Hypertension is the silent killer. The mental and physical stressors of working within prison walls causes a daily toll on the health of Correctional Officers. Sometimes, Correctional Officers recognize the impact their career is having on their health, however, some health conditions develop without the officer realizing it. For example, the prevalence of hypertension amongst Correctional Officers is widely known, whereas many of them may unknowingly have heart disease due to the lack of symptoms in its early stages.

For one Correctional Officer in the Central Valley, this became a reality. This officer had worked for the Department since 2002 and been on medication for his hypertension since 2005. After arriving to his doctor’s office for a renewal of his hypertension medication prescription in 2020, the officer’s incredibly high blood pressure readings concerned his doctor and turned the appointment into a full cardiac work-up. His doctor immediately performed an echocardiogram (ultrasound of the heart) and the study revealed that he had been living with heart disease. The doctor immediately increased the officer’s medication and discharged him from the office for further follow up. This officer had heard of the “heart presumption” – a legal presumption for Correctional Officers through workers’ compensation that assumes work is the cause for a diagnosed heart injury – and immediately filed a workers’ compensation claim. 

While the heart presumption is controlling in the court room, it does not necessarily mean that the Department is going to accept the injury. CDCR still attempts to fight these injuries, causing more issues for injured Correctional Officer’s seeking medical treatment. Such was the case for this Correctional Officer. After filing his claim, the employer failed to review the file and simply stated, “your claim is denied, so it’s not our problem.” After dedicating 18 years of service and commitment to the Department, the officer began suffering from heart disease. Despite this clear medical evidence and the legal presumption, the employer unreasonably denied his claim in violation of the Labor Code. The Department’s denial was the first of many errors that caused a delay of medical treatment and monetary benefits through the workers’ compensation system. 

As a result, the officer appealed the denial and went to a Qualified Medical Examiner, also known as a QME. A QME is supposed to be a trained, unbiased doctor that determines, from a medical perspective, whether the injury is work-related. However, the QME’s opinion on this officer’s case made neither medical nor logical sense. The QME stated that the officer’s heart disease was not work related since a medical record revealed a diagnosis of hypertension in 1999 – prior to his work with the Department. The QME added that this record shows the officer’s work with the Department did not impact his hypertension at all. This opinion was significant as a pre-existing injury is one of the few ways the legal heart presumption is overcome. The officer read this report and attempted to correct QME, stating that his hypertension began in 2005, not 1999. However, his many attempts to correct the record fell short as it was “the officer’s word against the medical records.” The QME’s opinion was the second error that caused a delay of medical treatment and monetary benefits through the workers’ compensation system.

Naturally, the officer disagreed and requested a hearing with the judge to discuss the issues. However, his medical and legal issues continued to compound when the judge blindly followed the QME’s opinion. The judge told the officer that the legal heart presumption likely does not apply to his case since the QME’s opinion clearly found a medical record that showed a pre-existing injury caused the heart disease. The judge’s preliminary opinion at the court hearing was the third error that caused a delay of medical treatment and monetary benefits through the workers’ compensation system.

The officer felt hopeless. He could not receive treatment through workers’ compensation because the Department denied his claim and he struggled to get treatment through his private insurance because he had a workers’ compensation claim pending. He did not know where to go, he did not know what to do. If he continued to dispute the case on his own and took the case to trial with this judge, he would likely lose the case and be left with heart disease, no treatment, and no monetary benefits. After four (4) years of people telling him he was wrong, a co-worker told him to call us, Ferrone Law Group. 

Many civilians are blessed to never experience or know about the prison environment. For Correctional Officers, however, dealing with these issues is everyday life. Correctional Officers can understand when outsiders do not support them, as those that have never experienced life within those prison walls may not fully comprehend the daily toll on a CO’s body. However, when the employer – the very entity that they have sacrificed for – does not support them in time of need, the lack of support feels like betrayal. Additionally, Correctional Officers face unique challenges making it imperative for them to find a law firm that understands those challenges and has vast experience dealing with CDCR. When this officer’s partners told him to call Ferrone Law Group, we gladly took over the case and were determined to resolve the many issues he was facing. After looking into the case, the Department’s, QME’s, and judge’s errors shocked us. 

To Ferrone Law Group, a review of the treating doctor’s medical records demonstrated a straightforward case – the officer began working for the Department in 2002, was diagnosed with hypertension in 2005, and manifested heart disease in 2020. As such, it is a work related injury under the presumption and the officer should receive free medical treatment and a large monetary settlement for the injury. However, a review of the QME’s opinion revealed grave mistakes. The QME erroneously based his opinion on a 1999 medical record. The major issue – we could not find a 1999 medical record that showed a diagnosis of hypertension. After re-reviewing thousands of pages of records, it was no where to be found. We then subpoenaed the officer’s medical records from 1999 – none mentioned hypertension. It became painfully obvious that the 1999 hypertension diagnosis did not exist.  The devil was in the details and before the officer called us, no one had found it. Without a medical record to support it, the QME’s opinion could not stand. 

When Ferrone Law Group pointed out this mistake to the QME, he did not acknowledge the error. Instead, he doubled down on his incorrect opinion, stating that there is no way the officer’s heart injury is work related. It became clear that what we perceived as an error, was an agenda from a biased QME. 

Even in the face of an obviously biased QME, the employer continued to deny the claim. We were forced to take it to a judge to correct the multitude of errors. However, once again, the judge did not do his job at trial. He did not perform a thorough review of the medical records. Instead, he again blindly followed the QME’s opinion and ruled that the injury was not work-related. The tragedy of errors continued. We had no choice but to appeal the judge’s ruling. 

We presented our appeal to the reviewing court, pointing out the clear and obvious errors. Finally, the reviewing court recognized that everyone had been wrong. The court stated that Ferrone Law Group clearly proved that that the Department, QME, and judge had been relying on a non-existent medical record. As a result, the reviewing judge awarded our client reimbursement of his significant medical costs, free medical coverage for the rest of his life, and a substantial monetary payout for his disabling heart disease. Finally, the tragedy of errors concluded. The officer, who carried a significant financial, medical, and emotional weight when he first called Ferrone Law Group, could breathe a sigh of relief. 

Mistakes can happen, however, this mistake almost cost our client his claim. With our help, the officer now receives free medical treatment and hundreds of thousands of dollars for his injury. Like many officers, he entered the system with the simple hope of receiving medical treatment for his heart disease that his career caused. Instead, his employer turned him away in violation of the Labor Code, the QME turned him away due to clear bias, and even the judge turned him away due to incompetence. 

Though these errors were fixed, this demonstrates the importance of using competent counsel to help navigate the workers’ compensation minefield. Disputing your employer’s denial of your claim, choosing a QME, and strategically navigating the system in a complex heart case are moves that should be made with the advice of competent counsel with experience working with correctional officers. 

Without the proper help, this officer would be left to deal with his heart disease and crippling debt on his own. Don’t make that mistake. The workers’ compensation system is a minefield, be sure to navigate it with someone that has travelled this road before.