Fall at work not determined unexplained and claim found not compensable—the importance of medical evidence.

This case involved a worker that worked as a maintenance worker in a ski resort area. As part of his duties he was at times required to go into private apartments to repair items.  Claimant alleged he was in a unit checking on a leak based on a “strange noise” he heard while he was sitting at his office desk.  While checking on the alleged leak, claimant passed out and hit his head.  He alleged he hit his head on the toilet and then passed out again in the kitchen hitting his head on the floor.  Respondents maintained he was in the private unit for non-work related reasons – such as eating his lunch and using the restroom.  Thus he was not in the course and scope during the incident.

The claimant was flown to a Denver Hospital from the mountains and he was treated for intracranial hemorrhage.  No tools were found in the unit where the incident occurred, however his dirty dishes were found in the sink. The claimant had pre-existing diabetes and a subarachnoid hemorrhage which Respondents maintained was the cause of claimant’s incident and resulting injuries. Ultimately the Judge did not find the Respondents’ course and scope argument compelling.

However, Respondents expert stated that claimant’s pre-existing condition was the cause of the fall.  This was evidenced by the fact that claimant passed out before hitting the floor and the claimant had no defensive wounds on his arms and hands – which the expert testified he would have if he was conscious when he fell.  Claimant’s expert agreed that claimant suffered from a “drop attack” meaning that claimant was not conscious when he fell and hit his head.  Respondents’ expert further testified that claimant’s fall was no unexplained given the numerous pre-existing conditions claimant had at the time of the incident.

The ALJ found Respondents expert credible and determined that claimant’s claim was not compensable.

Jesus Tapia vs. Lowe Enterprises, Inc. and Federal Insurance Company, WC 5-113-677-001 (March 19, 2020)

Would you like to know more?  Contact Christin Bechmann at cbechmann@pollartmiller.com or 877-259-5693.

From the April 2020 Newsletter