The Ever-Evolving Idiopathic Defense

 
 

idiopathic injury workers comp

Many states provide an employer with the opportunity to reduce its financial exposure to workplace accidents through an “idiopathic defense,” which traditionally means that, if the cause of an injury is unknown, then it should not be deemed work-related. Classic examples of an idiopathic injury include an employee who was simply walking when her knee popped or an employee with epilepsy who happened to have a seizure while standing in the office. Although workers compensation is considered a no-fault system (as opposed to liability cases, where it is required to identify some level of fault, be it negligence or otherwise), the idiopathic defense can provide employers with protection from injuries incurred in the workplace that are not truly causally connected to work.

Precedent for Successful Idiopathic Defense

It is important for employers to identify whether their states allow them to avail themselves of this line of defense. Past cases offer important insight for businesses in states allowing the idiopathic defense. A few states they can look to for examples are Florida, Georgia, Maryland, Mississippi, Ohio and South Carolina.

While employers have raised the idiopathic defense for many decades in Georgia, the seminal case of Chaparral Boats Inc. v. Heath did not arrive to the Court of Appeals until 2004. In that case, the employee was in the act of walking across her employer’s premises to clock in when she experienced a pop in her knee. The facts showed she did not trip or fall as a result of a workplace condition, nor did she encounter any object.

The court concluded that the injury had not arisen out of the employee’s employment as there was no evidence of a causal connection between her employment and the injury. Indeed, the court noted that her hyperextension and subsequent cartilage tearing could have occurred anywhere, regardless of the circumstances. As a result, the court held that the injury did not arise out of her employment because she had only engaged in an effort of walking—a risk she was equally exposed to apart from her employment—and did not encounter a workplace object or hazard. Her claim was thus not compensable.

Since this case, the Georgia courts have encountered many similar instances, including a nurse who twisted her knee while turning to provide a cup of water to a patient and a firefighter who stood up from her desk when directed to do so by her supervisor. These accidents were both deemed not compensable.

Recent Confusion

The Court of Appeals has taken a less traditional approach, however, in the case of Cartersville City Schools, et al. v. Johnson, which was decided in March 2018. In the case, a school teacher was instructing her students when she walked back to her desk to utilize the smartboard. As she turned from her computer desk, she fell and injured her knee. Though these facts align with other cases that were held to be not compensable, the Georgia Court of Appeals awarded benefits in this instance. In essence, the court said that it is not just that the hazard was one to which the employee would have been equally exposed, but also that the injury cannot be traced to the employment as the proximate cause. In this case, the teacher was walking, which she would have been equally exposed to outside of her classroom, but the court found a causal connection because she was “moving” at work when the peril struck.

There is no question that the Cartersville City Schools decision muddies the water with regard to the idiopathic defense in Georgia. Several points remain critical, however. Even in the newest case, the court makes apparent that Chaparral Boats Inc. remains the standard. There should be no question, therefore, that an accident and injury can (and should) be properly denied as idiopathic in nature if it would have occurred regardless of where an employee was located, results from a risk to which the employee would have been equally exposed apart from any condition of employment, and lacks a causal connection between the employment and injury.

More Similar than Different

In trying to understand and apply the law as it relates to an idiopathic injury, one must not focus solely on the most recent case without consideration of the cases that form the foundation for this body of law. For example, as in Georgia, Maryland courts define an idiopathic injury or condition as those that are “personal to the claimant” and do not themselves arise out of employment. In the 1952 case of Watson v. Grimm, an employee fell off a garbage truck after becoming dizzy. The employer denied the claim, contending that the dizzy spell was caused by an idiopathic condition not connected to his employment. The court agreed, finding the employee had failed to establish a causal connection between his injury and the work of a garbage collector.

In order to prevail in Florida, it is the employee who must show that the circumstances of their employment were different than those encountered in their personal life. By way of illustration, in the 2008 case Market Food Distributors v. Levenson, the court found that pulling out a drawer is no greater a task than those faced in the employee’s personal life, thereby deeming the injury idiopathic.

In the 2017 case of White v. Buehrer, the Ohio Court of Appeals explained that it is the employee’s burden to eliminate all idiopathic causes of a workplace injury. In the instance of an unexplained fall, the court will begin its analysis with “a completely neutral origin of the mishap.” As such, should an employee admit her fall was personal in nature, her success will hinge on a demonstration of how her employer made an affirmative contribution to the injury.

South Carolina carved an exception into their workers compensation laws, specifically for an idiopathic fall. In the 2015 case of Barnes v. Charter, the Supreme Court of South Carolina explained “idiopathic falls are excepted from the general rule that a work-related injury is compensable.”

Meanwhile, in its statutory construction, Missouri excluded any injury either directly or indirectly resulting from an idiopathic cause. From this, the courts extrapolated that an idiopathic condition is one peculiar or innate to the employee, such as an underlying seizure disorder.

What Employers Should Do

The best practice is to analyze every case and its individual facts. With respect to situations that could potentially involve the idiopathic defense, it is important to ask questions like: 1) Did the accident involve a fall? 2)Was the reason the employee fell explained? 3) Did the employee strike an object on the way down? 4) Can a causal connection be made between the work and injury?

For states allowing the idiopathic defense, an employer familiar with these types of injuries can potentially reduce its overall exposure by asking the right questions at the outset of the claim.

 

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About the Author

Emily J. Truitt is an attorney with Swift, Currie, McGhee & Hiers LLP in Atlanta.

 
 
 

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