Can the family of a police officer with a pre-existing heart condition still get the line-of-duty death benefit?

Plain-English summary

Maryland's Secretary of Public Safety and Correctional Services asked the Attorney General to clarify who qualifies for the state's $25,000 statutory death benefit under Article 41, §4-1002 when a law enforcement officer, correctional officer, sheriff's deputy, or firefighter dies from a heart, lung, or similar medical condition rather than a sudden injury like a gunshot wound. The Secretary specifically asked whether a pre-existing medical condition would disqualify a family from the benefit, and whether it mattered if the condition was aggravated, rather than originally caused, by the officer's duties. The Attorney General concluded that the statute, which pays benefits when an officer "is killed or dies in the performance of duties," covers a death caused by job-related aggravation of a pre-existing disorder, as long as that aggravation was a contributing cause of death. The opinion explained that a 1986 amendment adding the word "dies" alongside "is killed" was specifically meant to fix this exact gap, since Maryland courts had previously read similar "killed" language to require an accidental, not a gradually developing, cause of death.

Currency note

This opinion was issued in 1988. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Common questions

Did a police officer's pre-existing heart condition disqualify the family from the death benefit if the officer died on duty?
Not automatically, according to this opinion. The Attorney General concluded that a pre-existing condition did not by itself bar the benefit, as long as the performance of official duties aggravated that condition in a way that contributed to causing death, since aggravation supplies the required causal link between the job and the death.

Did the officer have to die immediately, during the triggering activity, to qualify?
No. The opinion concluded that the survivors could still be eligible even if the officer suffered a heart attack during a hazardous duty but died at a later time, so long as the chain of causation from the job-related aggravation to the death remained unbroken by any other intervening cause.

What was the difference between an officer dying at his desk versus dying while chasing a suspect?
The opinion used exactly that contrast: it concluded a heart attack suffered while actively performing hazardous duties, like pursuing a suspect, would ordinarily be compensable if medical evidence tied the death to that activity, while a collapse during routine desk work like bookkeeping presumably would not meet the causation requirement.

Background and statutory framework

The opinion traced Article 41, §4-1002's death benefit back to its original 1971 enactment, which paid $15,000 to survivors of an officer "killed in the performance of his duty," language that Maryland courts, following Police Commissioner of Baltimore City v. King, interpreted to require a genuine causal connection between the officer's duties and the death, not merely that the officer happened to be an officer when death occurred. The opinion explained that this "killed" language created a real problem for officers with pre-existing disease: citing the reasoning behind Courtney v. Board of Trustees, Board of Trustees v. Grandinetti, and similar cases, Maryland's courts generally required an "accidental" cause for benefits, and treated a death traceable to a pre-existing condition as not accidental even if job stress or exertion played a role, a line of authority the opinion also traced through Baker v. Board of Trustees, Vaughan v. Mayor and City Council of Baltimore, Williams v. McCardell, and Stancliff v. H.B. Davis Co.

The opinion explained that the General Assembly responded directly to this gap: after the Board of Public Works confronted the issue in 1985, Chapter 387 of the Laws of Maryland 1986 added the words "or dies" to the statute, so that the benefit became payable when an officer "is killed or dies in the performance of duties." The opinion read this amendment as a deliberate legislative choice to extend coverage to officers whose duties aggravated a pre-existing condition and thereby contributed to their death, reasoning that the "aggravating event serves as the link between the death and the duties, keeping the chain of causation intact."

To support this reading, the opinion surveyed a substantial body of out-of-state case law construing similarly worded death-benefit and pension statutes, including Seybold v. Commonwealth, Dept. of Gen. Services (Pennsylvania firefighter who died of a heart attack after fighting a fire despite a pre-existing "slowly progressive disease process"), Sabathier v. Board of Trustees (Louisiana firefighter whose pre-existing heart disorder was aggravated by heat, smoke, and exertion), Bergman v. Board of Trustees, Vernon v. Firemen's Pension Fund, Naughton v. Retirement Board of San Francisco, and Buckley v. Roche, all of which allowed benefits where job-related exertion aggravated an underlying condition and contributed to death. The opinion also invoked ordinary tort-law principles from Reagan v. Rider and Mitchell v. City of Springfield for the proposition that a cause need not be the sole cause of an injury to count as a legally sufficient cause.

Applying this framework, the opinion illustrated its conclusion with a direct contrast: an officer who suffers a fatal heart attack while actively pursuing a suspect would likely qualify for the benefit if medical evidence tied the death to that exertion, even with a history of heart disease, while an officer who collapses and dies while doing routine desk work like bookkeeping would presumably not meet the causation requirement, since nothing about that activity aggravated the condition in a job-related way.

Citations and references

Statutes:

• Article 41, §4-1002
• Article 41, §4-1002(b)(1)
• Article 73B, §86(4a)
• Chapter 539, Laws of Maryland 1971
• Chapter 32, Laws of Maryland 1972
• Chapters 823 and 824, Laws of Maryland 1975
• Chapters 55 and 551, Laws of Maryland 1976
• Chapter 406, Laws of Maryland 1980
• Chapter 350, Laws of Maryland 1981
• Chapter 254, Laws of Maryland 1985
• Chapter 387, Laws of Maryland 1986

Cases:

• Police Commissioner of Baltimore City v. King, 219 Md. 127, 148 A.2d 562 (1959)
• Courtney v. Board of Trustees, 285 Md. 356, 402 A.2d 885 (1979)
• Board of Trustees v. Grandinetti, 269 Md. 733, 739, 309 A.2d 764 (1973)
• Baker v. Board of Trustees of Employees' Retirement System, 269 Md. 740, 744, 309 A.2d 768 (1973)
• Vaughan v. Mayor and City Council of Baltimore, 229 Md. 547, 184 A.2d 842 (1962)
• Williams v. McCardell, 198 Md. 320, 84 A.2d 52 (1951)
• Stancliff v. H. B. Davis Co., 208 Md. 191, 117 A.2d 577 (1955)
• Lovellette v. City of Baltimore, 297 Md. 271, 465 A.2d 1141 (1983)
• Landis Office Center v. Barefield, 73 Md. App. 315, 533 A.2d 1332 (1987)
• Lodowski v. State, 302 Md. 691, 731 (1985)
• Seybold v. Commonwealth, Dept. of Gen. Services, 461 A.2d 353 (Pa. 1983)
• Sabathier v. Board of Trustees, Firemen's Pension and Relief Fund, 72 So.2d 1 (La. 1954)
• Reagan v. Rider, 70 Md. App. 503, 508, 521 A.2d 1246 (1987)
• Mitchell v. City of Springfield, 410 S.W.2d 585 (Mo. 1966)
• Bergman v. Board of Trustees, 425 S.W.2d 143 (Mo. 1968)
• Vernon v. Firemen's Pension Fund, 52 A.2d 199, 201 (Pa. 1947)
• Naughton v. Retirement Board of San Francisco, 110 P.2d 714 (Cal. 1941)
• Buckley v. Roche, 4 P.2d 929 (Cal. 1931)

Source

• Landing page: https://oag.maryland.gov/resources-info/Pages/attorney-general%E2%80%99s-opinions.aspx
• Original PDF: https://oag.maryland.gov/resources-info/Documents/pdfs/Opinions/1988/Volume73_1988.pdf

Original opinion text

Best-effort transcription from a scanned PDF. Minor errors may remain, the linked PDF is authoritative.

LAW ENFORCEMENT OFFICERS

Death Benefits — Pre-Existing Disorder - Benefits Payable If Causal Connection Between Performance Of Duty and Death Is Established.

February 5, 1988

The Honorable Bishop L. Robinson
Secretary, Department of Public Safety
and Correctional Services

You have requested our opinion regarding the proper construction of Article 41, §4-1002. This statute provides for payment of a death benefit to survivors of a law enforcement officer of the State or any political subdivision "who is killed or dies in the performance of duties ...." Specifically, you ask about payment of death benefits in the following circumstances:

      1. Officer dies while on duty from a heart, lung or similar medical condition. In this context, the term 'on duty', I believe, refers to the officer being then in the course of a normal shift or other active work assignment, as opposed to being off duty.

   2. Officer has a pre-existing medical condition and later dies from that medical condition or a related one. Does this mean that if the officer dies from such a condition while on active duty, a benefit is to be paid, but if the death occurs while off duty, the benefit is not to be paid?

   3. With regard to question 2 above, would it matter if the pre-existing medical condition was not work related but was aggravated by the performance of the officer's duty?

For the reasons given below, we conclude as follows: Article 41, §4-1002 authorizes payment of a death benefit if an officer's performance of duties aggravates a pre-existing physical disorder and this aggravated condition causes death, in other words, if the job-related aggravation is a contributing cause of death. Our response to the several hypotheticals you pose is that, in each case, entitlement to payment of the death benefit depends on whether the requisite causal connection exists between death and performance of official duties.

                                       I
                               Background

Article 41, §4-1002(b)(1) provides:

 A death benefit shall be paid to the surviving spouse, children, or designated beneficiary of any law-enforcement officer of the State or of any political subdivision of the State, any sheriff or deputy sheriff, any correctional officer, or any volunteer or professional firefighter or rescue squad member who is killed or dies in the performance of duties on or after January 1, 1980. The amount of the benefit shall be $25,000.

The underlying purpose of Article 41, §4-1002 is to provide additional benefits to dependents of safety officers in light of the unusual risks these officers face in their work. Cf. Police Commissioner of Baltimore City v. King, 219 Md. 127, 148 A.2d 562 (1959). The statutory death benefit is not a form of life insurance. The benefit, therefore, is not available for death under all circumstances while an officer is on duty. Rather, it is limited to deaths caused by hazards involved in the services rendered.
As enacted by Chapter 539, Laws of Maryland 1971, §4-1002 (then Article 41, §59A-1) provided in pertinent part:

 The sum of fifteen thousand dollars ($15,000.00) less any lump sum death benefit, exclusive of any return of contributions, payable by the State or any political subdivision shall be paid to the surviving spouse or children of any law enforcement officer of the State or of any political subdivision of the State who is killed in the performance of his duty. This sum shall be in addition to any workmen's compensation benefits.

The statute subsequently was amended several times.1 Most recently, Chapter 387, Laws of Maryland 1986, inserted the words "or dies" in subsection (b)(1) of §4-1002, making the benefit available when an officer "is killed or dies in the performance of duties ...."2

1 Chapter 539, Laws of Maryland 1971; Chapter 32, Laws of Maryland 1972; Chapters 823 and 824, Laws of Maryland 1975; Chapters 55 and 551, Laws of Maryland 1976; Chapter 406, Laws of Maryland 1980; Chapter 350, Laws of Maryland 1981; Chapter 254, Laws of Maryland 1985; and Chapter 387, Laws of Maryland 1986.
2
Chapter 387, among other things, also excluded special police officers from the purview of the statute, established a priority of beneficiaries, and provided for the right of judicial review.

The events preceding the 1986 amendment to Article 41, §4-1002 indicate that the addition of the words "or dies" was intended to cover deaths caused by aggravation of medical conditions. In 1985, the Board of Public Works faced the issue of the effect of pre-existing disease on death benefit eligibility. The Board was advised informally by its counsel that entitlement under such circumstances generally was found under statutes providing for payment not only in the event an officer "is killed," but also if an officer "dies" from duty-related injuries; however, the Maryland statute, then providing for award only where an officer was "killed in the performance of duties," suggested that the benefit was limited to accidental deaths. The Board was also advised that Maryland follows the view that for an "accident" to have occurred, there must be an accidental cause and not simply an accidental result: in cases of pre-existing disease, the Court of Appeals generally has not recognized claims made under statutes requiring accidental death or disability on the theory that if the injury is attributable to a pre-existing cause, it is not an accidental injury.3
The General Assembly promptly responded to this problem in the application of the statute. In the next legislative session, the statute was broadened to provide the benefit when an officer "is killed or dies in the performance of duties."

3
For example, in Courtney v. Board of Trustees, 285 Md. 356, 402 A.2d 885 (1979), a member of the Maryland Teachers Retirement System sought a retirement allowance for mental incapacitation under Article 73B, §86(4a), which authorizes the payment of an "accidental disability retirement benefit" to a member who "has been totally and permanently incapacitated for duty as the natural and proximate result of an accident occurring while in the actual performance of duty ...." The claimant described the "accident" that caused his mental incapacitation as "[a] two year period of being severely understaffed, plus a lack of administrative concern [which] led to severe depression ... and culminated in ... a nervous breakdown." 285 Md. at 357-58. Although the expert testimony was conflicting, the Medical Board determined that Courtney had not suffered an "accidental injury" since his disability was attributable to a pre-existing condition of paranoia-schizophrenia. The Court of Appeals agreed. The Court explained that to be accidental, an injury must result "from some unusual strain or exertion of the employee or some unusual condition of employment." 285 Md. at 363, quoting Board of Trustees v. Grandinetti, 269 Md. 733, 739, 309 A.2d 764 (1973). If the injury is attributable to a pre-existing cause, the Court wrote, it is not an accidental injury, and the claimant is not entitled to the benefit. See also Baker v. Board of Trustees of Employees' Retirement System, 269 Md. 740, 744, 309 A.2d 768 (1973) (accidental disability benefits denied to a marine engineer who claimed that an incapacitating heart attack he suffered was the result of striking his head on a pipe while on the job; court ruled that because the claimant "had a predisposition toward this sort of attack and ... his head injury was not the direct cause of the myocardial infarction"); Vaughan v. Mayor and City Council of Baltimore, 229 Md. 547, 184 A.2d

Note 3 continued
842 (1962), and Williams v. McCardell, 198 Md. 320, 84 A.2d 52 (1951) (both upholding denial of accidental disability benefits to firemen with history of heart disease who suffered heart attacks while on duty); Stancliff v. H. B. Davis Co., 208 Md. 191, 117 A.2d 577 (1955) (death not accidental when pre-existing cardiac condition was worsened by exposure to fumes). But see Lovellette v. City of Baltimore, 297 Md. 271, 465 A.2d 1141 (1983) (heart attack suffered by a firefighter as a result of unusual job related physical strain may be compensable as an accidental injury); Landis Office Center v. Barefield, 73 Md. App. 315, 533 A.2d 1332 (1987) ("accident," for worker's compensation purposes, includes heart attack precipitated by on-the-job stress, even if also linked to pre-existing disease).
4
"The Special Fund," codified as Sections 580-596, Charter and Public Local Laws of Baltimore City (Flack 1949).

                                        II
                 Causation and Pre-existing Disease

Although the phrase "is killed or dies in the performance of duties" has not been construed in any case involving Article 41, §4-1002, the Court of Appeals has interpreted similar language in closely related statutes to mean that the death or the injury must result from the job. For example, in Police Commissioner of Baltimore City v. King, a provision of the Baltimore City Code provided for payment of benefits to survivors of a member of the police department who was killed "while in the actual performance of duty" or who had died in consequence of injuries received "while in the discharge of duty."4 Denying benefits where an officer had died from a self-inflicted accidental gun shot wound, the Court of Appeals held that the requirement that death occur in the performance of duties means that a causal connection must exist between the injury or sickness resulting in death and the decedent's official duties. In other words, benefits are not payable unless death occurred because the decedent was an officer, rather than merely while the decedent was an officer. See 219 Md. at 133. See also Lodowski v. State, 302 Md. 691, 731 (1985) ("on duty" status in itself does not determine benefit award).
When death occurs in the performance of duties but involves pre-existing disease, the issue is whether the death was caused by the duties of the job or whether the death was caused by a disorder outside the statute's scope. Typically, cases of this nature involve an individual with a history of heart disease who has a heart attack on the job and dies at some later time.

In our judgment, the current scope of §4-1002, that is, that the benefits are payable not only when an officer "is killed" but also when an officer "dies" in the performance of duties, reflects a legislative intent that pre-existing disease not foreclose recovery. If the performance of duties aggravates a medical condition, thereby accelerating death, the necessary causal connection is established. The aggravating event serves as the link between the death and the duties, keeping the chain of causation intact.5
Seybold v. Commonwealth, Dept. of Gen. Services, 461 A.2d 353 (Pa. 1983) strongly supports our conclusion that the phrase "is killed or dies" in §4-1002 contemplates cases involving pre-existing disease. In Seybold, a firefighter died from a heart attack a half hour after returning from the scene of a fire. Although there was evidence that the decedent's death was the result of a "slowly progressive disease process that had built up to a climax resulting in cardiac death," the court awarded the statutory death benefit. 461 A.2d at 354. The court explained that Pennsylvania's death benefit statute, as originally enacted, provided for payment if a firefighter were "killed in the performance of his duties" but subsequently was amended to include "the deaths of all firefighters ... dying ... as the direct result of injuries sustained in the performance of their duties." 461 A.2d at 355. The Pennsylvania court concluded that the amendatory language clearly allowed the benefit where a fire-fighter with a history of heart disease experienced a fatal heart attack that could be traced to the hazardous aspect of his job.
Numerous other cases hold that aggravation of a pre-existing condition satisfies the causation requirement under similarly worded statutes. In Sabathier v. Board of Trustees, Firemen's Pension and Relief Fund, 72 So.2d 1 (La. 1954), the court explained that the duties of the job must be the effective cause of death, but not necessarily the sole cause:

  Although [the decedent firefighter] experienced at the time a heart disorder, very likely his demise would not have taken place had he refrained from enduring the heat and smoke and from expending extraordinary energy in handling the hose.

5
This reasoning is entirely consistent with general principles of tort law. See, e.g., Reagan v. Rider, 70 Md. App. 503, 508, 521 A.2d 1246 (1987) (there is no requirement that a proximate cause be the sole cause of an injury); Mitchell v. City of Springfield, 410 S.W.2d 585 (Mo. 1966) (whatever is the product of two or more concurrent and contributing causes is the direct result of each, though neither is the sole cause).

This activity, according to medical testimony, accelerated or aggravated decedent's condition; it was a contributing, if not the efficient, cause of death. 72 So.2d at 3.6

To cite another example, in Bergman v. Board of Trustees, 425 S.W.2d 143 (Mo. 1968), the court ruled that, under a city ordinance providing for increased benefits if a fireman was "killed or fatally injured in the line of duty," aggravation of a pre-existing heart condition that precipitated a fatal coronary thrombosis was an injury resulting in death. See also, e.g., Vernon v. Firemen's Pension Fund, 52 A.2d 199, 201 (Pa. 1947) (benefit allowed when fireman died from heart attack at scene of fire under statute covering individuals "who may be killed or die from injuries ..."); Naughton v. Retirement Board of San Francisco, 110 P.2d 714 (Cal. 1941) and Buckley v. Roche, 4 P.2d 929 (Cal. 1931) (both holding that benefits were payable to widow of police officer who died of heart attack although heart disease was pre-existing condition, under statute providing for benefits to the family of any officer "who may be killed or injured while in the performance of his duties, and who shall have died within three (3) years from the date of such injury ....").
As amended, the death benefit provided by Article 41, §4-1002 to survivors of a law enforcement officer who is "killed or dies" in the performance of duties is payable if there is a causal connection between death and the decedent's duties as a police officer. The death of an officer from a heart, lung, or similar medical disorder in the course of a normal shift ordinarily will be compensable if the death can be directly attributed to duties being performed by the officer. To illustrate, if an officer has a fatal heart attack while actively discharging his duties (for example, while pursuing a suspect), benefits would be payable if medical evidence establishes that the death was attributable to that activity. In contrast, were that same officer to collapse and die at his desk while performing some bookkeeping task, the causation requirement presumably would not be met.

6
The statute in Sabathier provided for payment of a death benefit if a fireman, "while in the act of performing any part of his duties as a fireman, is killed or receives injuries which result in his death ...."

Even if the officer in the hypothetical above had a history of heart disease, his survivors most likely would still be eligible for the benefit if he were engaged in a hazardous activity when he suffered a heart attack. The activity could qualify as an aggravating circumstance, linking the job performance to the death for purposes of establishing causation. The survivors likewise could be eligible for the benefit if the officer experienced a heart attack in the course of that activity but died at a later time, if the chain of causation remained intact, that is, if no other force intervened to cause death.

                              III
                          Conclusion

In summary, it is our opinion that the survivors of a law enforcement officer who "is killed or dies in the performance of duties" are entitled to the payment of a death benefit pursuant to Article 41, §4-1002 if a causal connection between the officer's official responsibilities and death is established.

       J. Joseph Curran, Jr., Attorney General
       Gail Cohn, Assistant Attorney General

Jack Schwartz
Chief Counsel
Opinions & Advice