Idiopathic Falls

    On Sunday, my family will not only be celebrating Mother’s Day with my beautiful wife, but we will also be sharing that day with my little girl’s first birthday. In fact, this past weekend, we had a photographer take pictures for her first birthday. Needless to say, she is quite photogenic. She clearly did not get that from me.

    Charlotte, or sissy girl (I am not exactly sure where that nickname came from), is almost one now, and she is beginning to walk. The addition of shoes to her wardrobe has quickly picked up the pace of her abilities. In saying that, do not expect her to sign up for any races anytime soon. She stumbles around our house now like a newborn giraffe, hitting her head on everything in sight. Between the bruises and knots, it’s a wonder she has not been concussed yet. I would describe her walking abilities at this point to be similar to those of Otis from The Andy Griffith Show, as follows:

    While not necessarily the same, I have recently been asked by multiple adjusters about “idiopathic falls”. The term has been defined in medicine to mean arising spontaneously or from an obscure or unknown cause. Some states have even broadened the definition to include an injury brought on by a purely personal condition. These idiopathic falls would have occurred regardless of the employment. There are many different scenarios which fit this definition, including such examples: heart attack, epileptic seizure or a syncope. A claimant may be suffering from a medical problem that is totally unrelated to the work activities or job itself, but said problem could cause the claimant to fall and sustain other injuries.

    An example of this would be a claimant who suffers from epilepsy. This very well could be a condition the claimant may have had their entire life, which has absolutely nothing to do with their work environment or activities. In this scenario, let us assume the claimant has an epileptic episode, and in the process, the claimant hits his/her shoulder on a table while falling to the ground. The medical evidence later reveals the claimant suffers from a torn rotator cuff as a result of the fall. In our scenario, the epileptic episode would not be considered a work-related injury; however, claimant hitting his/her shoulder on the table which caused the torn rotator cuff would be. Therefore, as the employer and carrier, you would owe benefits resulting from the injury sustained to the shoulder only.

    This is the general rule regarding idiopathic falls. Without getting into specific and more rare scenarios, understand the rule is that an idiopathic fall in and of itself is not a compensable injury. However, any injury sustained by making contact with the employer’s premises, after said idiopathic fall, would be compensable. Anytime you have a case which involves an idiopathic fall, feel free to call or email if you need confirmation based upon your specific fact scenario.

    P.S. I cannot talk about Charlotte’s photo shoot without including at least one picture. Below is a picture of Charlotte, as well as my son, Sawyer, at the end of the shoot when they were covered in what was left of her smash cake.