Are Opioid Overdoses Covered by Workers’ Compensation?

In 2016, an estimated 2,155 opioid-related deaths occurred in Massachusetts, according to the state’s Department of Health. While the estimated number of deaths in 2017 was lower than the previous year at 1,977, the number has been on a steady increase over the last several years. In 2013, 961 people died opioid-related deaths; in 2010, it was only 560. Such tragedies have become an unfortunate part of life for many families in the area.

Many of these deaths are due to illicit forms of opioids, such as illegally produced fentanyl, heroin, and cocaine. However, prescription opioids have been the proximate cause of 20% of deaths in the past four years. In many cases, patients recovering from injuries received a prescription opioid as a painkiller and later suffered from addiction and overdose.

Not all opioid prescriptions are the result of work-related accidents, but many are. For individuals suffering from opioid overdoses connected to their work-related accidents, does workers’ compensation apply? The answer depends on the situation.

When Does Workers’ Compensation Covers Drug Overdose?

Workers’ compensation doesn’t have to cover a drug overdose accident. However, they may, if the overdose is the direct result of the prescription and not another error on the patient’s part. When determining such cases, the court will consider:

  • Proximate cause. What natural or probable cause resulted in the worker’s injury.
  • Chain of causation. Whether the injury or death connects to the original accidental injury.
  • Superseding cause. When another action breaks the chain of causation.

Independent intervening act is another way to describe superseding causes. When such acts occur, they break the chain of causation, halting liability for the injury. For example, if the patient didn’t correctly follow the doctor’s instructions for taking the medication, there’s a chance the patient has broken the chain of causation. If the court acknowledges a superseding cause, workers’ compensation will not cover the damages.

However, circumstances do exist where workers’ compensation might be responsible for the overdose. In these cases, compensation will cover survivor death benefits or the cost of opioid addiction treatments. As long as a chain of causation linking the overdose to the initial prescription doesn’t involve a superseding clause, workers’ compensation will cover drug overdose.

Proving Liability

Like a personal injury or medical malpractice case, the burden of proof rests with the plaintiff. The plaintiff must prove it was the drug prescription that led to the addiction or death. To prove liability, the overdose must not be due to the patient’s failure to follow prescription instructions or other medical conditions.

Proof must also fall within reasonable medical bounds. If a patient dies due to a supposed drug overdose, but upon autopsy, the level of drugs in his or her system isn’t enough to be fatal, the court may drop the case.

Cases where the workers’ compensation doctor prescribed the responsible drugs are more likely to see successful claims. As higher opioid availability increases the risk of injury and disability, doctors also have a responsibility to distribute and prescribe proper amounts of medication. Failure to act with an awareness of these risks can constitute grounds for a workers’ compensation claim.

Opioid overdoses are an ongoing problem across Massachusetts. Addictions and deaths connected to workers’ compensation claims can become complicated, with multiple cases across the country not reaching a unified conclusion to serve as legal precedent.

The personal injury attorneys at Sweeny Merrigan Law, LLP understand the challenges of these claims and are always available to answer your questions. If you or a loved one has suffered due to an opioid overdose because of workers’ compensation care, talk to a workers’ compensation lawyer.