The Iowa Supreme Court has recently rendered an opinion on an issue of first impression –  compensability for an idiopathic fall on a hard floor, resulting in head injuries, (Bluml v. Dee Jay’s Inc. No. 18-0317, Nov. 16, 2018).  Claimant, a fast food employee was handling a customer order when he suffered a seizure and fell backwards onto a ceramic tile floor, sustaining serious head injuries. The Deputy and Commissioner denied benefits, explaining that idiopathic falls from a standing or walking position to a level floor simply do not represent an increased risk of employment under long-standing worker’s compensation law. The District Court affirmed, and on appeal to the Supreme Court, the Court reversed, rejecting the idea that there is any blanket rule covering these situations as a matter of law, and instead holding that an actual factual inquiry of the employment risk of injury must be undertaken.

There was no issue that the fall the employee sustained was the result of his personal idiopathic condition.  He had a medical history of seizures in the past, and was on anti-seizure medication, but leading up to the accident had not been taking his antiseizure medication regularly. The Commissioner, in affirming the Deputy, reviewed various other jurisdictions on this issue, noting that only the minority rule holds that such idiopathic falls are compensable when the hardness of the floor affects the severity of the injury. On the other hand, the majority of jurisdictions hold that idiopathic falls on a level floor are not compensable regardless of the hardness of the floor, because the floor represents a risk routinely encountered by all members of the public.  The District Court then affirmed the decision of the Commissioner denying benefits.

The Supreme Court first reviewed it’s prior Iowa holding regarding an employee’s idiopathic fall from a ladder to a cement floor, resulting in serious injuries.(Koehler Electric) In awarding benefits, the Court in the Koehler case first noted an exception to the general non-compensability of idiopathic falls, where an employee is placed in a position that aggravates the effects of the idiopathic fall, such as a height. In such situations, the employee sustaining the idiopathic fall, must prove that a condition of employment (height) increased the risk of injury. The Court then also reviewed its prior holding in the Lakeside Casino case, in which a cocktail server injured her ankle while stumbling (non-ideopathic) on stairs which were in no way defective.   In that case the Court upheld an award of benefits based on an actual risk analysis, something less onerous than an increased risk analysis, essentially concluding that the employee need not prove anything about the stairs contributed to her injuries, just the fact that she was traversing stairs was sufficient.

In reconciling these two prior decisions, the Court held that for an idiopathic situation like the one at hand, an employee must still provide some evidence of increased risk of injury resulting from a condition of employment. Thus, the Court held that there is no legal principle that as a matter of law idiopathic falls onto level floors in Iowa are not compensable. Whether the condition of the floor posed an increased risk of injury must be determined factually on a case-by-case basis. The Court acknowledged that the majority of other jurisdictions have denied recovery for idiopathic falls regardless of the hardness of the floor. (Idaho, Illinois, New Mexico, Rhode Island, Wisconsin, Colorado, Indiana, Oklahoma, Oregon, South Carolina,, Michigan, Ohio)  The Court, on the other hand, also rejected an opposite Mississippi holding that idiopathic fall onto a concrete floor represents, as a matter of law, sufficient risk of employment. The Court instead chose to adopt the position from the Florida courts, holding that an idiopathic fall to a level concrete floor was a factual issue for which the Commissioner may consider evidence of the hardness of the floor and which must be decided on a case-by-case basis. An employee should have both the burden and the opportunity to meet the increased risk standard of proving that a condition of their employment increased the risk of injury.

Justice Waterman dissented, noting that there was no evidence that the ceramic tile floor was slippery, and that hard surface floors are ubiquitous and not a hazard of employment. He observed it was simply fortuitous that the employee fell from his seizure at work, rather than after hours walking down a concrete sidewalk or some other hard surface. Justice Waterman argued that any contrary finding converts the employer to a general health insurer, which is contrary to the purpose of Iowa Code chapter 85.

Therefore, with this new pronouncement from the Supreme Court, when you have an employee who falls as a result of a personal condition onto a level floor, the claim cannot automatically be denied on those facts alone. Further investigation and inquiry must be undertaken regarding the hardness of the flooring and whether it increased the injuries. The employee, of course, still has the burden of proving this.

Thanks to Partner Terry Donohue for providing this timely update and analysis. Terry represents employers and insurers in both Iowa and Illinois on behalf of the firm.