by Alissa C. Atkins, Esq.

One of the more spirited panels at the annual conference was on the topic of idiopathic claims. Not surprisingly, the perspectives from the claimant and defense sides of the bar were very different. Idiopathic claims are those in which an injury is deemed not to have arisen out of employment because the claimant’s injury was from an unknown cause or for reasons personal to the employee. Generally, the standard set forth in Chaparral Boats v. Heath, 269 Ga. App. 339 (2004) has remained the law for the past ten years. In Chaparral Boats, the Court of Appeals found that if the claimant’s injury would have occurred regardless of where the claimant was located, and there is no inherent additional risk imposed by any condition of employment, there is no causal connection between the employment and the injury. In layman’s terms, this generally breaks down to an investigation of whether the claimant’s injury could have happened anywhere but just happened to occur while the claimant was working.

For example, a knee pop that happened while an EMT stood up from a work chair so her supervisor could sit was found not compensable in a decision issued this July. Chambers v. Monroe County Board of Commissioners, No.A14A0265, Ct. App. (GA) (July 16, 2014). The Court of Appeals judges cautioned that if the claimant stood up for a work-related emergency such as a fire alarm, the case would have been compensable because this would have been causally related to work. They also would likely have found a compensable injury if the claimant struck her knee on the desk, or on stairs, or equipment.

Ultimately, the panelists concluded that the legal standard remains the same in all cases, but there is no definitive rule in these cases. Since the facts of each claim are so specific, each fact pattern is different and must be judged separately. The facts found by the Board are generally accepted, but there is limited certainty in these claims. Employers and insurers can attempt to limit liability at hearings by showing medical evidence that the claimant’s injury would have occurred regardless of the claimant being at work. Generally this involves medical records as well as doctor depositions in idiopathic claims.