In July 2008, Joshua Gartland, 33, moved back into his mother’s Westmoreland County home. He had run away at age 15, started using drugs a year later and struggled with addiction from then on. As a result, he had many medical problems, and in 2007 one of his legs had to be amputated because of necrotizing fasciitis — a flesh-eating bacterial infection — and he required dialysis for kidney failure.

His mother, Laura O’Rourke, then-59, of North Huntingdon, agreed to allow him to move back into her home and become his paid caregiver as part of an arrangement through Three Rivers Center for Independent Living.

In that role, she was responsible for bathing him, preparing his meals, changing his dressings and all other aspects of his care.

Less than a year later, on April 11, 2009, Gartland attacked his mother as she slept, stabbing her twice in the chest and once in the neck.

She survived, and filed a workers’ compensation claim against her son, in his role as her employer, and the State Workers’ Insurance Fund.

The claim, originally granted by an administrative judge, was overturned late last month by the state Supreme Court in a 4-1 decision.

“While it is undeniable that these circumstances are tragic, we cannot conclude [Ms. O’Rourke] has shown her injuries are within the type of harm the legislature intended to provide compensation for under the Workers’ Compensation Act and agree with the Commonwealth Court dissent, which states it ‘defied logic’ to find this case to involve a work-related injury,” wrote Justice Correale Stevens.

Ms. O’Rourke’s attorney, Michael E. DeMatt, will ask the court for reargument this week.

“I think this is a case that warrants that,” he said.

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According to court records, Ms. O’Rourke had gone to a bingo game with friends the evening of April 10, 2009, and returned home about 10 p.m. When she got home, her son was angry because she was late and demanded that she fix him something to eat. She told him she wanted to change her clothes first, and they continued to argue.

After she changed, she prepared his food, and went to bed about 11:30. She awoke two hours later with her son on top of her, holding a pillow over head, stabbing her with a 12-inch kitchen knife and yelling, “I’ll kill you.”

Ms. O’Rourke’s husband heard her screaming, entered the room, knocked Gartland off her, struggled with him and forced him to the floor. She was able to call 911, and when police arrived, her husband was still holding Gartland down.

Ms. O’Rourke spent two days in intensive care at UPMC Presbyterian, and recovered, although according to her claim, she lost function in her left arm and has post-traumatic stress disorder.

Gartland, who had no history of violent crime, pleaded guilty to attempted homicide in March 2010 and was ordered to serve 12 to 25 years in prison. He is now being held at the State Correctional Institution at Fayette.

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After Ms. O’Rourke filed her workers’ comp claim, the judge hearing the case found that she ought to be compensated for her injuries. Although the judge acknowledged that Ms. O’Rourke was not working at the time of the attack, that she did not routinely work in the middle of the night and that her son did not qualify for overnight care, he ruled that she should receive payment because “her employment required her to be on the employer’s premises at the time that she sustained her injuries.”

In addition, the judge found that the State Workers’ Insurance Fund failed to show that Gartland’s attack was strictly personal to his mother and not related to his employment of her.

Ms. O’Rourke was awarded $466 per week, dating back to the attack, as well as 47 weeks of payment for disfigurement. Both sides appealed.

The Workers’ Compensation Appeal Board reversed the judge’s ruling, finding that Ms. O’Rourke was not injured during the course of employment, nor was she required to be on the premises at the time of her injury.

Ms. O’Rourke appealed again, and this time, again, the Commonwealth Court, reversed the lower decision, finding on Jan. 8, 2014, that the woman should receive compensation because she was “practically required” to live with Gartland, given the hours she worked, by the nature of her employment, and because he had nowhere else to live.

But in the Supreme Court’s decision, Justice Stevens wrote that Ms. O’Rourke’s job description did not require 24-hour care or late-night shifts, nor did it require her to live with Gartland or provide housing for him. Instead, he wrote, that arrangement arose out of their relationship as mother and son.

“[Ms. O’Rourke’s] motivation to allow [Gartland] to move into her home arose out of her perceived moral obligation to care for her son and not from an employment-related compulsion that necessitated her presence in her bedroom at the time of the attack.”

But Mr. DeMatt said evidence presented at the workers’ compensation hearing showed that Ms. O’Rourke and her son had an agreement that they had to live together because he was unable to care for himself.

“That was uncontradicted by any other evidence,” Mr. DeMatt said. “The Supreme Court didn’t reference that at all.”

Justice Debra Todd agreed that the nature of the work required Ms. O’Rourke to live with her son. In a dissenting opinion, she noted that Ms. O’Rourke was able to work up to 64 hours per week at any time necessitated by Gartland’s needs.

“[T]he son-employer, mother-employee relationship found here is incongruously atypical. Yet, that relationship, created by a state-funded program, was a bona fide employer-employee relationship to which the Workers’ Compensation Act applies,“ Justice Todd wrote. “Further, the act is remedial in nature, and must be liberally construed to effectuate its humanitarian objectives.”

First Published: November 9, 2015, 5:00 a.m.