It depends. The North Carolina Workers’ Compensation Act states that an employee’s injury is compensable only when it arises out of and in the course of’ the employment. Whether or not a heart attack is compensable will typically depend on whether or not it was an “injury by accident” and whether or not it “arose out of” the employment.
In Dillingham v. Yeargin Construction Company, the North Carolina Court of Appeals wrote that when the employee suffers a heart attack, he or she must show that it was caused by some unusual or extraordinary exertion. Dillingham v. Yeargin Constr. Co., 82 N.C. App. 684, 348 S.E.2d 143 (1986), rev’d on other grounds, 320 N.C. 499, 258 S.E.2d 380 (1987). For example, in King v. Forsyth County, the North Carolina Court of Appeals held that when a sheriff suffered a heart attack immediately after he engaged in a vigorous foot chase of a fleeing suspect caused by the overexertion experienced during the foot chase was an “injury by accident.”
Whether or not a heart attack arises out of the employment is a question of what caused the heart attack. For example, were you pre-disposed to having a heart attack and this just happened to be when you had it or was something at work the reason for it? Take the previous police chase example. The Court would probably consider the chase to have caused the heart attack since it involved overexertion and it occurred immediately after the chase. If so, then the heart attack arose out of the employment.
This question of what caused the heart attack is always up to the medical experts. Therefore, even if you think work caused the heart attack, if the medical experts say otherwise, the court is likely to agree with them.