A forklift operator was wrongly denied workers compensation benefits for a workplace accident because the cause could not be determined, a judge with the Kansas Court of Appeals held Friday, affirming an appellate court panel’s ruling that his injury could not be precluded despite a state law excluding compensability for accidents arising from “idiopathic causes.”
In Estate of Graber v. Dillon Cos., Terrill Graber had been attending a paid safety meeting on the second floor of his employer’s headquarters on Aug. 21, 2011. At some point, Mr. Graber walked to a restroom near the stairs and ended up on a landing halfway down the concrete staircase and shattered three vertebrae in his neck, requiring surgery and the use of a neck brace for 11 weeks. He said he did not remember leaving the restroom and there were no witnesses to his fall or evidence of anything that could have caused him to trip or slip. Mr. Graber also suffered from diabetes, and he testified that he had not checked his blood sugar the day of the accident. However, there was no evidence that his diabetes contributed to his accident, and a co-worker testified that there was nothing unusual about his behavior that day.
He applied for workers comp benefits, which an administrative law judge granted after finding that the injury arose out of and in the course of his employment. The employer appealed, and the Workers Compensation Appeals Board found that because of the unknown origin or cause of the fall, that it was excluded in the Kansas Workers Compensation Act 2011 change where the “legislature displayed a clear intent to exclude such unexplained and neutral risk injuries from compensation.”
Mr. Graber appealed, an appellate court reversed the decision and remanded the case to the board. The employer sought a petition for review, which was granted, and after his death in 2016, Mr. Graber’s estate was substituted as plaintiff. The Supreme Court of Kansas affirmed the appellate court’s decision. The court held that “idiopathic causes” means medical conditions or medical events of unknown origin that are peculiar to the injured individual — and since there was not substantial competent evidence to support the board's finding the accident arose directly or indirectly from an idiopathic cause under this statutory exclusion, that the court should be reversed and remanded to the board for reconsideration consistent with its interpretation.
To obtain benefits under the Kansas Workers Compensation Act, an injured worker must demonstrate that the worker suffered personal injury by accident, repetitive trauma or occupational disease arising out of and in the course of employment. In 2011, the state’s legislature excluded compensability from accidents or injuries that “arose either directly or indirectly from idiopathic causes.”
Although the employer contended that Mr. Graber’s accident arose directly from an idiopathic cause, the court rejected that argument, holding that the act renders an injury noncompensable “only upon proof the injury or accident arose directly or indirectly from a medical condition or medical event of unknown origin peculiar to the claimant.”
The court agreed with the appellate court’s decision that there was not substantial evidence to support the board’s finding that Mr. Graber’s fall was due to an idiopathic condition, and therefore affirmed the judgment of the appellate court, which reversed the board’s decision denying workers comp to Mr. Graber.
The attorney for the company declined to comment. The attorney for the estate did not immediately respond to calls for comment.
Angela Childers - Business Insurance