Since 1990, Scott Crane has worked as a firefighter for Snohomish County, Washington Fire District #1. On December 12, 2007, Crane awoke with chest pain. When the pain did not subside, Crane and his wife decided he should go to the emergency room. Doctors diagnosed him with bilateral pulmonary emboli. A pulmonary embolism is a blood clot that obstructs arteries in the lungs. Crane spent two days in the hospital. After returning home, his breathing worsened, and he spent another two weeks in the hospital.

During his stay at the hospital, doctors determined Crane had developed pulmonary infarction, a complication of a pulmonary embolism in which the blood clots cause part of the surrounding lung tissue to die. Crane suffered further complications in the form of hemothorax, where his blood vessels bled into the pleural cavity between the chest wall and lung.

Crane eventually returned to work, and filed a workers’ compensation claim. The Washington Department of Labor and Industries rejected the claim, taking the position that Crane could not show that his condition was related to his work.

Under Washington’s “Heart-Lung” law, there is a prima facie presumption that respiratory disease in firefighters is an occupational disease. This presumption of occupational disease may be rebutted by a preponderance of the evidence. Such evidence may include, but is not limited to, use of tobacco products, physical fitness and weight, lifestyle, hereditary factors, and exposure from other employment or non-employment activities.

The Washington Court of Appeals found that the Department failed to rebut the presumption of causation, and found that Crane should be entitled to workers’ compensation benefits. The Court pointed to an examining physician’s testimony that the physician “had no theory about what caused the disease. Because the doctor could not determine what caused the pulmonary emboli, and because there can be more than one proximate cause of a covered condition, the Department’s evidence is not sufficient to rebut the presumption that Crane’s disease arose naturally and proximately out of his employment as a firefighter. To hold otherwise would mean the doctor’s inability to rule out firefighting as a possible cause of Crane’s disease nevertheless demonstrated by a preponderance of the evidence that Crane’s disease did not arise naturally or proximately from firefighting.”

Crane v. Washington State Department of Labor and Industries, 2013 WL 5561250 (Wash. App. 2013).