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IDIOPATHIC INJURIES AND CORRESPONDING CASE LAW
Prepared By:
Jennifer M. Gibson, Esq.
COUSINEAU McGUIRE CHARTERED
Attorneys at Law
|
Minneapolis Office 1550 Utica Avenue South Suite 600 Minneapolis, Minnesota 55416 (952) 546-8400 (952) 546-0628 (fax) |
N. Wisconsin/Michigan Office 225 East Aurora Street Ironwood, Michigan 49938 (906) 932-0726 (800) 877-866 (906) 932-1688 (fax) |
www.cousineaulaw.com
INTRODUCTION
All compensable work injuries must arise out of and in the course of employment. Minn. Stat. §176.011, subd. (16) (1992). The phrase "arising out of and in the course of employment," appears deceptively simple. However, this is not the case. These simple words have fostered much litigation in the workers' compensation area. In that regard, no area of "arising out of" law has been subject to greater recent uncertainty than the law involving injuries that take place "in the course of" employment but which are caused by personal conditions or which occur spontaneously under circumstances no different than normal activity apart from work. These injuries have been deemed "idiopathic" injuries. Webster's Dictionary defines idiopathic as: "peculiar to the individual; arising spontaneously or from an obscure or unknown cause."
The rule in many jurisdictions is that idiopathic injuries caused by conditions truly personal to the employee are not compensable. Thus, if an employee falls at work due to a heart attack or epileptic seizure, injuries caused when striking the floor are not compensable. 1A Larson & L. Larson, §12.11. However, if the employment premises aggravate or increase the risk of injury, an otherwise noncompensable idiopathic injury becomes compensable.
Up until recently, the Minnesota Supreme Court used an increased risk approach in the analysis of injuries that fall under the "idiopathic" definition. However, in recent years the Workers' Compensation Court of Appeals cases provide inconsistent treatment of idiopathic injuries making it less certain whether the "increased risk" or some other legal causation test should be used.
CASE LAW ANALYSIS
The first Minnesota Supreme Court case dealing with an idiopathic injury does fit within the increased risk approach. In Stenberg v. Raymond Cooperative Creamery, 11 W.C.D. 415, 296 N.W. 498 (1941). The employee fell and hit his head at work. This resulted in his death. He previously had a bad knee and a weak heart. His personal medical condition caused his fall. As he fell he struck the protruding leg of an adding machine, sustained a skull fracture and died. The Minnesota Supreme Court affirmed the employee's award of benefits because his death "had its origin in a risk connected with the employment." The protruding table leg increased the risk of injury and aggravated the effects of his fall. The Court specifically stated "if an unforeseen accident to an employee, while engaged in the performance of his work, directly causes an injury to the physical structure of his body, the injury is compensable, even though the employee had a natural weakness predisposing him to such an injury."
The court began to confuse or blur the use of the increased risk test in Barlau v. Minneapolis Moline Power Implement Co., 12 W.C.D. 531, 9 N.W.2d 6, 13 (1943). The employee in Barlau dislocated his humerus bone in an apparent fall on a flat surface following a seizure that was personal in origin. The employee had epilepsy. The employee was awarded benefits in reliance on Stenberg. However, the Court did not comment on the significant factual distinction between the two cases, i.e., the employee hit his head on a table leg in Stenberg whereas the employee in Barlau fell on a flat surface.
The increased risk standard concerning idiopathic injuries further obscured in Miller v. Goodhue- Reiss-Wabasha Citizens Action Council Inc., 26 W.C.D. 187, 197 N.W.2d 424 (1972). In Miller, the employee's knee locked due to a personal condition while he was climbing stairs at work. As a result, he fell and broke his hip. He was awarded workers' compensation benefits. It is not clear in this case whether the Court concluded the stairs presented an employment instrumentality that increased the risk of injury or whether benefits were awarded simply because the injury occurred at work.
The Minnesota Supreme Court returned to the majority rule i.e., the increased risk test, in O'Rourke v. Northstar Chem., Inc., 281 N.W.2d 192 (Minn. 1979). The Court upheld an award for the death of an employee who, because of a hemorrhage in his brain, fell into a boxcar containing Bauxite and suffocated on the Bauxite. The Court held the employee's fall itself was caused by an idiopathic condition not shown to have any relation to his employment. However, it is generally agreed that if an employee who falls because of such a condition is placed by his employment in a position which aggravates the effects of the fall, the resultant injury and death are causally related to and arise out of his employment. Thus, if the employee's death was caused by suffocation and the inability to obtain prompt resuscitative measures because of his employment conditions, it arose out of his employment. The Minnesota Supreme Court continued to follow O'Rourke and the majority view in Koenig v. Northshore Landing, 54 W.C.D. 86 (1986). The employee in Koenig was a part-time janitor and back-up cook for a restaurant. On the day of the incident he was asked to stay later. Thereafter, he fell on flat ground covered with slate tile. The compensation judge found the employee fell on a flat surface due to the effects of a non-work-related seizure or alcohol withdrawal. The employee argued that by falling on a hard, flat surface, the effects of his injury were aggravated. However, the Workers' Compensation Court of Appeals did not agree holding that the flat floor, regardless of its hardness, does not pose an aggravating hazard. A flat surface, regardless of its softness or hardness, is the ordinary standard for workplaces and does not pose a unique or unusual standard. Thus, the employee's fall on the flat surface was not compensable.
In Duchene v. Aqua City Irrigation, 58 W.C.D. 223 (W.C.C.A. 1998), the apparent certainty regarding the law of idiopathic injuries was again confused. In Duchene, the employee felt his knee pop as he got up from some grass following a lunch break. Please note, under the 'personal comfort doctrine' the "in the course of" requirement was satisfied. During the hearing on this matter the employee presented no medical or other evidence as to how his knee was injured or whether his knee condition already existed. There also was no evidence that the employment activity increased the risk of knee injury. In this case the Workers' Compensation Court of Appeals relied extensively upon Professor Larson's analysis instead of applying O'Rourke or any of the other prior idiopathic injury cases which used the increased risk test.
Professor Larson has divided the dictionary definition of idiopathic into two groups. Risks that are peculiar or personal to the employee, such as the consequences of a seizure, pre-existing orthopedic condition or heart condition, are noncompensable personal risks unless the employment aggravates the risk of injury. In contrast, when the injury is neither uniquely work-related nor personal, Professor Larson considers the risk "neutral." In neutral risk situations Professor Larson recommends applying a "positional risk" test rather than the increased risk test. Under the positional risk test the employee only need show the obligations of employment placed him/her in the particular place at the particular time that the employee was injured by some neutral risk or hazard. Professor Larson concludes the injury should be compensated because the employment put the employee in a position to be injured, even if the same thing might have happened performing the identical activity at home.
Professor Larson goes onto split the neutral risk category into two groups. The first group involves such things as acts of God and stray bullets.1 The second group involves injuries with truly unknown causes, such as an employee found dead on the job with no medically determined cause or a fall that simply occurred without explanation.
After thoroughly discussing Professor Larson's analysis, the Court in Duchene held the employee's knee condition resulted from a "neutral" risk. Thus, the Court awarded benefits under the positional risk test rather than the increased risk test. The employee was relieved from having to prove he was exposed to a higher risk of injury during his lunch break or that his employment caused him to bend, twist or slip while standing up.
Duchene represents Minnesota's first specific extension of the positional risk test beyond street risk cases. It is also important to note that the Duchene court failed to take into account the fact that the Minnesota Supreme Court had already impliedly rejected Professor Larson's approach in the case of neutral risks involving known causes. While Professor Larson would compensate lightening strikes and stray bullet injuries under the positional risk test, Minnesota clearly applies the increased risk test. See, Aumon v. Breckenridge Telephone Co., 7 W.C.D. 349, 246 N.W. 889 (1933) (stray bullet injury in private parking lot not compensable street risk, employee denied benefits because he failed to satisfy the increased risk test).
As one would expect, Duchene muddied the waters regarding idiopathic injuries. However, since Duchene the Workers' Compensation Court of Appeals appears to have made an effort to distinguish or sidestep the case without expressly overruling it.
For example, in Otto v. Midwest of Cannon Falls, slip op. (W.C.C.A. January 28, 1999), the employee developed knee problems at work while simply walking along a flat surface. The employee testified at the hearing that she was not carrying anything, nor did she slip, twist or trip. The employer and insurer appealed the compensation judge's award of benefits on the basis that the medical support lacked foundation. The employer and insurer argued one doctor took an erroneous history that the employee twisted her knee and another doctor failed to explain the mechanism of injury or how walking on a smooth floor can damage the meniscus. In contrast, the employee argued that benefits should be awarded based upon Duchene.
The Workers' Compensation Court of Appeals quoted Minnesota's increased risk test and did not rely upon Duchene. The employee was nevertheless still awarded benefits pursuant to the Hengemuhle decision. The court acknowledged that the idiopathic injury issue existed, however, they never addressed or resolved the issue.
In Bohlin v. St. Louis County, 61 W.C.D. 69 (W.C.C.A. 2000)2, the Court significantly narrowed Duchene. In Bohlin, the employee was a nurse. She was in the employer's parking lot and felt a "pinch" in her back while turning to exit her vehicle. On appeal, the Workers' Compensation Court of Appeals conducted a lengthy analysis of the idiopathic injury case law and reversed the compensation judge's award of benefits under Duchene's positional risk test. Instead, the Workers' Compensation Court of Appeals applied the increased risk test to deny the claim holding that "[W]ere this [the positional risk test] the law, every injury would be presumptively compensable so long as it occurred at work." The W.C.C.A. held that "Duchene does not support the unqualified application of a positional risk test. Rather, whether there exists the requisite causal connection between the work activities and the disability is a question of fact." The theory set forth in deciding this case has also been referred to as the "quantum theory."
Bohlin can be viewed as a return to the increased risk standard. In the context of idiopathic injuries, Duchene is just as much of an anomaly as Barlau. However, it is important to note that until the case is specifically overruled, it will continue to be relied on and cited by parties.
This is clearly demonstrated in Cauwels v. Schotts, Inc., slip op. (W.C.C.A. May 23, 2001). In Cauwels, the employee experienced shoulder symptoms while performing repetitive duties at work. After a hearing in the matter the compensation judge found the source of the employee's injury was "unexplained . . . similar to the injury in Duchene." The compensation judge awarded the employee benefits using the positional risk test. On appeal, the W.C.C.A. held that the compensation judge erroneously relied upon Duchene, and that instead, the increased risk test applied. However, the award of benefits to the employee was affirmed because the employee satisfied her burden of proving medical causation. In other words, the increased risk legal causation test was met because repetitive work activities medically caused the employee's injuries, and the instrumentality that medically produced the injury was uniquely an employment risk.
In Wermerskirchen v. United Parcel Service, slip op. (W.C.C.A. October 7, 2003), the employee sustained an injury to his knee while descending three flights of stairs after making a delivery. Similar to the Miller case cited above, the W.C.C.A. affirmed the compensation judge's determination that descending the stairs was a substantial contributing factor to the employee's knee condition, and that the injury was sustained in the course and scope of his employment. The employee's award of benefits was affirmed by the Workers' Compensation Court of Appeals.
In contrast, the more recent Minnesota Workers' Compensation Court of Appeals cases appear to be more in line with the increased risk test and corresponding case law.
In Polz v. Jackson County Sheriff's Department, slip op. (W.C.C.A. September 29, 2003), the employee experienced a right hip dislocation while at work as he started to lean against a retaining wall. He had a pre-existing history of medical treatment relating to his right hip. The compensation judge determined that his injury did not arise out of and in the course of his employment, and that there was no causal connection between his injury and his employment. The Workers' Compensation Court of Appeals affirmed this determination. The Court's analysis is interesting in light of the fact that the activity resulting in the employee's hip dislocation did occur in the course of his employment and presumably the leaning against the wall caused the dislocation. The Court in this case applied the increased risk test to require "a showing of some hazard [associated with the employment] that increases the employee's exposure to injury beyond that of the general public." The Court affirmed the compensation judge's decision that there was an insufficient connection between the employee's work activities and his injury to result in a compensable claim.
Similarly, in Sphinx v. Ecowater Systems, 65 W.C.D. 32 (2005), the employee was denied benefits. He had polio and walked with the assistance of a hinged walking brace. In order to help the employee transport himself around the employer's plant, the employer provided him with a motorized scooter for transporting himself. During the course of his day he periodically stepped off the scooter to perform work activities. On the date of injury the employee, while on the way to his work area, left his scooter to purchase a soft drink in the company cafeteria. On this particular occasion, his leg brace failed to lock, causing him to fall to the floor. This resulted in injury. He was denied compensation due to the Workers' Compensation Court of Appeals' conclusion that his injury was not due to any increased risk associated with his workplace, but rather was due to a condition entirely personal to him.
Likewise, in Goebel v. Dyneon Corporation/3M Co., slip op. (W.C.C.A. January 24, 2005), the compensation judge denied the compensability of the employee's injuries resulting from a workplace fall on the basis that there was no causal connection between the employment activities and her fall. In this case, the employee fell landing face down on a flat floor while carrying papers to the shipping room. This resulted in a fracture to her elbow. The compensation judge determined that her fall was occasioned not by her employment activities or environment, but rather, because her knee gave out due to a pre-existing condition that was personal to her. In contrast, the employee claimed her fall resulted from slipping on the floor surface. The Workers' Compensation Court of Appeals affirmed the compensation judge's finding. It should be noted that the compensation judge relied more heavily on the injury report and medical records which indicated that the employee's fall was caused by a "buckling" of her knee.
The Workers' Compensation Court of Appeals also denied compensation in Pratt v. Minnesota Tex Invs., slip op. (W.C.C.A. September 19, 2005). The employee in Pratt was stepping over a quarter to half- inch rubber floor mat at the time his knee gave out. The compensation judge found that the act of stepping over the rubber floor mat was not a "special hazard" and did not create an increased risk of injury sufficient to create workers' compensation liability. The Workers' Compensation Court of Appeals agreed that a quarter to half-inch floor mat does not represent an injury-producing hazard.
Conversely, in Smith v. Holy Family Church/Diocese of Winona, slip op. (W.C.C.A. March 30, 2006), the Workers' Compensation Court of Appeals affirmed the compensation judge's award of benefits to the employee. In Smith, the employee worked as a custodian. It was her normal practice to wash towels and rags used at work at home since the church had no laundry facilities. She would then return them to the church for use in her job. On the date of injury she was walking into the church when she fell injuring both her legs. Upon opening the doors she stepped on a metal threshold that rose approximately one-half to three-quarters of an inch above the floor. She was carrying a set of keys and her purse with her right hand and arm and a large bag of towels and rags and her lunch with her left hand when she walked in. As she passed through the doors, she stepped on the metal threshold with her right foot and fell to the floor breaking her right leg and injuring her left leg. In contrast to Pratt, the compensation judge found the employee's injuries arose out of and in the course of her employment. The judge found the employee's fall was not idiopathic, but rather, the raised threshold which was part of the work environment, was a substantial contributing factor in causing her fall. In affirming the compensation judge's finding, the W.C.C.A. indicated the primary test in determining whether an injury arises out of the employment in Minnesota is the "increased risk" test. The W.C.C.A. found the compensation judge could reasonably have concluded that stepping on the raised threshold caused the employee to fall. Further, the bag of towels the employee was carrying obscured her vision of where she placed her feet as she walked through the door.
Footnotes:
1 In cases of acts of God, Minnesota uses the increased risk test. The employee must show that his/her employment exposed him/her to an increased risk which resulted in injury. Further, in the case of street risks, the Minnesota Supreme Court has held that if an employee is injured "by what is usually called a street risk to which his/her employment subjects him, [the injury] arises out of employment, although others so employed, where the public using the streets, are subject to such risks." The court has held that the street risk rule applies only if the employee is injured while on a public street. BACK
2 The employee in Bohlin could not present evidence that she touched her feet down out of her vehicle into the parking lot prior to the "pinch" in her back. Therefore, the issue of the employer needing to provide reasonable ingress and egress from the employment premises did not apply.BACK