The “idiopathic defense” against employee compensation claims is still viable following a recent ruling by the Georgia Court of Appeals.
“Idiopathic,” as defined by the Georgia Court of Appeals, means “injuries sustained at work that are unrelated to work or do not occur while performing the job.” In the Stoker v. Walker County Board of Education told the appeals court that an accident at work resulting from a fall for no apparent work-related reason was not recoverable.
background
As most of you know, to be eligible for compensation in Georgia requires the employee to provide evidence that he or she has suffered an accident that arose out of and during the employment relationship. In the event of a fall at the workplace, the question of the replacement capacity usually arises according to whether the fall and the resulting injury occurred “from” the job. An industrial accident occurs when a reasonable person, after considering the circumstances of the employment relationship, would recognize a “causal link” between the conditions under which the employee must work and the resulting injury.
Examples of falls at work that were compensable can be found in two recent cases, Cartersville City Schools v Johnson and Frett v State Farm Employee Workers’ Compensation. The Cartersville plaintiff, Celia Johnson, was a teacher who went to the back of her classroom during her class to upload a picture to her smartboard. After uploading the picture, she turned from her computer and desk to quickly maneuver around the desks and head back to the front of her classroom to continue her class. She fell and injured her knee.
During the workers’ compensation insurance hearing, the evidence revealed that these necessary quick movements and the layout of Ms. Johnson’s classroom contributed to the acute strain on her knee that resulted in the injury. As a result, it was found that her knee injury resulted from her employment and was eligible for compensation.
At Frett, plaintiff Rochelle Frett was an insurance claims associate. She decided to take her lunch break (during which she could leave the company premises and use her planned break time at her own discretion) in the employer’s break room. While she was preparing her lunch, she slipped in some water on the floor and was injured. Although the injury occurred during a break and the fall was not directly related to work activity, her injury was found to be indemnifiable. In the court’s view, the preparation of lunch for Ms. Frett was reasonably necessary to ensure her well-being at work, and therefore alongside her employment, and therefore the injury was eligible for compensation.
the Stoker decision
With the erosion of “break protection” and the finding in Cartersville that “walks and falls” can be compensated, Georgia employers wondered if there was still a viable idiopathic defense against employee compensation claims for falls at work, but not because of work hazard.
In Stoker, the Georgia Court of Appeals has now clarified that a fall by a worker on the employer’s premises, but not due to an identifiable hazard in the work environment, may not be eligible for compensation.
The Stoker applicant was a substitute teacher who was injured while leading her class down a flat, straight hallway to the cafeteria. Ms. Stoker testified that she didn’t trip over anything, didn’t slide any substance on the floor, and didn’t know why she fell. She testified that she had moved on to the floor from performing her job duties.
The plaintiff must provide evidence that links the alleged work damage to the work. It is not enough to prove that the damage occurred during the plaintiff’s working hours. The appellate court found that Ms. Stoker had failed to meet her burden of proof by having predominantly evidence that her injury was due to her employment. The Court further stated that an injury which is intrinsic to a person or which arises spontaneously from an unclear or unknown cause and which is not causally related to the activity or conditions in the workplace is idiopathic and is not a work-related injury.
Stoker’s decision sends a clear message that Georgia workers seeking compensation must prove that their falls and resulting injuries were due to employment. And that’s good news for employers.
