United States: The Court Of Appeals Chips Away At The Idiopathic Defense

Last Updated: October 9 2018
Article by Thomas C. Cauthen

When the law surrounding the idiopathic defense to on-the-job injuries is so often misunderstood, misconstrued, and misapplied by judges and lawyers, it can be very difficult for the average claims adjuster or employer to make heads or tails of the idiopathic defense, what it means, and when it applies. The Georgia Court of Appeals recently attempted to provide some clarity in this morass of conflicting decisions and legal theories. In doing so, the Court chipped away at the scope of the idiopathic defense by its ruling in Cartersville City Schools v. Johnson  345 Ga. App. 290, 812 S.E.2d 605 (2018). This article will examine the current state of the idiopathic defense under Georgia Law and discuss the effect of the Johnson decision on the same.

For an accidental injury to be compensable under the Workers' Compensation Act, the injury must not only occur in the course of the employment, but also must arise out of the employment. O.C.G.A. § 34-9-1 (4)See also Chaparral Boats, Inc. v. Heath, 269 Ga. App. 339, 340, 606 S.E.2d 567 (2004). Traditionally, an idiopathic injury is an injury that occurs while an employee is in the course of their employment; meaning that the employee is actually on the job. However, an idiopathic injury does not satisfy the second prong of the compensability test; arising out of the employment itself. For example, the employee in Chaparral Boats was simply walking across the premises at a quick pace in order to clock in for her shift when she felt a pop in her knee. Chaparral Boats at 339, 568. The Court of Appeals held that the action of walking was not causally related to her work, and there was no medical evidence to suggest that her quickened pace would have caused or exacerbated her injury as compared to her normal speed. Id.

In Johnson, the employee was a 5th grade teacher at Cartersville Elementary School. The evidence presented at the hearing was interpreted to show that she was instructing her students in her classroom and walked back to her desk to put an image on the smartboard. She then turned from her computer to walk back to the front of the classroom to continue her instruction and fell (without hitting any desk or other object), injuring her knee. At the trial level of the State Board, the Administrative Law Judge (ALJ) found that the injury was compensable because her necessary and swift movements, and the configuration of her classroom, caused her to place an acute stress on her knee that resulted in the sustained injury. In other words, because she had to maneuver around her students' desks and was doing so at a faster pace meant that the injury arose out of her employment as a school teacher.

The State Board's Appellation Division applied the framework of Chaparral Boats and found that there was no evidence that the act of weaving through the classroom caused the employee's knee injury. Furthermore, the Appellate Division reasoned that the act of turning and walking was "not a risk unique to her employment, but rather a risk to which she would be equally exposed apart from the employment." It held that her injury was the result of an idiopathic fall, and thus, her claim was non-compensable. It should be noted that the Appellate Division rendered its reversal of the trial judge over a well-written dissent. The dissent argued that "judicial verbicide" had been committed in the area of law concerning the idiopathic injuries. The "peculiar to employment" and "specific to employment" had been twisted to mean "unique to employment." The dissent argued that the law does not require an injury to be "unique to employment to arise" out of the employment; only that it be proximately caused by the employment. Consequently, the dissent argued that the activity of twisting and turning to move around the desk was incidental to the employee's job as a teacher. Although she very well may twist and turn outside of work, this particular act of twisting was in furtherance of her job duties and arose out of her employment.

The Bartow County Superior Court next took up the case based on the employee's appeal. It reversed the State Board's Appellate Division while impermissibly substituting its own findings of fact. The Superior Court reasoned that the majority in the Appellate Division applied an erroneous legal standard regarding causation that would render "any injury that could have occurred off-site as idiopathic." The Superior Court found that there was no evidence to indicate that the employee's fall was idiopathic because it "arose out of performance of the duties of a classroom teacher."

Despite the Superior Court overstepping its bounds by substituting its own findings of fact for the Appellate Division's, the Court of Appeals affirmed the Superior Court's reversal of the Appellate Division based on the Appellate Division's misconstruction of the legal framework. The Court of Appeals commented that that the Appellate Division fell prey to the confusion that their own conflicting case law had sown. Johnson at 296, 611. The Court admonished—echoing the dissenting opinion from the Appellate Division—"as a preliminary matter, in considering whether an injury arose out of employment, the focus should be on the causal link between the injury and the employee's work-related conditions or activity." Id; See also Hennly v. Richardson, 264 Ga. 355, 356 (1), 444 S.E.2d 317 (1994). The Court found that the Appellate Division erred when interpreting and applying what the Georgia Supreme Court and prior Court of Appeals decisions meant in holding that injuries do not arise out of employment where they "can not fairly be traced to the employment as a contributing proximate cause, and which comes from a hazard to which the workmen would have been equally exposed apart from employment."  Chaparral Boats, 269 Ga. App. at 343-346, 606 S.E.2d 567 (emphasis added). The Court reasoned that Appellate Division too quickly dispensed with the proximate cause portion of the inquiry and solely focused on the equal exposure analysis—a fatal flaw. The Court cautioned that the analysis cannot simply focus on whether the injury could have occurred outside of work, but rather was the injury caused by the performance of the job duties. Johnson at 296, 611. The Court went further in explaining that just because an employee could theoretically be exposed to a hazard outside of work that mirrors that which he or she must face while at work does not render an injury resulting from that workplace hazard non-compensable. Id at 296, 612. The Court then attempted to take the Appellate Division's analysis to its logical extreme by stating that holding otherwise would necessarily mean that any injury occurring as a result of walking, running, or jumping would be non-compensable. Id. The Court concluded by overruling a defense favorable decision with very similar facts. St. Joseph's Hosp. v. Ward, 300 Ga. App. 845, 846, 686 S.E.2d 443, 444 (2009). In Ward, a nurse injured her knee when turning around to retrieve a cup of water for her patient. The Court in Ward found that the act of turning to get some water did not expose the employee to a risk peculiar to her employment. The Johnson Court makes it clear that it disapproved of the legal analysis in Ward and that Ward should have been found compensable if the proximate cause test was properly applied.

We believe that the Court did not need to go so far as to overrule Ward and essentially strip away the teeth of any idiopathic defense. The Court seems to focus too much on the claimant's movements and behaviors being those of a class room teacher. Johnson at 290, 605. This pre-occupation with movements such as walking and twisting would seem to make any injury other than simply standing still and passing out as a result of a personal medical condition compensable under Georgia Law. There simply needs to be more of a causal connection between the hazards of employment than walking to the front of a classroom. For illustration, the injury should only be compensable if employee had injured herself in a manner that is peculiar to her employment such as tripping on a piece of chalk or slipping on a wet floor and falling against a student's desk; not merely walking, as she would do anywhere and anytime outside of work. At the very least, there should be some medical evidence supporting that her quickened paced necessitated by the need to instruct her students caused the fall and resulting injury whereas walking at a regular pace would not likely have resulted in the same injury.

We hope that the Georgia Supreme Court will take the case on appeal in order to provide some clarity on idiopathic injuries in general, as well as to scale back the Court of Appeals' wholesale acceptance of a standard that essentially deems any injury incurred while performing an everyday, mundane task compensable.

For the time being, it bears repeating that as in most closely disputed claims, cases involving idiopathic defenses largely pivot on the quality of the facts and testimony available to the parties at State Board Trial Division. The entire case could hinge on the employee's or employer witness' testimony as to the exact sequence movements, distances travelled between two objects, the layout of a room, and the motivation behind certain movements. Depositions, witness interviews, site inspections, and careful hearing preparation will go a long way toward laying a careful factual framework for this most difficult area of the law.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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