Greetings,  the 1^st DCA just affirmed (without written opinion) a JCC decision denying a claim for idiopathic/MCC, in Wendall v. Enterprise/York (links below).

In this case,  an 86 year old claimant simply fell while walking.  She did not know what caused her to fall, and she did not trip.  She had a history of falls in 2012, 2013 and 2015, along with diabetic peripheral neuropathy and gait imbalance.  The E/C denied the claim.

The judge reiterated that if the E/C was not able to identify any preexisting causes/non-work related reasons for the fall, it would be compensable. This is often where we have a hard time.  Pure clumsiness and tripping over your own feet in the course and scope of employment is compensable unless we can find another reason outside of work.  However, in this case the JCC accepted the personal health history as a possible cause of her fall, and then the burden shifted to the claimant to prove the work was the major contributing cause of her fall.  And she could not do so as no one knew why she fell.

The JCC also pointed out that even if the claimant could not prove her work was the MCC of the fall, if there was an increased hazard due to work, then it would be compensable.  The JCC ruled an asphalt parking lot was NOT an increased hazard.  

The case gives a good framework for all of us to analyze our claims.

1. Did anything preexisting/non-work related cause the fall?  (if not, then it is compensable)
2. Even if there is a preexisting condition, was the work still the MCC?  (if she tripped while carrying boxes for example)  (if work is not the MCC its not compensable unless….)
3. Even if the above answers are not compensable, was there an increased hazard due to work which would make it compensable?  (Driving, on a ladder, falling onto machinery, etc…)

Here are some good quotes from the case:

“Absent a competing cause the case law holds that this claim is compensable. But if there is a competing cause then Claimant must prove that work was the major contributing

cause of the accident or that employment itself created the hazard of risk. Claimant argues there is no pre-existing condition, such as a seizure or syncope. But EC

has proven that Claimant has pre-existing gait disturbance, balance problems, peripheral neuropathy, and problems with walking”.

“Notwithstanding the above the claim is compensable if Claimant is able to prove an increased risk associated with her employment.”

“Here there is no evidence that Claimant struck any object during her fall. The only evidence is that Claimant fell to the ground, which per Claimant was a regular asphalt surface

parking lot. The court has never extended the increased hazard doctrine to include an asphalt parking lot. Moreover, Claimant has not shown that the parking lot was a risk different from that

necessarily encountered in non-employment life. Therefore the undersigned does not find the asphalt parking lot to be an increased hazard of employment.”

Here is the PCA and full JCC decision.

https://www.jcc.state.fl.us/jccdocs20/FMY/Lee/2015/016954/12545672.pdf

https://www.jcc.state.fl.us/jccdocs20/FMY/Lee/2015/016954/15016954_229_07292016_09363113_i.pdf

We have a whole seminar on Idiopathic claims, it’s a tough topic.

Thanks,

Sincerely, Morgan Indek | Partner