Deciphering Falls at Work: Explained, Unexplained, and Idiopathic

  • Feb 08, 2023

Legal Update by Attorney Alison Stewart and Law Clerk Morgan Todd Borron

Image of people falling

When a worker falls at work, and the fall cannot be attributed to an acute event caused by the work (e.g., tripping over an object, slipping on ice or water, losing balance while carrying an object, etc.), the fall will likely fall into one of two categories: idiopathic or unexplained. These types of falls require additional analysis into compensability. An idiopathic fall is one that originates from a purely personal condition to the claimant. See Koehler Elec. v. Wills, 608 N.W.2d 1, 4 (Iowa 2000) (citing Arthur Larson, Workmen’s Compensation Law, sec. 12.11, at 3-356 (1994)); Bluml v. Dee Jay’s, Inc., 920 N.W.2d 82, 84 (Iowa 2018). An unexplained fall is where a claimant trips, slips, or falls for no specifically identifiable reason. Bartle v. Sidney Care, Inc., 672 N.W.2d 333, 2003 WL 22346956 at *2. (Iowa Ct. App. Oct. 15, 2003).

There are different standards that apply to these different types of falls. In Bluml, the worker sustained an idiopathic fall. The Iowa Supreme Court determined that “the claimant should have both the burden and the opportunity to meet the increased-risk test[,]” and “may recover if he or she proves that ‘a condition of his [or her] employment increased the risk of injury.’” Bluml, 920 N.W.2d at 91 (quoting Koehler Elec., 608 N.W.2d at 5). The Court noted that for unexplained falls, the actual-risk rule is the appropriate standard. Bluml, 920 N.W.2d at fn.1.

Under the actual-risk doctrine, an injury is compensable “as long as the employment subjected [the] claimant to the actual risk that caused the injury.” Lakeside Casino v. Blue, 743 N.W.2d 169, 176 (Iowa 2007) (quoting Arthur Larson & Lex K. Larson, Larson’s Workers’ Compensation Law, sec. 3.04, at 3-5 (2007)). “[U]nder the actual-risk doctrine, the injury must result from a condition, risk, or hazard of employment.” Murray as Conservator of Meyers v. Lazer Spot, Inc., No. 21004833.01, 2022 WL 16826433 at *11 (Iowa Workers’ Comp. Comm’n Arb. Dec. July 28, 2022) (citing Lakeside Casino, 743 N.W.2d at 178; Hanson v. Reichelt, 452 N.W.2d 164, 168 (Iowa 1990)).

In Lakeside Casino, the worker was injured after she stumbled while walking down stairs at work. The Iowa Supreme Court stated, “it is a matter of common knowledge that stairs pose an actual risk of stumbling or falling when traversing them, similar to the risk posed by going up and down ladders. Although Blue did not stumble due to any particular defect in or condition of the stairs, it is not necessary under Iowa case law that that the stairs in Blue’s workplace be more dangerous than a typical set of steps. In addition, it matters not that she stumbled through her own inattention. Blue’s misstep was causally related to the fact that she was walking on stairs, and therefore, the Commissioner rationally concluded her injury arose out of her employment.” 743 N.W.2d at 177. The Court found that “Blue stumbled on the stairs, the Commissioner finding that ‘the injury occurred from the hazard of traversing stairs.’ It is this causal relationship between a condition of Blue’s employment—the stairs—and her injury that distinguishes the present case from those in which we have determined the employee’s injury was not compensable” (referring to earlier discussion distinguishing McIlravy, where EE injured knee walking across level floor; Gilbert, where EE arguably injured neck straightening up from signing a document; Miedema, where EE injured back turning to flush toilet; and Musselman, where EE injured back leaning against wall for balance). Lakeside Casino, 743 N.W.2d at 177-178.

In Lapcheske v. Polk Cty., No. 5055505, 2019 WL 7559785 (Iowa Workers’ Comp. Comm’n App. Dec. Nov. 6, 2019), the worker suffered an unexplained fall on a hard floor (described as concrete, marble, or terrazzo throughout the record) resulting in an arm injury. The treating physician opined that claimant’s landing on a hard surface resulted in a “higher-energy fracture than if she would have fallen on carpet” and “elevated the severity” of the fracture; Dr. Bansal opined similarly. Lapcheske, at *3. The Commissioner stated, “Simply put, claimant’s arm was not fractured until it struck defendant’s floor. This factor distinguishes the injury from one that coincidentally occurs at work.” Id. at *4. The Commissioner held that “the hard floor in this case did present an actual risk of injury; in fact, the hard floor even went so far as to increase the risk of injury. Thus, applying the actual-risk doctrine to this case, I find the hard floor was a condition and ultimately a hazard of claimant’s employment.” Id.

In McClain v. Lennox, No. 1664566.01, 2021 WL 2624684 (Iowa Workers’ Comp. Arb. Dec. Apr. 22, 2021), affirmed 2021 WL 4447174 (Iowa Workers’ Comp. App. Dec. Sept. 22, 2021), the worker tripped and fell landing on his right side. He thought he caught his toe on an uneven portion of the cement floor or a corner of a pallet but was not sure. Defendants argued that claimant’s fall was idiopathic or unexplained. The evidence presented at hearing showed that claimant had caught his toe on some kind of crack or obstruction, causing the fall and subsequent injury. McClain, 2021 WL 2624684 at *6. This was affirmed on appeal, with the Commissioner noting “I therefore affirm the deputy commissioner’s finding that claimant’s fall was explained, meaning the resulting injury arose out of and in the course of claimant’s employment.” McClain, 2021 WL 4447174 at *1.

In 2019, there was amendment to Iowa Code section 85.61, adding that “Personal injuries due to idiopathic or unexplained falls from a level surface onto the same level surface do not arise out of or in the course of employment and are not compensable under this chapter.” Iowa Code 85.61(7)(c). In light of the subsequent case law, however, we think application of this amendment is limited to cases where the worker does not hit another object (like a wall, or a desk or shelf) on the way to the ground.

Peddicord Wharton will continue to monitor this evolving area of the law and provide relevant updates.

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