When is a stroke considered a work-related injury?

An employee gets into a heated argument with a manager, receives a shocking message, or is required to deal with an exceptionally unusual task. Shortly thereafter, they experience weakness, confusion, or difficulty speaking, and it is later determined that they suffered a stroke. From the perspective of the employee and their relatives, the connection seems clear. However, for the National Insurance Institute (Bituach Leumi), temporal proximity alone is insufficient. A stroke is not automatically classified as a work-related injury simply because it occurred at the workplace or during working hours.

To be recognized as such, proof of two components is generally required: an unusual event that occurred during and because of work, and a medical causal link between that event and the brain injury.

The first stage is factual. Bituach Leumi examines what exactly happened before symptoms appeared: did an unusual argument, physical exertion, a difficult message, a sharp confrontation, or another event causing unusual emotional stress occur? It is not enough to claim that the work was stressful or that the employee was under pressure for a long period. One must point to a specific event that can be placed in time and described in detail. The 'unusual' nature of the event is examined relative to the specific employee and their work routine.

Only after a factual basis is established is the medical question examined: could the event have served as a factor that accelerated or triggered the stroke? At this stage, temporal proximity, medical documentation, previous risk factors, and medical opinions are significant. When the matter reaches the Labor Court, a court-appointed medical expert's opinion carries great weight.

A common mistake is focusing solely on medical evidence. A discharge summary and neurological diagnosis prove that a stroke occurred, but they do not necessarily prove what happened at work beforehand. Details that seem marginal at first—who was present, what was said, the duration of the event, and the employee's reaction—can be crucial.

Recommendations:

• Document the sequence of events as early as possible.

• Record the names of witnesses and save all relevant messages, correspondence, or documents.

• Check if an internal inquiry was conducted by the employer.

• When seeking medical treatment, state that the symptoms appeared following an unusual work event.

• Avoid general statements like "I was under stress"; describe the event chronologically and accurately.

Dealing with Bituach Leumi requires combining workplace facts with medical data. If a claim is rejected, one must determine whether the unusual event was not proven or if the dispute concerns the medical link. This analysis allows for a strategic approach in the Labor Court.

• This article is in cooperation with the Israeli legal website PsakDin

• Adv. Kobi Mizrahi specializes in Bituach Leumi cases

• Ynet is a partner of the PsakDin website