Labor Code section 3212 allows a presumption for “heart trouble” arising out of and in the course of employment for certain identified public officials, primarily peace officers and firefighters. However, a diagnosis of “hypertension” alone should not trigger the presumption as a finding of “heart trouble”.

“Heart trouble” is undefined in the statute. This has caused the Courts to determine its definition, specifically in regards to hypertension.

In Muznik v. WCAB, 40 CCC 578, hypertension was found to trigger the presumption when the hypertension causes “heart trouble”. However, in that case it was found that the applicant’s hypertension placed the heart in a “troubled” condition when upon exercise his heart skipped beats causing ventricular irritability. The Court even stated in a footnote, “we do not say that hypertension, in every instance, constitutes ‘heart trouble’; nor do we conclude that disorders in other areas of the body that do not place the heart in a ‘troubled’ condition, qualify as ‘heart trouble.’”

In Hamilton v. WCAB, 44 CCC 520, the Court further distinguishes “hypertension” from “heart trouble”. It finds that the two conditions should not be equated simply because sometimes hypertension is a precursor to heart trouble. The case then cites numerous legal authority, stating, “Medically as shown by the evidence [hypertension and heart trouble] are at least, ordinarily distinct pathological conditions.”

This is further defined in Hart v. WCAB, 82 CA3d 619. The Court furthers the notion that hypertension must place the heart in ‘troubled’ condition in order to trigger the presumption. Here, the Court found the presumption was not triggered even though the applicant suffered from hypertension. The medical evidence showed the applicant’s heart had normal sinus rhythm, no heart murmur, normal ventricular pattern, and a normal electrocardiogram.

Finally, in Palmieri v. WCAB, 56 CCC 287, the Court denied the applicant’s Petition for Writ of Review after it was found the applicant’s hypertension alone was not enough to trigger the heart presumption. The Appeal’s Board noted there was no evidence of coronary irregularity or disease but only that he suffered hypertension and that would not come under the Labor Code presumption as “heart trouble.”