## Facts

- Floyd Wilcut worked as a truck driver for Innovative Warehousing.
- Wilcut suffered severe injuries in a work-related trucking accident that caused significant blood loss.
- While hospitalized, Wilcut’s physicians unanimously recommended a blood transfusion as medically necessary care.
- Wilcut, a Jehovah’s Witness, refused any blood transfusion because he believed accepting blood was forbidden by his faith.
- Wilcut did accept other treatment, including medical care and supplements intended to stimulate blood production.
- Because Wilcut would not accept blood, he could not undergo certain procedures that treating providers viewed as important to address his injuries.
- Wilcut later died from complications tied to blood loss, including severe anemia and related cardiac conditions.
- Innovative Warehousing did not dispute that the accident occurred in the course and scope of employment; it paid certain benefits (including funeral expenses and death benefits) for a period of time.
- After payments stopped, Wilcut’s widow, Sharon Wilcut, filed a claim seeking workers’ compensation death benefits as his dependent.
- At the hearing, physicians testified with near certainty that Wilcut would have survived if he had accepted a blood transfusion and that the physical risks of transfusion were low compared to the expected benefit.
- A Jehovah’s Witness elder testified that receiving a blood transfusion is considered a serious sin within the faith, that a member may seek forgiveness for sins, and that Wilcut was a follower of the faith.
- The administrative law judge found the refusal was not unreasonable in light of Wilcut’s religious beliefs and awarded death benefits.
- The Labor and Industrial Relations Commission adopted the factual findings but reversed, concluding the refusal was an unreasonable refusal of treatment and denying benefits.
- Sharon Wilcut appealed the Commission’s denial.

## Issues

1. Whether Wilcut’s refusal of a medically recommended blood transfusion on Jehovah’s Witness religious grounds was an “unreasonable refusal” of medical treatment under Mo. Rev. Stat. § 287.140.5 that barred workers’ compensation death benefits.

## Decision

- The Missouri Court of Appeals reversed the Commission’s denial and remanded.
- The court held the Commission erred in concluding that Wilcut unreasonably refused the blood transfusion under § 287.140.5.
- The court rejected the Commission’s reliance on testimony about the faith’s concept of post-sin forgiveness as a basis to label the refusal unreasonable.

## Legal Principles

- Mo. Rev. Stat. § 287.140.5 permits denial or suspension of compensation when disability or death is caused, continued, or made worse by an employee’s unreasonable refusal to submit to medical or surgical treatment.
- Whether a refusal is “unreasonable” depends on the facts, including the nature of the proposed treatment, the risk involved, the probability of improving or saving the employee’s condition, and the employee’s stated reasons for refusing.
- A refusal may be reasonable even when the proposed treatment has a high likelihood of success and low medical risk, if the refusal rests on a sincere religious conviction.
- Factfinders may evaluate sincerity and whether the asserted belief was genuinely held and consistently acted upon, but they may not decide “reasonableness” by weighing or second-guessing the content of religious doctrine.
- Treating the availability of religious forgiveness as proof that the employee should have accepted the procedure is an improper basis for finding an otherwise sincere religious refusal “unreasonable.”
- On review, appellate courts defer to the Commission’s supported factual findings, but they independently review the Commission’s application of law to those facts.

## Conclusion

Wilcut held that a truck driver’s refusal of a recommended blood transfusion based on sincere Jehovah’s Witness beliefs was not an unreasonable refusal of treatment under Mo. Rev. Stat. § 287.140.5; therefore, the refusal did not bar his widow’s workers’ compensation death-benefit claim, and the court reversed the Commission and remanded for further proceedings consistent with that holding.


Wilcut v. Innovative Warehousing, 2007 Mo. App. LEXIS 915 (2007)