Fit Vs Faint: Assessing Work Causation in “Idiopathic Fall” Cases
Lorne Direnfeld
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David B. Torrey 1Workers' Compensation Judge, Pennsylvania Department of Labor & Industry. All statements are those of the author and are not to be attributed to his agency of state government

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Jim Black 2Managing Partner, Black & Rose, Los Angeles, California

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LuAnn Haley 3Administrative Law Judge, Arizona Industrial Commission. All statements are those of the author and are not to be attributed to her agency of state government

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Christopher R. Brigham
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Abstract

When an individual falls due to a nonwork-related episode of dizziness, hits their head and sustains injury, do workers’ compensation laws consider such injuries to be compensable? Bearing in mind that each state makes its own laws, the answer depends on what caused the loss of consciousness, and the second asks specifically what happened in the fall that caused the injury? The first question speaks to medical causation, which applies scientific analysis to determine the cause of the problem. The second question addresses legal causation: Under what factual circumstances are injuries of this type potentially covered under the law? Much nuance attends this analysis. The authors discuss idiopathic falls, which in this context means “unique to the individual” as opposed to “of unknown cause,” which is the familiar medical terminology. The article presents three detailed case studies that describe falls that had their genesis in episodes of loss of consciousness, followed by analyses by lawyer or judge authors who address the issue of compensability, including three scenarios from Arizona, California, and Pennsylvania. A medical (scientific) analysis must be thorough and must determine the facts regarding the fall and what occurred: Was the fall due to a fit (eg, a seizure with loss of consciousness attributable to anormal brain electrical activity) or a faint (eg, loss of consciousness attributable to a decrease in blood flow to the brain? The evaluator should be able to fully explain the basis for the conclusions, including references to current science.

  • 1.

    Courts in workers' compensation decisions universally use the phrase “idiopathic” as follows: “We use the word ‘idiopathic’ as it is used by Professor Larson, to mean ‘peculiar to the individual’ and not ‘arising from an unknown cause.’ Idiopathic refers to an employee's preexisting weakness or disease.” Patterson v Opelika Foundry Co., Inc., 561 So.2d 236 (Alabama 1990). See also, for example, Youngblud v Fallston Supply Co., 951 A.2d 118 (Maryland Ct. Special Appeals 2008; to the same effect). See generally http://www.merriam-webster.com/dictionary/idiopathic (identifying both as definitions).

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  • 2.

    Larson, Workers' Compensation, § 9.01 (Desk Ed. 2000).

  • 3.

    A straightforward discussion of these concepts is found in the recent idiopathic fall case, Hamilton v Lane Community College, 302 P.3d 1184 (Oregon Ct. Appeals 2013).

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  • 4.

    See infra.

  • 5.

    Arthur Honnold, Workmen's Compensation, § 97 (1917).

  • 6.

    Little JW, Eaton TA, Smith GR. Workers' Compensation: Cases and Materials. 6th ed. West/Thomson Reuters. St. Paul, MN. 2010; p. 250.

  • 7.

    Larson, supra note 2 [quoting Wright & Greig, Ltd. v M'Hendry, 11 B.W.C.C. 402 (1918)].

  • 8.

    Youngblud v Fallston Supply Co., 951 A.2d 118 (Maryland Ct. Special Appeals 2008).

  • 9.

    Hamilton v Lane Community College, 302 P.3d 1184 (Oregon Ct. Appeals 2013). The court contrasted another precedent. There, the patient/claimant was the driver of log truck. While performing his work, he experienced a seizure, passed out, and wrecked his truck. The resulting musculoskeletal injuries were held compensable. Marshall v Bob Kimmel Trucking, 817 P.2d 1346 (Oregon Ct. Appeals 1991).

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  • 10.

    Pemberton Chevrolet, Inc. v Harger, 120 P.3d 892 (Okla. Ct. Civ. App. 2005). The court identified a recent precedent on the issue. There, the patient/claimant fell at work due to an epileptic seizure. She happened to be standing near a coffee pot and was burned by the hot coffee when she fell. The court held that the coffee pot was a factor peculiar to her employment that contributed to her injuries from an idiopathic fall. The burn injuries were hence compensable. Flanner v Tulsa Pub. Schools, 41 P.3d 972 (Oklahoma S. Ct. 2002).

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  • 11.

    Hampton v Intech Contracting, LLC, 2013 Ky. Unpub. LEXIS 17 (Mar. 21, 2013), reversing, 2011 Ky. App. LEXIS 229 (Kentucky Ct. App., Nov. 18, 2011).

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  • 12.

    Blakesleee v Platt Bros. & Co., 902 A.2d 620 (Connecticut S. Ct. 2006).

  • 13.

    Urbina v Kindred Hospital, 103 So.3d 244 (Florida 1st Dist. Ct. App. 2012).

  • 14.

    Circle K Stores v Indus. Comm'n, 165 Ariz. 91, 796 P.2d 893 (1990).

  • 15.

    Hypl v Indus. Comm'n, 210 Ariz. 381, 111 P.3d 423 (2005).

  • 16.

    National Auto. & Cas. Ins. Co. v Industrial Acc. Com., 75 Cal.App.2d 677 [171 P.2d 594](1946), where numerous authorities are cited.

  • 17.

    Employers Mut. Liability Ins. Co. v Industrial Acc. Com., 41 Cal. 2d 676, 678-679 (Cal. 1953).

  • 18.

    National Auto & Cas. Ins. Co. v I.A.C. (Honerlah), 75 Cal. App. 2d 677, 680-681, 11 Cal. Comp. Cases 206, 171 P.2d 594 (1946).

  • 19.

    Pacific Emp. Ins. Co. v Industrial Acc. Com., 26 Cal.2d 286 [158 P.2d 9, 159 A.L.R. 313](1945).

  • 20.

    Pacific Emp. Ins. Co. v Industrial Acc. Com., 19 Cal.2d 622 [122 P.2d 570, 141 A.L.R. 798](1942).

  • 21.

    Colonial Ins. Co. v Industrial Acc. Com., 29 Cal.2d 79 [172 P.2d 884] (1946).

  • 22.

    Zemke v Workers' Comp. Appeals Bd., 68 Cal. 2d 794 (1968).

  • 23.

    Allied Compensation Ins. Co. v Industrial Acc. Com., 211 Cal. App. 2d 821 (Cal. App. 2d 1963).

  • 24.

    Section 301(c)(1) of the Pennsylvania Act, 77 P.S. § 411(1).

  • 25.

    Slaugenhaupt v U.S. Steel Corp., 376 A.2d 271 (Pa. Commw. 1977).

  • 26.

    Good Shepherd Workshop v WCAB (Caffrey), 555 A.2d 1374 (Pa. Commw. Ct. 1989).

  • 27.

    McCarthy v General Electric Co., 143 A. 116 (Pa. 1928).

  • 28.

    Slaugenhaupt v U.S. Steel Corp., 376 A.2d 271 (Pa. Commw. 1977). On page 273, the court declared, “Case law … prior to the 1972 amendments and interpreting what constitutes course of employment remains applicable.” See also Krist v National Home Life & Ass. Co., 422 A.2d 1220 (Pa. Commw. 1980) (patient/claimant, a clerk, who suffered from arthritis and “occasional episodes” of dizziness, inexplicably fell backward while at work and hit her neck and back—held: aggravation of spinal arthritis was compensable).

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  • 29.

    Musicus v Broadway Pastry Shop, Inc., 439 N.Y.S.2d 455 (N.Y. S. Ct. A.D. 1981).

  • 30.

    Larson, supra note 2, § 9.02.

  • 31.

    Panyko v WCAB (U.S. Airways), 888 A.2d 724 (Pa. 2005).

  • 32.

    City of Burlington v Davis, 624 A.2d 872 (Vermont S. Ct. 1993).

  • 33.

    Yarter v S.R. Beltrone, Inc., 454 N.Y.S.2d 35 (S. Ct. A.D. 1982).

  • 34.

    Posner RA. How Judges Think. Cambridge, MA: Harvard University Press; 2010.

  • 35.

    Barth RJ. Determining injury-relatedness, work-relatedness, and claim-relatedness. AMA Guides Newsletter. May/June 2012.

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