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August 4th, 2015
workers compensation
IDIOPATHIC DEFENSE

INTRODUCTION

     The doctrine of “idiopathic falls” can be a very fruitful defense in workers’ compensation cases. The doctrine arises from the general rule that, “the employment must be the source and cause of the accident in order to be compensable as a workers’ compensation injury.” Slimford Manuf. Co. v. Martin, 417 So. 2d 199 (Ala. Civ. App. 1981). Based on this rule, courts have held that injuries attributable solely to “idiopathic factors” are not compensable under the Workers’ Compensation Act. Idiopathic, when used by a Court in workers’ compensation cases, means “‘peculiar to the individual’ and not ‘arising from an unknown cause.’ Idiopathic refers to an employee’s pre-existing physical weakness or disease.’”  Ex parte Patterson, 561 So. 2d 236, 238 (Ala. 1990).

GENERAL RULE

     The Alabama Supreme Court first addressed the compensability of idiopathic injuries in Slimford Manuf. Co. v. Martin, 417 So. 2d 199 (Ala. Civ. App. 1981). In that case, the employee died after he fell while waiting to use the copy machine, striking his head on the floor. His employer offered evidence that the employee’s fall was due to a fainting spell caused by cirrhosis of the liver, although there was conflicting evidence that the injury might have occurred due to a slip and fall. The trial court concluded the claimant did not carry his burden to prove the accident arose in the course of employment, rather than from factors peculiar to him. The Court of Civil Appeals affirmed that conclusion, stating “the appellee was unable to prove that Martin's employment exposed him to a ‘danger or risk materially in excess of that to which people not so employed are exposed’.”

     The Court distinguished Irby v. Republic Creosoting Co., 228 F.2d 195 (5th Cir. 1955) which held that the plaintiff’s fall from a three foot platform, due to an epileptic seizure, was compensable. The Irby court reasoned that “the severity of the fall and the angle and position at which appellant struck the ground were directly influenced by the last three feet of his fall, one of the conditions of his employment.”

     In distinguishing that decision, the Court in Martin stated that, unlike the three foot platform in Irby, “in the instant case, at the time of his fall, Martin was exposed to no hazard indigenous to his employment.”

     In discussing this line of cases, the Alabama Supreme Court noted “The principal ‘fault line’ that has been revealed by the application of the ‘arising out of’ requirement by Alabama courts is the distinction between accidents that are at least partially attributable to an affirmative employment contribution and those that are attributable solely to what are called 'idiopathic' factors…’” Brown v. Patton, 77 So. 3d 591 (Ala. 2011) (quoting with approval Brown v. Patton, 77 So. 3d 587 (Ala. Civ. App. 2009)).

FALL CASES

     Application of the idiopathic falls doctrine is relatively straightforward when faced with a typical slip and fall case. If the employer can prove the fall was caused by a condition of the employment, whether it be a hazard in the work place or a requirement of the job, then the accident will be deemed compensable. For example, in Goodyear Tire & Rubber Co. v. Muilenburg, 990 So. 2d 434, 438 (Ala. Civ. App. 2008), the Court concluded there was substantial evidence that the Plaintiff’s fall was caused by his employment. The evidence indicated the Plaintiff tripped and fractured his ankle while walking. The Court affirmed the award of benefits, noting

When the accident occurred, the treads of Muilenburg's shoes were caked with rubber residue. The surface of Muilenburg's shoes also contained residue from slurry, a slick liquid. There was evidence establishing that slurry, stray pieces of rubber, and small rubber pellets sometimes were present on the floor in Muilenburg's work area.

     This was found to be substantial evidence of an affirmative employment involvement, despite evidence the Plaintiff could not recall precisely why he fell. See also Gold Kist, Inc. v. Oliver, 526 So. 2d 588, 589 (Ala. Civ. App. 1988) (“There was also testimony that the concrete floor was always wet and chicken residue would have to be periodically washed from the floor. From this testimony the trial court could have reasonably inferred that Mrs. Oliver, in the process of leaving her work station, slipped and fell as a result of the wet floor.”)

     Similarly, in Phenix Med. Park Hosp. v. Kozub, 575 So. 2d 1162, 1163 (Ala. Civ. App. 1991), the Court found the Plaintiff’s injuries were compensable, after she tripped and fell in the course of her employment as a nurse. Although she did not identify any hazards which caused her to fall, admitting that she stubbed her toe, she testified she left the patients room in a hurry in an attempt to finish her next shift. The Court found this was sufficient employment involvement. See also Crown Textile Co. v. Dial, 507 So. 2d 522, 523 (Ala. Civ. App. 1987) (testimony employee “tripped over something” combined with evidence of debris in area sufficient to support a compensable injury.)

     In contrast, in Wal-Mart Stores, Inc. v. Morgan, 830 So. 2d 741, 746 (Ala. Civ. App. 2002) the Court reversed the trial court’s award of benefits to a Plaintiff who fell while working at Wal-Mart. The Court noted:

The record contained no evidence indicating that the floor was wet or that it posed a risk to Morgan. Morgan testified that she did not see any water on the floor and that she simply lost her balance and fell.

     See also Ex parte Patton, 77 So. 3d 591, 592 (Ala. 2011) (evidence employee “inexplicably fell” insufficient to establish affirmative employee involvement).

     It is clear from these cases that when the fall occurs on flat ground, the Plaintiff is required to identify, or at least present some evidence of the existence of, some hazard that caused the fall. This can either be a substance, such as the slurry and rubber in Muilenberg, or some activity of the job, such as the nurse in Kozub hurrying to finish her shift. However, if the fall happens for an unknown reason, or due to a personal condition, benefits will not be awarded.

OTHER SCENARIOS 

     The issue is more complicated when faced with an injury other than one occurring on flat ground, such as a fall down stairs or while driving.

     The issues of a fall from a height, even when the fall is due to idiopathic reasons, has consistently been deemed to be compensable. See Irby v. Republic Creosoting Co., 228 F.2d 195 (5th Cir. 1955) (fall from three foot platform). Gold Kist, Inc. v. Pope, 539 So. 2d 291, 292 (Ala. Civ. App. 1988) (fall while “taking inventory on top of an eight-foot stack of feed” was compensable despite testimony fall was caused by seizure disorder.)

     However, a common issue that has not been affirmatively addressed by the Courts is whether an injury occurring on the stairs is compensable without evidence of some additional hazard. The issues potentially cut both ways. Unlike the three foot platform in Irby and the eight foot pallet in Pope, stairs cannot be described “as risk or hazard that he would not have been exposed to had he not been performing his job.” People are exposed to the risk of stairs in all walks of life, and are not a unique hazard indigenous to employment.

     We recently had success in obtaining a defense verdict in Octaviano v. Coast Personnel, wherein we argued the Plaintiffs’ fall down the stairs was not related to his employment, and instead was related to his pre-existing condition. The Court found, “The evidence presented in this case establishes that the Plaintiff’s fall was not due to any increased risk created by the employment, but was instead due to the Plaintiff’s idiopathic condition, namely, his pre-existing left knee injury, which caused the Plaintiff to fall.” In that case, the Plaintiff had already received knee treatment for a potentially torn meniscus, and was wearing a knee brace at the time. He fell down the stairs and aggravated his knee condition.

     The defense is more clear in car accidents that occur due to an idiopathic cause, such as a seizure or narcolepsy. In Muhammad v. Laidlaw Transit, Inc., 917 So. 2d 842, 846 (Ala. Civ. App. 2005) the decedent was killed in a bus crash which resulted from an epileptic seizure. The Court affirmed the denial of benefits, reasoning “ the trial court properly could have rejected the proposition that work-related stress and fatigue were contributing causes of the employee's seizure and, instead, could have concluded that the seizure that the employee suffered (one of at least four that she suffered during her lifetime) was idiopathic, i.e., peculiar to her.”

PRACTICAL TIPS

     As with all defenses under the Alabama Workers’ Compensation Act, application of this defense will be very case specific. Some things to look for, in determining the application of this doctrine, include:

  1. Was the injury caused by a fall from flat ground, stairs or a height?
  2. Was the cause of the fall a physical condition personal to the Plaintiff?
  3. Was the Plaintiff able to identify any hazards which could potentially cause the fall?
  4. Were any hazards present, even if Plaintiff could not identify them?
  5. Did the Plaintiff offer any explanation for the fall?
  6. If the accident involved a motor vehicle, was the accident caused by a personal condition, or a hazard of the road?

     Of course, as with all claims under the Workers’ Compensation Act, the Plaintiff bears the burden to prove causation. Therefore, if the Plaintiff is unable to offer an affirmative employment involvement, a denial may be justified.

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