As published in The Legal Checkup, Summer 2017 and on the Workers Injury Law and Advocacy Group blog

I have been representing injured firefighters and policemen for 43 years. Our office recently won a critical Workers’ Compensation case for a widow of a firefighter who died from a heart attack. The insurance company fiercely defended the claim, alleging that there is a “one hour” rule between the time of the firefighting activity and the heart attack.

Dr. Stefanos Kales, of Harvard University, was our expert medical witness. Dr. Kales has conducted wide scale studies to assess the causal connection between firefighting activities and heart attacks. After comprehensive review of the facts in our case, he issued a report, with scientific data, incorporating the results of the firefighter studies. This study persuasively demonstrated that there are multiple critical factors to be examined when a firefighter suffers a heart attack, such as: carbon dioxide in the blood, air temperature, dehydration, and physical exertion measured in METs (Metabolic Equivalent Task). Dr. Kales confirmed that the “one hour” theory has long been discarded as invalid.

Here are some basic recommendations from Dr. Kales for all firefighters and police officers:

• If you suffer from hypertension, you should be on blood pressure medication. Why? There is a high correlation between cardiac events in firefighting and police work among individuals whose blood pressure numbers may be only slightly elevated.
• Consider a flu shot. Why? Influenza makes you more susceptible to a serious medical event.
• Watch your weight. Why? Dr. Kales warns that obesity raises the risk of a serious medical event by 200% to 300%. Waist circumference is very important.
• Exercise. Dr. Kales points out that only 20% of firefighters are doing sufficient exercise, and therefore recommends that all firefighters be tested when hired to determine if they can reach 12 METs of aerobic capacity. Why? At some point, firefighting activities require 12 METs of exertion. The National Police Academy has suggested that the standard should be the ability to perform at 12 to 14 METs.

There are also several legal takeaways from this story:

• First: Always, always, always report any injury/accident/event no matter how minor it seems at the time.
• Second: In the case of death, the family should always obtain an autopsy. In my firefighter training case, a complete investigation and autopsy was performed by NIOSH and the findings were very critical in the case.
• Third: Each firefighter should undergo baseline and annual physical exams.