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David Taylor v. Contract Freighters, Inc.

Decision date: June 16, 200920 pages

Summary

The Commission affirmed the administrative law judge's decision denying workers' compensation benefits to David Taylor, who suffered injuries from a motor vehicle accident caused by a coughing episode while operating his vehicle. The Court found the coughing episode was idiopathic in nature, stemming from the employee's pre-existing condition rather than arising from his work environment, and therefore not compensable under Missouri law.

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Third-Party Injury Check

This workers' comp decision may point to a separate injury claim.

  • A driver, contractor, property owner, or equipment company may share fault.
  • The injury involved a vehicle, unsafe premises, defective equipment, or a non-employer vendor.
  • A serious injury or death may need both benefits review and civil-claim analysis.

Caption

FINAL AWARD DENYING COMPENSATION (Affirming Award and Decision of Administrative Law Judge With Supplemental Opinion)
Injury No.: 06-104584
Employee:David Taylor
Employer:Contract Freighters, Inc.
Insurer:Con-way Truckload, Inc.
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund
The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by § 287.480 RSMo. Having reviewed the evidence, heard the parties' arguments and considered the whole record, we find that the award of the administrative law judge is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Law. Pursuant to section 286.090 RSMo, we affirm the award and decision of the administrative law judge as supplemented herein, and award no compensation in the above-captioned case. The award and decision of Chief Administrative Law Judge L. Timothy Wilson, issued October 1, 2008, is attached and incorporated by this reference.The controlling statutes in the case at bar are § 287.120.1 RSMo and § 287.020.3(3) RSMo.
In pertinent part, and as of the date of the accident, these sections provided as follows:
Section 287.120.1 Every employer subject to the provisions of this chapter shall be liable, irrespective of negligence, to furnish compensation under the provisions of this chapter for personal injury or death of the employee by accident arising out of and in the course of the employee’s employment,. . . .
Section 287.020.3(3) An injury resulting directly or indirectly from idiopathic causes is not compensable.
Section 287.020.3(3) was enacted in 2005. For purposes of this appeal there was no substantive change in the 2005 enactment concerning § 287.120.1 RSMo.
Fact Findings/Credibility Findings of Administrative Law Judge
The administrative law judge thoroughly detailed his findings of fact and credibility determinations, and there is no reason to alter those findings of fact and credibility determinations, and in fact, we give deference to both.A relevant finding of fact, made by the administrative law judge, after carefully reviewing all of the evidence, was that employee, while operating his motor vehicle, suffered a coughing episode, which caused employee to lose control of his motor vehicle, and sustain the resulting injuries for which workers’ compensation benefits are being claimed. As determined by the administrative law judge “the evidence is supportive of a finding that he lost control of his vehicle as a result of his coughing.”

Additionally, the administrative law judge found the evidence to be supportive of a finding that the coughing episode suffered by the employee immediately preceding the accident, was due to an idiopathic occurrence. Employee had an admitted history of coughing episodes spontaneously occurring prior to the accident of November 4, 2006; and this condition continued subsequent to the accident occurring November 4, 2006. These "coughing spells" were noted in the medical records and were also admitted by employee. There is no evidence in the record to support a finding that the coughing spell occurring November 4, 2006, immediately preceding the motor vehicle accident, was due to employee's working environment. In fact, the Commission can not make an inferential finding that the coughing episode was causally related to employee's working environment due to the lack of any supportive evidence. The origin of the coughing spell, which caused the motor vehicle accident, was personal to the employee, or peculiar to the employee, due to the employee's admitted history of coughing spells, which consequently renders it idiopathic in nature. Idiopathic is defined as "peculiar to the individual: innate". Alexander v. D.L. Sitton Motor Lines, 851 S.W.2d 525 (Mo. banc 1993).

In summary, we agree with the finding by the administrative law judge that the coughing spell which immediately preceded the motor vehicle accident, was of an origin personal in nature, peculiar to the employee, thus rendering it an idiopathic occurrence; and, consequently, we further agree with the finding of the administrative law judge that the coughing episode caused employee to lose control of the motor vehicle which resulted in the motor vehicle accident/crash and resulting injuries for which workers' compensation benefits are being claimed.

Legal Discussion

Subsequent to the administrative law judge determining that employee's coughing episode, which caused the motor vehicle accident, began with an origin personal in nature, independent of employee's work environment, peculiar to employee, rendering it an idiopathic occurrence, the administrative law judge then addressed the issue of whether or not the employee was entitled to workers' compensation benefits for injuries sustained in a motor vehicle accident precipitated by an idiopathic occurrence. In other words, due to the fact that the precipitating event was an idiopathic occurrence, is a resultant injury deemed to have arisen out of and in the course of employment as prescribed by $\S 287.120$ RSMo? It is axiomatic that the burden of proof rests on employee.

Pursuant to the legislative changes enacted in 2005, specifically, § 287.020.3.(3) RSMo, we agree with the legal conclusion of the administrative law judge that this injury was not due to an accident that arose out of and in the course of employment.

Consistent with § 287.120.1 RSMo, an employee must show that his or her injury arises out of and in the course of his or her employment as a condition precedent to recovery. Abel v. Mike Russell's Standard Service, 924 S.W.2d 502 (Mo. banc 1996).

The precipitating cause of the motor vehicle accident was an idiopathic occurrence, i.e., attributable to employee's history of coughing episodes the origin of which was personal to the employee, the cause of which was unrelated to employee's working environment. Idiopathic is defined as "peculiar to the individual: innate". Alexander v. D.L. Sitton Motor Lines, 851 S.W.2d 525 (Mo. banc 1993).

Based on the foregoing, the remaining principal issue facing the Commission can be stated as follows: when an employee, solely because of an idiopathic occurrence, sustains an injury distinguished from the effects of the idiopathic attack or occurrence which in and of itself is noncompensable, be found to have sustained an injury arising out of his employment?

The general rule prior to the statutory changes enacted by the Missouri Legislature in 2005, was that such an

injury, distinguished from the effects of the idiopathic attack or occurrence, was compensable, if the employment placed the employee in a position increasing the dangerous effects precipitated by the idiopathic attack or occurrence. Alexander v. D.L. Sitton Motor Lines, 851 S.W.2d 525 (Mo. banc 1993).

By definition, idiopathic occurrences are peculiar or innate to an individual and begin with an origin which is personal. Alexander v. D.L. Sitton Motor Lines, 851 S.W.2d 525 (Mo. banc 1993). Prior to 2005, an employee, for injuries solely caused by an idiopathic attack or occurrence but distinguishable from the effects of the idiopathic occurrence, was able to recover workers' compensation benefits for distinguishable injuries if the employee satisfied the "arising out of" component of § 287.120 RSMo, by proving there was some affirmative employment contribution resulting in the distinguishable injury to offset the prima facie showing of a personal origin. Prime examples are injuries sustained due to idiopathic occurrences resulting in falls from heights; or injuries sustained due to idiopathic occurrences while driving a motor vehicle; etc. The conditions of the workplace either contributed to, increased the risk to, caused or bore a relationship resulting in these distinguishable injuries.

Prior to the legislative changes enacted in 2005, the proper test of "causal connection," involving an idiopathic occurrence, was whether the conditions of employment caused or contributed to cause the accident. If the conditions of the workplace contributed to cause the accident, even if the precipitating cause were idiopathic, the causal connection was established. In other words, the accident would not have occurred but for the condition of the workplace. Alexander, supra

The sine qua non of recovery under § 287.120.1 and Alexander, supra, prior to 2005, is a condition of the workplace that bears a causal connection to the employee's injury. The condition of the workplace bears a causal connection to the injury only when the condition is unique to the workplace or is a common condition that is exacerbated by the requirements of employment. Abel, supra. However, the legislative enactment of 2005, § 287.020.3(3), i.e., "an injury resulting directly or indirectly from idiopathic causes is not compensable," and the recent Appellate Court interpretation in the case of Ahern v. P \& H, LLC, 254 S.W.3d 129 (Mo.App. E.D. 2008), have mandated a change from the former general rule. In the Ahern case, supra, the employee fell from a roof while working as a carpenter and injured his shoulder. The fall was due to employee's pre-existent "seizure condition," the origin of which was personal to the employee, unrelated to his work environment. Employee's claim for workers' compensation benefits for the injured shoulder (a distinguishable injury from the idiopathic occurrence) was denied as the injured shoulder resulted directly or indirectly from an idiopathic cause, i.e., the employee's seizure which was personal in nature or idiopathic.

In affirming the denial of benefits to the employee's injured shoulder, the Appellate Court stated:

In his third point, Claimant contends the Commission erred in applying Section 287.020.3(3) because under the "increased risk analysis" Claimant's claim would be compensable. We disagree.

Claimant likens the circumstances of this case to those in Alexander v. D.L. Sitton Motor Lines, 851 S.W.2d 525 (Mo. banc 1993). In Alexander, a claimant became dizzy and fell from a raised platform on which he was required to work. Alexander, 851 S.W.2d at 526-27. In finding compensation proper, the Supreme Court indicated that a causal connection existed between claimant's injury and his work because his workplace contributed to, or increased the risk, of his accident. Id. At 528-529. While the facts of Alexander are similar to those of claimant's case, in light of the Legislature's 2005 amendment of Section 287.020, we cannot apply Alexander's holding here.

Ahern, 254 S.W.3d. at 135.

The Court in Ahern, supra, clearly rejects the former holding of Alexander, supra, and its prodigy, that injuries, distinguishable from the effects of an idiopathic attack or occurrence, were compensable if the

employment placed the employee in a position increasing the dangerous effects precipitated by the idiopathic attack or occurrence. A showing of some affirmative employment contribution to offset the prima facie showing of personal origin, i.e., the idiopathic cause, is no longer to be followed in the State of Missouri since the statutory enactment of 2005.

As simply stated by the Appellate Court in Ahern, supra, injuries resulting directly or indirectly from idiopathic conditions are not work-related and not compensable.

Conclusion

In the instant case, the "coughing episode," experienced by employee immediately preceding the motor vehicle accident of November 4, 2006, was of personal origin to the employee, peculiar to the employee, as indicated by his medical history of spontaneous coughing episodes and personal admissions of same, unrelated to his working environment, and thus, idiopathic in nature. Furthermore, the "coughing episode" solely caused the e

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