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Work stress, hypertension led to compensable aorta tear

A tribunal has overturned a self-insurer’s rejection of a compensation claim.
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Work stress, hypertension led to compensable aorta tear

Work stress, hypertension led to compensable aorta tear

21 April 2021

By Gaby Grammeno

A tribunal has overturned a self-insurer’s rejection of a worker’s compensation claim, finding that emotional stress from the man’s job caused an increase in blood pressure which in turn caused a tear in his aorta - the main artery that carries oxygenated blood from the heart to the rest of the body. The worker’s employment was found to be a significant contributing cause.

Medical incident at the winery

The worker was employed as Winery System Manager with a global wine producer. He was living in the Adelaide area but the role meant he often had to drive to Berri, a distance of 270 km, and he was regularly working 10- to 12-hour days.

Part of his job involved liaising between the IT and the operations departments of the company. He was supposed to ease the ongoing tensions between the two departments, which resulted from one department’s view that the other was resisting reforms aimed at improving efficiency, reliability and productivity.

Unfortunately, it seemed that the creation of his role only increased tensions between the two departments, which he found stressful.

Another anxiety-inducing problem he faced was that some winemakers were resisting the integration of new software into their existing systems. The implementation of the software project was ultimately unsuccessful, adding to the strain he was feeling.

Meanwhile he was juggling multiple other projects, including the purchase of automated guided vehicles. For these he needed to manage the design, analysis and testing of the vehicles then manage the project rollout.

In February 2019 he consulted his GP about his exhaustion and the degree of emotional stress that he was experiencing from his work. He’d been trying to push through exhaustion for some time but, by this date, had reached a point where he felt that he was physically unable to travel to Berri. His blood pressure had spiked to worrying levels.

After a few days off, however, he returned to work and continued to work long hours despite the ongoing emotional stress. He missed subsequent medical follow-ups due to the pressures of his job.

The day before the medical incident, he was ‘screamed at’ by a manager over the phone, in relation to an escalating problem at work. The next day, 6 September, he was in a meeting at work when he experienced strong chest pain – ‘as if someone had booted him in the chest’ – and felt lightheaded. His symptoms were due to an ‘aortic dissection’ a little below his heart.

What happened was that the inner layer of his aorta tore or split, and blood surged through the tear into the area between the inner layer and the middle layer of this crucial blood vessel. Hypertension – high blood pressure – is believed to be the main risk factor for an aortic dissection.

He was taken to hospital, where his blood pressure was 210 systolic (alarmingly high) and 85 diastolic.

He believed the work stress he’d been experiencing had caused the rise in his blood pressure, so he put in a workers comp claim. His employer, however – a self-insurer – rejected the claim, on the grounds that the worker had not proven that his employment was a significant contributing cause of the aortic dissection.

The worker applied for a review of this decision, and the case was heard in the South Australian Employment Tribunal.

Employer found liable for work stress that drove up blood pressure

The employer argued that there was insufficient evidence that the worker was experiencing a level of stress likely to result in hypertension on the day of the incident, in which case the employment was not a cause, let alone a significant contributing cause of the aortic dissection.

Medical evidence stated that a number of factors could have contributed to the aorta tear, possibly including a congenital weakness in the aortic wall, and the worker’s being overweight. But the tribunal was persuaded that emotional stress can have an impact on the level of hypertension.

The tribunal’s Deputy President Judge found that over a period of months, the emotional stress the worker experienced from his job produced a state of hypertension which was both an important and influential cause of the aortic dissection.

He therefore set aside the employer’s rejection of the worker’s bid for compensation, and ordered that his claims for weekly payments and medical expenses be accepted.

The bottom line: Emotional stress from work may be held responsible for pushing blood pressure to high levels, with potentially dangerous consequences.

Read the judgment

Cremasco v Accolade Wines Australia Limited [2021] SAET 64

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