One of the basic principles of Georgia workers’ compensation law is that for an injury to be compensable,
One of the basic principles of Georgia workers’ compensation law is that for an injury to be compensable, it must have arisen out of and in the course of employment. For an injury to have arisen out of employment, there must be a causal connection between the employment and the injury. The presence or absence that causal connection is at issue in so-called “idiopathic” cases.
The seminal idiopathic case is Davis v. Houston Gen. Ins. Co., 141 Ga. App. 385 (1977). In Davis, a nurse injured her shoulder while putting on her coat as she was leaving work. The Court of Appeals held there was no causal connection between the injury and the employment because the injury was caused by “a hazard to which she was equally exposed apart from her employment.” Id. at 387. In other words, the potential for the claimant to injure herself while putting on her jacket was the same in her workplace as it was anywhere else. Over the next twenty-five years after Davis, Georgia courts struggled with how to handle these idiopathic cases, and issued conflicting opinions as to what constituted the appropriate test to determine whether there was a causal connection between an injury and employment.
In 2004, the Court of Appeals tried to make sense of it all in Chaparral Boats v. Heath, 269 Ga. App. 339 (2004). In that case, the claimant was hurriedly walking across her employer’s premises when she felt popping and pain in her knee. The Court of Appeals clarified that the general rule for determining compensability in such a case is to first ask whether a condition of the employment brought the claimant “within the range of a common risk,” as opposed to requiring that the injury-causing risk be one that is peculiar to the employment. Id.at 344. This is known as the “positional risk” doctrine. However, the court also clarified that not every injury occurring at work is compensable. There still must be a causal connection, in that the risk must be one to which the employee is “subjected by the nature of the employment.” Id. at 342. Because the claimant in Chaparral Boats was injured as a result of a risk (walking) to which she was equally exposed outside of her employment, and because there was no other risk related to her employment (e.g., a wet floor, an uneven surface, etc.) that caused the injury, the claimant’s knee injury did not arise out of her employment.
In 2009, the Court of Appeals applied the less-than-clear legal framework of Chaparral Boats to two separate cases: Harris v. Peach County Bd. of Comm’rs, 296 Ga. App. 225 (2009) and St. Joseph’s Hospital v. Ward, 300 Ga. App. 845 (2009).
In Harris, the claimant was a custodian. She was talking to her supervisor at work when she realized that she had lost a pill (for a personal condition) that had been in her pocket. The supervisor saw the pill on the floor and pointed it out. When Harris bent over to reach for the pill, she dislocated her left knee. A physician concluded that the injury resulted from a combination of the reaching motion and the claimant’s obesity (she weighed “slightly less than 300 pounds”).
The employer controverted the injury on the theory that the claimant’s obesity was a personal condition and her reaching for her own pill was a personal activity – neither were causally connected to her employment. The Administrative Law Judge held that picking up debris from the floor was among the duties of the claimant’s job as a custodian, and that because she was injured in the performance of that duty, the injury arose out of her employment. The Appellate Division of the State Board of Workers’ Compensation affirmed. The Superior Court reversed, however, finding that the injury was not causally connected to her employment because the causative risk – the claimant’s obesity – was the same both on and off the job.
The Court of Appeals reversed the Superior Court. It held that the “causative danger” at issue was bending over to pick up the pill, and that the State Board of Workers’ Compensation was authorized to find that this danger was causally connected to the employment in light of the claimant’s job as a custodian. The court noted that the question was not whether merely bending over was a “mundane activity,” but whether Harris performed that activity in furtherance of her job duties. The court found that this was a question of fact for the State Board to determine.
In St. Joseph’s Hospital v. Ward – the next Court of Appeals case dealing with an idiopathic injury – the claimant was employed as a nurse. While turning to reach for a cup of water for a patient, she twisted her right knee. She felt her knee “pop” and had an immediate onset of pain. The Administrative Law Judge found that the injury arose out of her employment. The Appellate Division reversed, finding that the claimant was “not exposed to any risk unique to her employment by standing and turning, and that, in turning, she did not come into contact with any object or hazard of employment.” Id. at 848.
The Superior Court reversed the Appellate Division, finding that Ward’s injury resulted from the performance of her duties assisting a patient, and that turning to get a cup of water for a patient was not a risk that she would have been exposed to outside of her employment. There was therefore a causal connection between the injury and the employment.
The Court of Appeals reversed, finding that there was evidence to support the Appellate Division’s factual finding that “standing and turning” did not constitute a risk unique to the employment. The court held that the Superior Court should not have disturbed this finding and should have abided by the State Board’s application ofChaparral Boats.
In summary, the injury in the Harris case was compensable, but the injury in Ward was not. But why? Certainly, there are distinctions between the cases. Harris was bending over when she injured her knee, while Ward was turning and twisting. Harris was reaching for a pill, while Ward was reaching for a cup of water for a patient. Harris was a custodian, while Ward was a nurse. But should these distinctions make any difference as to the outcome of the case? It seems that in Harris, the court could have easily found that the claimant was “not exposed to any risk unique to her employment by [bending over], and that, in [bending over] she did not come into contact with any object or hazard of employment.” Likewise, in Ward, the court could have found that the claimant’s activity of reaching for a cup of water for a patient was “incidental to the character of [Ward]’s employment as a [nurse].” The only distinction that apparently could have made a difference is that fact that Harris was arguably engaged in a personal activity in picking up her own pill when the injury occurred, while it seems Ward had no personal motive in reaching for water for a patient. But if those facts made a difference in the analysis, one would think the courts would have reached the opposite conclusion in each case.
The bottom line is that the facts that should have mattered in deciding these cases are virtually identical. From that standpoint, it is hard to reconcile their outcomes. So what can be learned from Harris and Ward? First, when it comes to arguing that an injury is idiopathic, the Court of Appeals is going to give substantial deference to the findings of the State Board. The Court of Appeals stated in both Harris and Ward that the State Board, as the fact-finding body, “must in each case remain the final arbiter of… whether the claimant’s disability arose out of the employment….” Ward, 300 Ga. App. at 848 (citing Harris). Therefore, even though the Board reached different conclusions in two factually similar cases, the Court of Appeals acknowledged that the appellate courts were required to abide by those conclusions. From that standpoint, any party litigating an idiopathic case in the future should understand that the decision of the State Board’s Appellate Division is unlikely to be disturbed on further appeal.
These cases also reaffirm that every idiopathic case will be extremely fact-sensitive. Admittedly, it may be hard to decide which facts matter and which do not, based on the outcomes of Harris and Ward. But we know that Chaparral Boats remains good law, and provides the guidelines for deciding these cases. We also know that the State Board will ask whether the injury-causing activity was performed in furtherance of the claimant’s duties, while also still requiring that there be an injury-causing risk to which the claimant is not equally exposed outside of the employment. Beyond that, we can only say that because the law remains unclear, litigation of idiopathic claims will continue to be prevalent, unless and until the courts are able to provide a clearer framework for analyzing these cases.