Is an “unexplained” fall covered by workers’ comp?

Jeff Dickson and Dickson Law Office recently won an important decision from a Vermont Department of Labor Administrative Law Judge, who held that an injured worker who experiences an “unexplained” fall at work is entitled to workers’ compensation benefits.  In the case, Jeff’s client suffered an unwitnessed fall from a standing position, striking her head and sustaining a traumatic brain injury in the process.  After being taken to the hospital and having a battery of tests performed, doctors were unable to determine what caused Jeff’s client to fall and hit her head.  What was clear, however, was that her head injury was very serious.

Although there was no dispute that Jeff’s client fell while working, her employer’s workers’ compensation insurance company denied her Vermont workers’ compensation claim, arguing that it was caused by an “idiopathic” injury.  An idiopathic injury is an injury which is caused by a purely personal condition of the employee, and therefore has nothing to do with their employment.  The insurance company moved the Department of Labor for “summary judgment” — in other words, it asked the Department of Labor to dismiss the employee’s claim without even holding a hearing.  At the time, Jeff’s client was represented by a different Vermont workers’ comp attorney who refused to help Jeff’s client fight the motion for summary judgment.  Jeff was happy to help.  Fortunately, Jeff not only convinced the Administrative Law Judge to deny the insurance company’s motion for summary judgment, he convinced the Judge to grant his client summary judgment!

According to the Administrative Law Judge’s written decision, Jeff’s client was entitled to summary judgment because her fall was “unexplained” rather than “idiopathic.”  Although the difference is small, prior decisions from the Department of Labor indicated that a person who is injured in an unexplained fall is entitled to workers’ compensation benefits, while a person who is injured by an idiopathic fall is not.  Jeff convinced the Judge that because none of his client’s diagnostic testing revealed any cause for her fall, there was no evidence that it was caused by a “purely personal condition” of his client.  In other words, it was unexplained.  As a result, Jeff’s client was awarded all of the workers’ compensation benefits to which she was entitled, plus her attorney fees and costs.

If you’re facing a tough challenge to your workers’ compensation claim, you can trust that if Jeff agrees to take your case, he will fight for you until the end — and hopefully win!