NEW Idiopathic Decision from the Georgia Court of Appeals.

If you have paid attention to Idiopathic claims over the years, you might have noticed that these claims always seem to involve knee injuries. If you have not paid attention to them, you might be asking “what is an idiopathic claim?” Either way, the caselaw regarding idiopathic injuries is confusing enough that a recent Court of Appeals Decision for the State of Georgia went out of its way to console the State Board of Workers’ Compensation for the error in that the State Board “fell prey to the confusion that our case law has sown.” In short, the Courts have for years struggled with how to define and how to recognize an idiopathic injury such that the Georgia Court of Appeals felt the need for clarification of authority and a reversal of at least one prior significant decision. So, to that extent, the Court’s decision, handed down on Friday, March 16, 2018 in the case of Cartersville City Schools v. Johnson is significant. In order to understand the significance, let’s first recap what precisely is an idiopathic injury, what is the standard of review on appeal and why the Johnson decision is breaking new ground. IDIOPATHIC INJURIES Remember that compensable injuries must “occur in the course of employment: (they must occur when the employee is where he is supposed to be and when he is supposed to be there) and it must “arise out of” (he must be doing WHAT he is supposed to be doing related to his Employer’s work). The Idiopathic Defense attacks the second of those two requirements, the “arising out of” portion of the test. The Court defined Idiopathy as “injuries sustained at work, that are unrelated to, or do not occur while engaged in, work.” By way of explanation, the court explained that “the activity or hazard resulting in injury must be ‘incidental to the character of the business, and not independent of the relation of master and servant. “ In short, if the injury was caused by something PERSONAL to the employee, then it is not “incident to the character of the business” and would not be seen as being engaged in “work” when the injury happened. The problem is that when applied to the facts, even this explanation can be confusing. As a result, the Court felt that “clarification” was in order. Mixed up in all of this analysis is the “Peculiar Risk” doctrine and that of “Positional Risk”. “Peculiar Risk” can be thought of as a special danger of the employment whereas the “Positional Risk” focuses on whether the Employment places the employee in a locale which exposed the employee to a common risk.” “Peculiar Risk” might relate to certain equipment or work implements to which the employee is not equally exposed outside of work. “Positional Risk” is WHERE the incident happened and considers whether it was the Employment that placed the Employee in that place.” In this regard, think of a meter reader experiencing a bee sting while going into the bushes to read a customer meter. Both Peculiar and Positional Risks attach to the “In the Course of” part of the analysis. MS. JOHNSON’S INJURIES Ms. Johnson was employed as a 5th Grade school teacher with Cartersville Elementary and, while instructing students ”walked back to her desk to put an image up on the smartboard. She then turned from her computer and desk to walk back to the front of the classroom and fell, injuring her knee.” The State Board of Workers’ Compensation agreed with Ms. Johnson that the necessary swift movements and configuration of her classroom caused her to “place acute stress on her knee resulting in the injury she sustained. The Appellate Division of the State Board, disagreed as “the act of turning and walking was not a risk unique to [her] work, and is a risk to which she would have been equally exposed apart from the employment.” The Superior Court disagreed and reversed, reinstating the award in Ms. Johnson’s favor. THE STANDARD OF REVIEW AND THE APPELLATE PROCESS Appeals in worker’s compensation matters proceed as a matter of right to the Appellate Division of the State Board. After a ruling from the Appellate Division the parties can appeal to the Superior Court in the County in which the injury occurred but the Superior Court must accept the facts as determined by the Appellate Division and must affirm if there is “any evidence to support the decision.” In short, at the Superior Court level and beyond, the facts as found by the Appellate Division are binding . The Superior Court, the Court of Appeals or the Supreme Court must accept this facts as binding even if they might disagree with them. The Superior Court may rule on errors of law but may not reweigh the evidence to arrive at a different result. After the Superior Court, the parties may petition the Court of Appeals for an “Application for Discretionary Review” which is not granted as a matter of right. In practice, the Court of Appeals grants such applications only rarely and most commonly grants the application of the Superior Court has violated the “any evidence rule.” A similar process applies for appeals to the Supreme Court for the State of Georgia when the aggrieved party files a “Petition for Writ of Certiorari.” If such a petition is granted, the same standards apply. As a practical matter, few workers’ compensation appeals to the Georgia Supreme Court are granted. JOHNSON’S FINDINGS AND THE “NEW” STANDARD FOR IDIOPATHIC INJURIES Since Idiopathic injuries are said to have no connection to the work place, another way to say it is that the injury is “personal to the employee” or that the incident “cannot 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.” This seems fair enough in that if an employee is “equally exposed” to a risk outside of the employment, then the injury should not be rendered compensable based on the fortuity of the incident happening AT WORK. The language quoted is from the Appellate Division’s own opinion and is still good and settled law. However, the Court of Appeals broke with the Appellate Division stating : The Appellate Division overlooked the proximate cause requirement and focused on the concept of equal exposure, interpreting it to mean that because Johnson could have fallen outside of work while walking and turning, as she did while she was at work, and nothing particular about the classroom appears to have caused the fall, that her injury resulted from an idiopathic fall and is not compensable. But 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. [citing Harris v. Peach County Board of Commissioners 296 Ga. App. 225 at 230, 674 SE2d 36 (2009)]. To hold otherwise would render virtually any case in which an employee is walking, turning, or standing (or some combination of these activities) while performing his or her job non-compensable. The Court went continued: “ Thus, to the extent that St. Joseph’s Hosp. v. Ward, 300 Ga. App. 845, 848 (1) (686 SE2d 443) (2009) holds that an activity is not compensable because an employee could have engaged in the activity giving rise to the injury outside of work, it must be and is overruled.” The Ward decision, also involved a knee injury and occurred when a nurse was turning to get some water for a patient. Relying on Ward, seemed to be the foundation of the Appellate Division’s award and the reason that the Court of Appeals found it necessary to grant Cartersville’s Application for Discretionary Review when in the end the Court would still rule against Cartersville. The Court of Appeals found that in focusing on idea of “equal exposure” the Appellate Division, ignored the proximate cause requirement which provides that the activity or hazard resulting in injury must be “incidental to the character of the business, and not independent of the relation of master and servant.” We should expect that Idiopathic injuries will receive more exacting scrutiny in the coming months and years. While this may result in more injuries being considered as compensable, employers and insurers can at the least be thankful that some light has been shone on this most confusing problem.


"Skedsvold and White
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