3-8-24; Law Update; Chicago School Teacher's Challenging Fall Found Compensable; WC Claims Appear to be "Doubling" into Civil Rights Claims and more

Synopsis: So, Can We Deny All Idiopathic Falls in IL WC? Not So Fast, the Devil is in the Details! Opinion and comments by John Campbell, J.D.

Editor’s comment: This Month, We Review the decision in Chicago Board of Education v. IWCC IL APP (1st) 1-22-0341WC (issued March 17, 2023)

Although we have seen recent rulings where idiopathic (or completely unexplained) falls are denied under IL WC as non-compensable, the Workers’ Compensation Division of the Illinois Appellate Court finds an Idiopathic fall may STILL be compensable where the work environment was a contributing factor to the injury.

Petitioner worked as a Chicago school-teacher at a location with two buildings; she was required to walk between the buildings and navigate stairs several times per day. That doesn’t sound “dangerous” to us. Specifically, she was required to climb 25 stairs to clock-in and out each day. On the date of injury, she had just clocked out and began descending stairs with a co-worker when she fell, suffering injuries to her back and multiple limbs. The ER records reflected a history of “feeling light-headed and passing out” leading to the fall. This medical history was repeated days later at her personal doctor.

At trial, Petitioner disputed these medical histories and, under oath, alleged she slipped on wet stairs from snowy conditions. Of particular importance, this fact was supported by her co-work witness’s testimony as well.

Ruling:

While the Arbitrator found Petitioner’s testimony not credible, and ruled her fall was caused exclusively by an idiopathic condition of syncopal episode, the IL WC  Commission panel reversed and awarded benefits, concluding

(1) dilapidated and worn stairs contributed to the fall and also

(2) because Petitioner was required to navigate 25 stairs to clock-in and out each day, the employment contributed to her injuries by placing her in a position of increased risk.

After a routine affirmation by the circuit court, the IL Appellate Court, WC Division accepted review and similarly affirmed the Commission but for slightly different reasons.

The Appellate Court, WC Division found greater evidence that the stairs were wet and slippery (not necessarily worn), based on Petitioner’s testimony and her co-worker’s testimony. Thus, the Appellate Court found alternative sufficient evidence of a work-related condition contributing to the fall. In ruling so, they cited case-law finding “an idiopathic fall may be compensable if the employment significantly contributed to the injury by placing the employee in a position increasing the dangerous effects of the fall.”

However, perhaps more concerning from the defense perspective, the Court further commented that here, “the employer required claimant to traverse a flight of stairs at least two times a day to clock in and out of work” and the fall occurred immediately thereafter.

Analysis:

We are always troubled when an arbitrator makes an initial denial ruling based on Petitioner (lack of) credibility that gets reversed on review, as occurred here. Please note the only person to consider actual live testimony is the Arbitrator assigned—the rest of the folks in the system are simply reviewing a transcript and never see Claimant’s sworn testimony under oath.

Further, not one but two medical records cite Petitioner’s initial history of growing dizzy and losing consciousness as the cause of the fall, with no mention of wet stairs. That means Claimant told two different medical historians a conflicting version of this event.

It seems to us that Petitioner did not come off credible at trial, and the medical history from two initial providers is likely more accurate. It is always a red flag when the medical history magically changes weeks after an incident to fit a more compensable fact pattern.

In the end, we do have to acknowledge that wet/slippery conditions can certainly trigger a compensable condition leading to a fall down stairs. However, the more interesting question is whether our IL Appellate Court would have found this compensable ABSENT the wet conditions, where the Court also pointed out the necessity to navigate the stairs twice per day. It remains unclear if compensability would be upheld without the snowy/wet conditions present.

Practice Tip:

For risk/safety managers, or anyone responsible for investigating injury incidents, this case exemplifies why a thorough incident investigation and documentation is critical to a solid defense. Witness statements at the time of the incident may have further substantiated the loss of consciousness vs. an alleged slip as the cause… were the stairs even wet? Photos or video of the area could have proven that point. Evidence must be gathered immediately to accurately assess compensability and afford opportunity for valid defenses.

We appreciate your thoughts and comments. Please post them on our award-winning blog.

Synopsis: “Exclusive” WC Remedy Not Exclusive in relation to Employee’s Civil Rights Claim for Forced/Mistaken Strip Search—This Ruling is from a Virginia Federal Appellate Court But May Be Coming Across the Country To WC Claims Like Yours.

Editor’s comment: We are seeing a clear trend of Claimants and attorneys trying to maintain parallel claims for WC and employment rights. We don’t agree with this trend but the industry has to be aware of this new change to your claims handling/practices.

A federal appellate court from the East Coast ruled neither qualified immunity nor the exclusive remedy provision of the State of Virginia’s Workers’ Compensation Law barred a nurse’s civil rights claims of being inappropriately strip-searched as she reported for a job assignment at a jail.

Claimant Amisi came to the Riverside Regional Jail to work as a contract nurse. When she arrived, she didn't know where to go for orientation, so she asked a jail sergeant for help. The sergeant directed Claimant to enter the back door of the jail's pre-release center, which housed "weekender" inmates serving nonconsecutive sentences. When weekenders arrive, these inmates have orientation and complete the jail's intake process, including strip and pat down searches.

A jail officer instructed Claimant to take a seat in the intake area. While Claimant was waiting, a female Officer came in. She directed Claimant to follow her into the women's locker room shortly thereafter, the female officer then strip-searched Claimant and conducted a pat down search after Claimant dressed.

Other than the discomfiture with having to be searched by a female guard, the ruling doesn’t outline anything that we would characterize as an incident or injury. The ruling also doesn’t outline any objection by Claimant to the search. After Claimant returned to the intake area, a female weekend coordinator was informed Claimant worked for the jail's health contractor, and she called a nurse to retrieve Claimant for the prison’s nurse orientation.

Claimant later sued all of the jail staff, alleging they violated her Fourth Amendment right to be free from unreasonable searches and seizures. She also brought a variety of Virginia state law tort claims.

Defendants moved for summary judgment, challenging the nurse’s claims on the merits and asserting qualified immunity and Virginia good-faith immunity. They also asserted that the Virginia Workers' Compensation Act barred Claimant’s state law claims. The federal district court denied their motions and an appeal was taken to the federal appellate court—please note the next level of appeal would be the U.S. Supreme Court..

The U.S. 4th Circuit Court of Appeals ruled neither jail staff members were entitled to qualified immunity. “Taking Amisi's account as true, Brooks acted unreasonably when she mistook Amisi for an inmate, not an employee,” the court said, as Amisi testified she told Brooks she was a nurse and asked if employees of the jail needed to be strip-searched.

“While Brooks disputes these facts, that's for a jury to decide, not us,” the federal appellate court said. “We decide only whether those facts are material, which they are.” The court also said it was clearly established law when prison staff strip-searched Amisi that she couldn't do so without individualized suspicion that Amisi possessed contraband.

As for Townsend, the court said he effected a seizure of Amisi, since his actions would have led a reasonable person to believe that she wasn't free to leave. Claimant Amisi further testified she told Townsend she was an employee reporting for work, and he admittedly didn't see Amisi's name on his list of weekender inmates. These facts, if proven, suggest that Townsend's mistaken belief Amisi was an inmate was unreasonable, the court said.

Most important for WC risk and claims managers, the federal appellate court went on to say neither Brooks nor Townsend were protected from civil liability by the exclusivity provision of the Virginia Workers' Compensation Act. The court said this case presented a close question, but it concluded Claimant Amisi's injuries didn't arise out of her employment. “Though Amisi may not have gone to the jail but for her employment, she faced the same risk of an erroneous search as any visitor arriving to the jail for the first time,” the court reasoned. Additionally, the court said, Amisi wouldn't regularly be exposed to a search while on the job, since by her second day, she knew not to go to the pre-release center.

To read the court’s decision in Amisi v. Brooks, Nos. 21-1960 and 21-1962, 02/22/2024, published, click here.

We appreciate your thoughts and comments. Please post them on our award-winning blog.