I. Introduction
On May 4, 2011, the plant manager (hereinafter referred to as “the Employee”) of a milk-carton printing company, located in Gyeonggi province (hereinafter referred to as “the Company”), died from a heart attack (acute myocardial infarction) while at his office desk. His spouse applied to the Employee Welfare Corporation for a survivor’s pension claiming this was an occupational accident, that the Employee had died from overwork and stress related to work.
Generally, an injury occurring at work is easily admitted as an occupational accident. However, it is possible to have an illness occurring from overwork and stress declared an occupational accident when the survivor can satisfy the strict criteria presented by the Minister of Labor for recognition of a considerable relationship between work and death. Accordingly, it is not possible to declare an incident like this an occupational accident when the survivor applying for industrial accident compensation cannot confirm a cause-and-effect relationship between work and death.
The Employee Welfare Corporation, after this widow’s application for the survivor’s pension, declared in August 2011 that the employee’s death was caused by overwork and stress related to work. In reality, it is difficult to prove overwork and stress are the cause of death at work, but it was estimated that there was sufficient evidence to verify this case as related to overwork. In this article, I will explain the details of overwork and stress that caused illness in this employee’s case. After reviewing the criteria for determination as an occupational accident concerning the acute myocardial infarction (heart attack) according to the Industrial Accident Compensation Insurance Act, I will lay out the considerable cause and effect relationship between the employee’s work situation and his death.

II. Details of Overwork
1. Summary
The Company, with a head office located in the US, an administrative office in Seoul, and a factory in Gyeonggi province, has been engaged in printing milk cartons, etc. with about 100 employees. Since the Employee was hired by the company in 1984, he had been given many different positions until he became plant manager in 2004. In February and March 2011, foot-and-mouth disease was spreading around the country, causing a reduction in Company sales and increased labor costs. Then, the head office in the US ordered him to implement redundancies), which created stress for the Employee as he had to lay off many of the colleagues who had worked together well for more than 10 years. In the meantime, a huge earthquake and tsunami occurred in Japan, resulting in the Company receiving a great number of production orders in April 2011. Production was extended from two shifts to three shifts to meet the sudden increase in orders. Because of the strict quality demands from the Japanese milk carton production company, the Company had to scrap many defective products, which increased labor costs even more. In the middle of this, just one day before the Employee’s death, the Employee entertained directors from the head office who had just arrived in Korea to visit the factory. He returned home very late, and went to bed even later after putting together a presentation on the Company’s business situation. The following morning, the Employee went to the office at 7 o’clock, and while preparing for the presentation, had a heart attack (acute myocardial infarction) and died around 8:30 am, while sitting at his desk.

2. Details
A. The Employee’s health
In reviewing the Company’s Medical Checkup reports for the previous three years (from 2008 to 2010), no evidence was found that the Employee had died from natural deterioration of a pre-existing condition. Some doctors had noted that the Employee had to be careful with his blood pressure and high cholesterol, but his figures were within the normal range.
In reviewing details of his use of the National Health Insurance over the five years leading up to his death, it was discovered that the Employee had visited the hospital once every two months since 2006 to check his blood pressure, and had taken prescription medication for hypertension every morning. He did not have any disease or other condition.

B. Details of the Employee’s heavy workload
(1) Twenty-four hours before the heart attack
The day before his heart attack, the Employee arrived at his office one hour earlier and started working. Then in the evening, he entertained in Inchon some directors from the head office until 9:40 pm and arrived home at about 12 pm. He then stayed up one more hour working on the presentation for the directors from the head office before going to bed. The morning of the heart attack, the Employee arrived at the office one hour early, at 7am, to work some more on the presentation.
(2) One week before the heart attack
The Employee came to work every day of the entire week before the heart attack, including Saturday, April 30, Sunday, May 1, and the Company Foundation Day, May 2. Due to the combination of increased orders from Japan and peak-season production, the factory was in full-scale production, with employees working overtime and on holidays and weekends from the middle of April to the early part of May. These situations, as well as his preparations for the visit by company directors created physical and emotional hardship for the Employee that was too great for his body to bear.
(3) Three months before the heart attack
- In early February, foot-and-mouth disease was spreading around the country, which increased labor costs due to reduced production. Because of this situation, the Employee was ordered by the head office in the US to reduce the number of employees.
- Because of all the production orders from the Japanese company, the Employee had to deal directly with all disputes with the buyer over quality issues in April 2011. As he was the only one in the company who could speak Japanese, he also had to entertain the Japanese engineers with dinner several times.
- In April and May, the Company began emergency production, changing the work schedule from two shifts to three shifts, to meet the orders from Japan and peak-season production. The Employee worked at the office almost every day of April (including weekends & holidays) because of his responsibilities as the plant manager.

C. Major details of stress
The Employee also experienced significant mental stress as well as the physical fatigue mentioned in the above paragraphs. He was ordered to implement a redundancy plan because the production costs in the Korean plant were higher than in the Taiwanese or Chinese plants, and also due to the impact foot-and-mouth disease had on the industry. He had already reduced the number of employees by 30 percent from 2007 to 2009 through individual interviews, letting go of people who had worked with him for more ten years. This created greater stress, partly because he had never thought there would be more lay-offs so soon. Having this latest redundancy plan confirmed while entertaining the directors from the head office added to the burden.

III. Related Legal Regulations: Criteria for Determining Heart Attack or Brain Vessel Disease as Occupational Accidents
That an employee’s illness or disease was caused by his/her job-related duties must be verified before determination of that illness or disease as an occupational illness. The criteria for recognition ‘occupational illness or death caused by the reason’ are as follows. (Implementation Decree ([Article 34] and its attachment #3).

A. When an employee at work experiences such things as an intra-cerebral hemorrhage, subarachnoid hemorrhage, cerebral infarction, myocardial infarction, or aortic