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Idiopathic Injuries Under the Tennessee Workers' Comp Act

Idiopathic Injuries
Under the Tennessee Workers’ Compensation Act: 
What are they?  Are They Compensable?
 
Introduction
An idiopathic injury is one that has an unexplained origin or cause.  See Shearon v.
Seaman, 198 S.W.3d 209, 214 (Tenn. Ct. App. 2006).  An alternative definition is an
injury “caused by a purely personal condition” as opposed to an employment
condition.  See 20 Tenn. Workers’ Comp. Prac. & Proc. § 10:7 (2009-2010).  As a
general rule, idiopathic injuries are not compensable under the Tennessee Workers’
Compensation Act.  The determinative issue in such cases is often whether the injury
arose out of employment.  The following discussion provides an overview of Tennessee
caselaw determining whether an injury was idiopathic and whether it was compensable.

I.  Elements of a Workers’ Compensation Claim
Personal injuries are compensable under Tennessee’s Workers’ Compensation Act,
when: (1) the injury arose out of the employment, and (2) the injury occurred in the
course of employment.  Tenn. Code Ann. § 50-6-103(a).  The phrase “in the course
of” refers to the time, place, and circumstances of the injury, while “arising out of”
refers to its cause or origin.  Wilhelm v. Krogers, 235 S.W.3d 122, 127 (Tenn.
2007).  “[These] phrases…are not synonymous but rather embody distinct concepts.” 
Knox v. Batson, 399 S.W.2d 765, 770, 217 Tenn. 620, 630 (Tenn. 1966).  “
Generally, an injury arises out of and in the course of employment if it has a rational
casual connection to the work and occurs while the employee is engaged in the duties
of his employment.”  Wilhelm, 235 S.W.3d at 127.
 
A.  Occurring in the Course of Employment
“An injury by accident to an employee is ‘in the course of’ employment if it occurred
while [the employee] was performing a duty he was employed to do.”  Wilhelm, 235
S.W.3d at 127.  Generally, “an employee is not acting within the course of employment
when the employee is going to or coming from work unless the injury occurs on the
employer's premises.”  Phillips v. A & H Construction Co., Inc., 134 S.W.3d 145,
152 (Tenn. 2004).  While an employee may suffer an accidental injury in the course of
employment “it does not necessarily follow that the injury arose out of his employment.
”  Knox, 399 S.W.2d at 770.  While one may exist without the other, the absence of
either element means that an employee cannot recover benefits for injuries sustained
while in the workplace.  Id. 

B.  Arising out of Employment
            An accidental injury arises out of employment “if caused by a hazard incident
to such employment.”  Wilhelm, 235 S.W.3d at 127.  Whether an injury arises out of
employment requires consideration of the origin of the incident and causation. 
Shearon, 198 S.W.3d at 214.  In determining whether an injury arises out of
employment, Tennessee courts look to whether the injury arose “from an exposure
which is no more or different from that of any other member of the public similarly
situated in place and time.”  Sudduth v. Williams, 517 S.W.2d 520, 523 (Tenn.
1974).  If the answer is “yes,” then the injury will not be compensable.  See id.  “[T]he
mere presence of an employee at the place of injury because of his employment will not
alone result in the injury being considered as arising out of the employment.”  Id. 

II.  “Special Hazards” of Employment
      An idiopathic fall is one that is “unexplained in its origin.”  Shearon, 198 S.W.3d at
214.  When an employee is injured as a result of an idiopathic fall, “worker’s
compensation benefits are normally awarded only where some condition of the
employment presents a peculiar or additional hazard.”  Id. at 215.  In other words “
benefits have generally not been allowed where the cause of the fall has been found to
be due to some diseased or other idiopathic condition personal to the employee,
absent some ‘special hazard’ of the employment.”  Sudduth, 517 S.W.2d at 523. 
When an employee appears to have suffered an idiopathic injury in the workplace, he
must prove his injures arose out of his employment by showing “that a special hazard
incident to employment caused or exacerbated his injuries.”  Wilhelm, 235 S.W.3d at
128.  Specifically, “an employee may not recover for an injury occurring while walking
unless there is an employment hazard, such as a puddle of water or a step, in addition
to the injured employee’s ambulation.”  Id. at 129.  Put simply, “an employee must
walk a short distance to and from his work station every day…[and] [s]ome hazard,
such as the presence of a liquid, hole, obstacle, or a vehicle, must exist before an
award…is permissible.”  Id.  When an employee falls to the level ground or bare floor,
on the other hand, Tennessee courts find this to be an idiopathic fall and, thus, deny
recovery.  Id. at 128.

III.  Cases
A.  Wilhelm v. Krogers
In Wilhelm, the Supreme Court of Tennessee found that plaintiff’s back and hip
injuries did not arise out of or in the course of his employment when he worked for the
defendant/grocery store by stepping up and down and lifting heavy cases.  Wilhelm,
235 S.W.2d. at 130.  While on the job, the plaintiff ruptured his right Achilles tendon
which caused him to develop problems in his lower back and left hip due to an
accompanying limp.  Id. at 124.  In Wilhelm, the trial court found that the plaintiff’s hip
and back injuries should be compensated because walking six-hundred yards daily to
and from his work station qualified as an employment hazard that caused or
exacerbated the injuries.  Id. at 127.  The Supreme Court disagreed and found that
these injuries were idiopathic and, therefore, did not arise out of the course of the
plaintiff’s employment.  Id. at 128. 
For one, the court noted that “the injury would have eventually occurred, whether the
plaintiff was walking at work or not.”  Id. at 129.  Also, the court supported its
decision by noting that “there was simply no condition or hazard at the place of
employment [as] [t]he record establishes that the plaintiff was walking on an
obstacle-free concrete surface when he felt an increase in pain in his back and left hip
area.”  Id.  Since “the floor leading to the work station was smooth and flat, without
any steps, with no rough or uneven surfaces,” the court in Wilhelm held that the plaintiff
’s injuries did not arise out of or in the course of his employment and were
consequently not compensable.  Id. at 130.

B.  Shearon v. Seaman
The court in Shearon found that while the plaintiff’s death occurred in the course of his
employment, it did not, however, arise out of the scope of his employment.  Shearon,
198 S.W.2d at 214.  Specifically, when the cause or origin of the plaintiff’s fall and
resulting death could not be explained, the court held that they were idiopathic and,
therefore, not compensable under worker’s compensation laws.  Id. at 215.  While it
was undisputed that the plaintiff in Shearon died from a head injury and that he did so
while at work, “there [was] insufficient evidence from which the trier of fact could
determine, within a reasonable degree of medical certainty, any cause for the injury.” 
Id.  The court additionally supported its decision on the fact that “there [was] no
evidence that the [plaintiff’s] employment presented ‘a peculiar or additional hazard.” 
Because “compensation will not be awarded where the cause of death [or injury] is a
matter of speculation or conjecture,” the court held that the plaintiff’s injury and
subsequent death were “idiopathic or unexplained.”  Id.  Without more, the court
stated that it could not find them compensable under the worker’s compensation laws. 
Id. 

C.  Thornton v. Thyssen Krupp Elevator Mfg. Inc.
When the plaintiff in Thornton v. Thyssen Krupp Elevator Mfg. Inc. suffered an
injury to his leg as his knee buckled while walking across his employer’s warehouse
floor, the court found that his injury did not arise out of or in the course of employment
for purposes of recovering worker’s compensation benefits.  No.
W2006-00254-SC-WCM-WC, 2007 WL 1203586, at *2 (Tenn. April 24, 2007). 
Instead, the court in Thornton found that the plaintiff’s injuries were idiopathic because
there was not “a sufficient relationship between the knee injury and the actions of the
employee in walking on a level floor without obstacles or obstructions and then
stopping abruptly to find a part.”  Id. at *5.  Thus, “[t]here [was] no hazard incident to
the employment.”  Id.  Furthermore, the court found “no instrument at all which caused
the injury, but rather circumstances within the employee’s own body.”  As a result, the
court concluded that a “rational mind, upon consideration of all the circumstances”
would not find “a casual connection between the conditions and the resulting injury.” 
Id.

D.  Sudduth v. Williams
Similarly, the court found that the plaintiff’s death in Sudduth was not compensable
when his fall while at work for the defendant/service station resulted from an idiopathic
seizure for which no hazard incident to his employment accompanied or contributed. 
Sudduth, 517 S.W.2d at 523.  Particularly, the court noted that there was no evidence
that plaintiff had slipped or fallen on grease or oil.  Id. at 521.  On the contrary, the
record reflected corroborating testimony that the area had been clean and free from
any substances at the time of the fall.  Id.  Moreover, the court relied on the plaintiff’s
medical history from which it “was a permissible inference to be drawn” “that the fall
sustained by the decedent at his place of employment resulted from an idiopathic
seizure.” Id. at 523. Thus, court concluded that the plaintiff’s injuries and ultimate death
did not arise out of his employment because no hazard incident to his employment
accompanied or contributed to his fall.  Id.

[*] Mr. Thomas is a Member of the firm practicing out of the Nashville office.  His
practice areas include General Litigation, Insurance Defense, Insurance Coverage
issues, Property Loss, Premises Liability, Product Liability, Workers’ Compensation
and Employment Law.  Mr. Thomas can be reached via email at
frank.thomas@leitnerfirm.com.
[†]  Brad Hearne is an Associate of the firm practicing out of the Nashville office.  His
practice is concentrated on general civil litigation.  He can be reached via email at
brad.hearne@leitnerfirm.com.
 

Submitted by:
Frank Thomas, Esq.
and
Brad Hearne, Esq.

Leitner, Williams, Dooley, & Napolitan, PLLC
Bank of America Plaza
414 Union Street, Suite 1900
Nashville, Tennessee  37219
Phone: 615.255.7722
Fax: 615.780.2210