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What are Idiopathic Injuries?

What are Idiopathic Injuries?

February 28, 2018

By: Amy Markham

In a workers’ compensation case in Arkansas, a claimant (injured worker) is charged with the burden of showing that the claimed injury was caused by his or her employment. However, issues of causation are not always straight-forward.

In some cases, an employer or its workers’ compensation insurer may deny a workers’ compensation claim because it was “idiopathic.” Idiopathic injuries are peculiar to an individual employee, rather than one caused by a risk related to the employment.  They are not necessarily tied to the workplace itself.  Although almost any condition can be idiopathic, the most common examples are diabetes, heart disease, seizures, epilepsy, hypoglycemia (low blood sugar), and syncope (fainting), to name a few.

Injuries of an idiopathic cause are different from injuries sustained due to an unexplained cause.  Unexplained injuries at work are generally compensable where idiopathic injuries are not unless a claimant’s employment placed the employee in a position to contribute to the risk.

Employment conditions can sometimes contribute to or increase the risk that an injury will occur or aggravate the injury.  Such conditions include placing an employee in a position to increase the risk of injury caused a fall by placing him on scaffolding, requiring an employee to drive a vehicle or causing an employee to work with dangerous objects.

In a recent Arkansas Court of Appeals case, an employer denied a workers’ compensation claim arguing that the claimant failed to show a causal connection between her employment and an injury or that the injury arose out of her work. The claimant was a firefighter and an emergency medical technician.  He worked 24-hour shifts and was required to remain on premises unless he was performing a work-related task.  Because of the requirement to stay on the premises, the employer-provided claimant with sleeping accommodations.  The claimant was encouraged to sleep during nighttime hours.  The claimant was working a 24-hour shift when in the middle of the night, he awoke from a bad dream about spiders crawling on him.  He jumped from his bed in a sleepy stupor and injured his foot. He required surgery for a fracture of his fifth metatarsal.

The claimant filed a claim for benefits, but the claim was controverted on the basis that it was idiopathic in nature and not related to his employment.  The Administrative Law Judge agreed that the injury was idiopathic and while sleep benefited the employer, it was claimant’s dream about spiders that caused him to jump out of bed, which was the cause of his injury.  It was held that sleeping at his employer’s facility did not increase his risk of harm.  The claimant’s bad dream involving thoughts of spiders could have occurred in his own bed in his home the same as it did at his place of employment.  Nothing about claimant’s employment contributed to the risk that such an incident would occur.   It was not his job that caused him to jump from his bed; it was his unfortunate dream about spiders. Therefore, the claim was found to be uncompensable.

Cases involving idiopathic allegations are often unpredictable, and the outcome depends greatly upon the facts and complexities involved.  The success of defeating a claim based upon an idiopathic condition will require a thorough review of the facts including all medical records, both past and present.

Amy Markham, Managing Partner of the Little Rock, Arkansas office, focuses on Workers’ Compensation, Liability (Automobile, Premises, and Products) and Litigation (Construction, Insurance Defense and Property and Casualty).

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