Incident v. Injury

It is a standard and reinforced concept in workers’ compensation that claims may be compensable when injuries arise out of employment risks or neutral risks.  In Washburn v. City Market, the Industrial Claims Appeals Office (“the Panel”) decided whether the ALJ erred in finding that this workplace incident did not rise to the level of being considered a compensable work injury, regardless of whether the incident was resultant of an employment risk or a neutral risk.

In Washburn, Claimant walked into the restroom after clocking-in and claimed to have gone “blank.” Claimant stated that when she had come to, she was struggling to get up from the floor.  However, video showed that Claimant had slipped on a recently mopped area and fell into a wall.  Claimant landed on her left knee and then stood up.  Claimant alleged that due to the fall, she suffered upper back pain, as well as shoulder, arm, and right hip pain that had gotten worse in the days following the fall.  Claimant was examined by a physician who subsequently recommended a CT scan, an x-ray, and an MRI.  While the CT scan, x-ray and MRI did not reveal any traumatic injuries or abnormalities Claimant alleges to have sustained due to her workplace fall, the results did reveal degenerative changes in her spine. Based on the evidence, the ALJ denied Claimant’s claim for compensation.  Claimant then underwent an independent medical examination, the results of which also found that Claimant did not sustain an injury related to the slip and fall. 

The ALJ acknowledged that while an incident took place at work, there was no injury that produced the need for medical treatment.  Claimant argued that because she had slipped and fell on a wet floor while at work, her alleged injury was resultant of an “employment risk” category as defined by City of Brighton.  However, both the ALJ and the Panel found that this case did not involve a City of Brighton issue of determining whether the injury was a result of an employment risk, personal risk, or neutral risk. This was because there was no injury that occurred as a result of the workplace incident. The Court explained that if there is no incident that results in an injury, then the claim is not compensable, regardless of what category of risk that incident may have fallen under. In order to recover, there needs to be proof that the incident resulted in an injury.

Claimant appealed and alleged that the ALJ was holding her to a higher standard by requiring Claimant to show her injury accurately matched what was shown in the video of the incident.  However, the Panel found that the ALJ did not impose a heightened burden upon Claimant.  Rather, the ALJ properly weighed the evidence, including the video of the incident and Claimant’s subsequent medical records.  Each of piece of evidence allowed the ALJ to conclude that there was no injury sustained by the Claimant.  Without injury, there was no compensable claim to be made by Claimant.  The Panel upheld the ALJ’s ultimate determination that there was no compensable claim.  

Donna Washburn v. City Market, W.C. No. 5-109-470 (ICAO, June 3, 2020) 

Would you like to know more? Contact Karina Prigge at kprigge@pollartmiller.com or 877-259-5693.

From the June 2020 Newsletter

2020-07-02T08:51:37+00:00